Minnesota Hospital Association


May 07, 2013

MHA Newsline

In this issue:

BCBS delays change in payment method for critical access hospitals

Implementation delayed until Jan. 1, 2014

Last week, Blue Cross and Blue Shield of Minnesota (BCBS) announced it would delay implementation of its new payment system for critical access hospitals until Jan. 1, 2014. MHA had raised concerns on behalf of members regarding the unilateral decision to change the payment model effective May 1. MHA issued the following statement:

"MHA is pleased that BCBS has decided to delay implementation of its payment model changes that were scheduled to begin May 1. A delay provides a window of opportunity for BCBS and hospitals to work through the issues before attempting to implement payment changes that could have jeopardized access to care in some communities. MHA appreciates that BCBS has heard the concerns of our members and that it is willing to respond to those concerns.

"BCBS has assured MHA that it will engage hospitals on a one-on-one basis to work through the transition to the new payment model. MHA and BCBS both recognize the need to move our health care system away from volume-driven, fee-for-service payments and toward payment methodologies that emphasize the value of care patients receive and reward providers for delivering the high quality care as efficiently as possible. MHA is hopeful that additional time and more open communications with hospitals will result in mutually agreed upon, fair and sustainable solutions that protect residents’ access to high quality care in their communities.

"Finally, MHA appreciates the leadership of Gov. Mark Dayton who took quick action to make this issue a priority after listening to hospitals' concerns during an April 19 MHA board of directors meeting. We also appreciate the engagement of Commissioner Ehlinger and Attorney General Lori Swanson, who both met individually with BCBS executives on Monday."

MHA has a follow up meeting scheduled this week with BCBS executives. We will continue to share information on these issues. ^top of page

MHA urges conference committee to reject increased hospital surcharge

Last week, MHA sent a letter to members of the Health and Human Services (HHS) Conference Committee detailing our concerns with the surcharge in the HHS omnibus finance bill, H.F. 1233. In addition, the letter urges support for Medical Education and Research Costs (MERC) funding and provider rate increases.

The House’s proposal would increase the hospital surcharge from the current 1.56 percent to 2.68 percent (a 71 percent increase) and would result in hospitals paying $202 million in additional surcharge taxes for the 2014-15 biennium. This is problematic for several reasons:

  • Despite creative efforts to target the Medicaid rate increases ($193.8 million in state and federal dollars) the surcharge increase creates a disparate impact on members.
  • With federal Medicare cuts already in place and more on the horizon, the amount of upper payment limit (e.g. state Medicaid payment rates cannot exceed federal Medicare payment rates) availability is likely to diminish. This puts hospitals at risk for not being able to accept all of the medical assistance rate increases that are intended to put some of the surcharge money back into hospitals.

MHA continues to view the surcharges as a funding gimmick and will continue to encourage the conference committee to reject the use of surcharges as a funding mechanism. Please use this letter to reach out to your legislators over the next two weeks and encourage them not to resort to adding new taxes on hospitals. ^top of page

Nurse staffing legislation passes Senate

The Minnesota Nurses Association’s legislation to require hospital reporting of nurse staffing levels and a study to determine possible correlations between nurse staffing levels and patient outcomes has passed the Minnesota Senate. The bill was amended on April 30 in the Senate Finance Committee to be nearly identical to H.F. 588, which already passed the Minnesota House of Representatives. Click here for the version passed by the Senate. Minor changes were made to appropriate funding for the study and to clarify that the Department of Health will convene a work group “to consult with the Department” as it conducts the study. Since minor revisions were made to the House bill, it must go back to the House floor before going to the governor, who is expected to sign it.

MHA is pleased that no further amendments were added to the legislation on the House and Senate floors. Please encourage your members of the House to accept the Senate changes to H.F. 588 without further amendments.^top of page

Workers’ compensation legislation moving forward

Late in the legislative session, a bill was introduced with the recommendation of the Workers’ Compensation Advisory Council (WCAC) that would have resulted in a major hit to hospital reimbursement for workers’ compensation patients. The bill included a repeal of the Supreme Court decision known as the “Spaeth decision” that allows hospitals to re-bill workers’ compensation carriers for the difference between what a commercial insurer paid and what workers’ compensation would have paid. This comes into effect when a case is originally billed to a commercial insurer and later determined to be a worker’s compensation case.

In Senate floor action on Friday, S.F. 1603 was amended onto S.F. 1234, a non-controversial workers’ compensation technical bill. MHA was very concerned about the original language contained in S.F. 1603, which repealed the Spaeth decision, not only because of the financial impact to hospitals, but also because of the potential to delay health care services for injured workers.

MHA was able to get language removed that repealed the Spaeth decision in return for a study that will look at medical and administrative costs. The study will be completed this year and reported to the Legislature by the end of 2013.

Traditionally, workers’ compensation legislation that is agreed to by the WCAC — comprised of an equal number of labor and business representatives — has been non-controversial with bi-partisan support. Because this legislation was advanced after the legislative committee deadlines and because some of the provisions are fairly controversial, Republican senators voted no on the legislation despite letters of support from both the AFL-CIO and the Minnesota Chamber of Commerce. The legislation is currently being opposed by the Minnesota Association of Counties as well as some other self-insured organizations primarily because of extending coverage to post traumatic stress disorders. A special thank you to Department of Labor and Industry Commissioner Ken Peterson for helping to negotiate the bill language so that MHA could be supportive of the legislation in its current form. The bill is likely to pass, and MHA will be actively engaged in the Department’s study.^top of page

MHA chair Ben Koppelman earns AHA Grassroots Champion Award

The American Hospital Association presented its Grassroots Champion Award to Ben Koppelman, CEO of St. Joseph’s Area Health Services, Park Rapids, and MHA Board Chair, at its annual meeting last week in Washington, D.C. Ben was recognized by AHA for his effectiveness in educating elected officials on how major issues affect hospitals’ vital role in the community and for broadening the base of community support for hospitals. Ben has been an ardent advocate for rural hospitals in our state and served as the chair of MHA’s Small, Rural Hospital Committee for several years. Congratulations, Ben!


photo of Ben Koppelman with AHA and MHA presidents

L to R: Lawrence Massa, MHA president and CEO; Ben Koppelman, CEO, St. Joseph's Area Health Services and Rich Umdenstock, AHA president and CEO.

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Riverwood Healthcare Center names new CEO

Riverwood Healthcare Center in Aitkin has named Chad Cooper as its new chief executive officer. Cooper is currently serving as the president of another Catholic Health Initiative facility, Unity Family Healthcare in Little Falls, where he is responsible for leading both St. Gabriel’s Hospital and the Albany Area Hospital & Medical Center, along with multiple physician practices consisting of more than 40 employed physicians and other practitioners.

Cooper is anticipated to start July 1 upon the retirement of Michael Hagen who has been the Riverwood CEO for 12 years. ^top of page

Minnesota hospital leaders visit congressional staff during AHA’s annual meeting

Minnesota hospital leaders, auxilians and MHA staff advocated on behalf of Minnesota hospitals and health systems in visits with Minnesota’s congressional delegation staff during the American Hospital Association’s annual meeting last week in Washington, D.C.

The group delivered the following key messages:

  • Support thoughtful, targeted policy reforms instead of across-the-board payment reductions that harm Minnesota’s high-quality, low-cost providers disproportionately.
  • Oppose additional Medicare provider cuts under consideration including reductions to outpatient evaluation and management services; graduate medical education; assistance to low-income beneficiaries (bad debt); elimination of the sole community hospital program; and cuts to critical access hospitals.
  • Lift the 1996 cap on residency slots by supporting Senate legislation S.577.
  • Repeal the Independent Payment Advisory Board.
  • Encourage the Centers for Medicare and Medicaid Services to release Basic Health Plan rules so Minnesota can make any necessary changes to MinnesotaCare to qualify for federal funding.
  • Support continued funding for Hospital Engagement Networks.
  • Reverse new interpretations of physician supervision requirements for outpatient therapeutic services.

Facts sheets on MHA’s federal policy priorities can be found on our website. ^top of page

Reminder: PPS hospitals must submit health care personnel flu vaccination data by May 15

Wednesday, May 15, is the last day for prospective payment system (PPS) hospitals to submit the health care personnel (HCP) influenza vaccination summary data into the National Health Safety Network (NHSN) system in order to meet the Centers for Medicare & Medicaid Services Inpatient Quality Reporting (IQR) program requirements. Hospitals must fulfill all IQR data submission requirements and deadlines in order to earn a full annual payment update each fiscal year. Failure to submit complete and timely data for the HCP influenza vaccination measure may result in a hospital not receiving a full annual payment update in FY2015.

Hospitals must report influenza vaccination summary data for health care personnel physically working in the hospital for at least 30 working days between Oct. 1, 2012 and March 31, 2013, regardless of clinical responsibility or patient contact. Please be sure to share this information with your infection control staff to ensure your hospital meets this requirement. For more information, visit the NHSN website. ^top of page

MHA to host workshop with NGS to provide transition information

MHA is hosting a workshop with Minnesota’s new fiscal intermediary, National Government Services (NGS), on June 20 to provide informational updates and transition information.

NGS will begin processing claims for Part A on Aug. 10 and Part B on Sept. 7. NGS has served as a Medicare contractor with CMS since 1966 and serves nearly 24 million people with Medicare in 18 states and 5 U.S. territories. NGS’s aim is to make this transition as smooth and seamless as possible.

The program will take place at the Minneapolis Marriott Northwest in Brooklyn Park. For more information or to register download the brochure or visit our website. ^top of page

Celebrate your nurses for National Nurses Week, May 6-12

Nominate your nurses for Nurse of the Year Awards

This week is National Nurses Week, a time to honor the nurses in your organization for their hard work and dedication to providing top-notch, safe patient care. We encourage you to recognize your nurses this week for the valuable role they play in your hospitals.

You can also honor your nurses by nominating them for the March of Dimes’ Nurse of the Year Awards. Patients, families, friends and colleagues can nominate nurses in 15 categories, including Distinguished Nurse of the Year.

Complete category descriptions and nomination forms are available here. Nominations are due by July 15. For more information contact Victoria Bibeau, March of Dimes senior community director, at 612-326-9436.