Minnesota Hospital Association


July 01, 2013

MHA Newsline

In this issue:

Latest information about MNsure: Hospitals encouraged to apply by July 19

MHA staff is working to answer your questions about MNsure, the state’s health insurance exchange that will open for enrollment on Oct. 1 for policies that take effect Jan. 1, 2014. In addition to offering individual and small group coverage, MNsure will be the new and only vehicle for enrolling low-income Minnesotans in Medical Assistance and MinnesotaCare.

We received clarification from MNsure on June 28 that hospitals seeking to become consumer assistants (including navigators, in-person assisters, or certified application counselors) should fill out a Consumer Assistance Partner Application by July 19 in order to be ready to enroll people on Oct. 1. Note that the notice of intent that MHA encouraged you to submit (in our communication to you on June 24) is only for brokers and not for hospitals or hospital staff. Members do not need to submit a letter of intent.

Members should submit an application by July 19, and instructions can be found here:
     - Application - Appendix A (multiple locations form)
     - Application Instructions

While there are some distinctions between the roles of the certified application counselors, navigators and in-person assisters, MNsure staff acknowledges that those differences may not be very material to hospitals initially. Hospitals can choose the level of assistance that is most appropriate for your patient population and within your staffing capacity. At a minimum, MHA encourages members to partner with MNsure and have hospital staff qualified as certification application counselors.

For more description of the various categories of consumer assistant partners, go to: http://www.mn.gov/hix/your-benefits/consumer-assistant/.

MHA strongly suggests members get their applications in to MNsure by July 19 in order to receive training and certification by Oct. 1. MNsure expects most of its training to be Web-based and on-demand. Training modules are expected to be launched in August, although education for some of the topics might not be available until September.

Many questions about MNsure, the process and requirements for consumer assistants, consumer outreach efforts and other aspects of the new exchange will continue to be addressed over the weeks and months ahead. MNsure intends to issue weekly updates to its list of frequently asked questions on its website. In addition, MHA members are encouraged to contact Matt Anderson, MHA vice president of strategic and regulatory affairs, or Jennifer McNertney, MHA policy analyst, with questions about MNsure and the role hospitals and health systems can play in helping their patients and community residents obtain health coverage through MNsure.

Second, to facilitate MHA communications with you regarding MNsure, please provide the name and email contact information for your key staff person to whom we should communicate on this subject. Please respond to Lynette Virnig, 651-603-3545. ^top of page

Hospital spotlight: Ortonville Area Health Services’ focus on patient safety the ‘right thing to do’

Delivering safe, high quality patient care is at the core of what Ortonville Area Health Services strives to achieve. Situated on Minnesota’s western border with South Dakota, Ortonville Area Health Services is a critical access hospital with 25 beds. Yet the hospital doesn’t let its limited resources impact its commitment to patient safety. Ortonville is among only a handful of hospitals to have reached the national Partnership for Patients goal of a 40 percent reduction in five different hospital-acquired conditions and a 20 percent reduction in readmissions. Read more about how Ortonville is making strides in delivering safer patient care.^top of page

MHA comments on CMS proposed rule

In April, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the Medicare FFY2014 inpatient prospective payment system (IPPS). MHA submitted comments on June 25 noting objections to some of the changes being proposed by CMS. The primary issues of concern are the revised formula for the Medicare Disproportionate Share Hospital (DSH) add-on payments, CMS’ proposed time-based presumptive medical necessity, payment reductions for hospital-acquired conditions (HAC), changes to value-based purchasing, and cuts to graduate medical education (GME).

The estimated payment cut to Minnesota hospitals for the inpatient admission guidance is $3.5 million. The estimated payment cut for the reformed DSH payment is $22.8 million. MHA also supported more detailed analysis and comments made by the American Hospital Association. For more information, contact Matt Anderson, MHA vice president of strategic and regulatory affairs, 651-659-1421 or Joe Schindler, MHA vice president of finance, 651-659-1415. ^top of page

Cook Hospital CEO named Rural Health Hero

Cook Hospital CEO Al Vogt was named this year’s Rural Health Hero at the Minnesota Rural Health Conference. Vogt is a longtime hospital administrator and advocate for rural health. In addition to his accomplished track record as a health care administrator in his local community, Vogt has helped bring together other Minnesota hospitals in collaborations recognized nationally for their innovation and effectiveness, particularly in the use of technology and telehealth. He also served two terms on the MHA board of directors.

Vogt is known as an entrepreneur and a collaborator extraordinaire. Among other partnerships, he helped form the Minnesota Wilderness Health Care Coalition, a group of northeastern Minnesota hospitals that have joined forces to ensure access in one of the most rural areas of the state through innovations such as a telepharmacy service that brings after-hours services to member hospitals. He is also a founding member and current board member of SISU Medical Solutions, which also uses a cooperative approach, in this case to bring information technology services to rural hospitals and other health care providers throughout the state. Vogt is also active in statewide and national advocacy organizations. Congratulations to Al on this well-deserved award. ^top of page

DHS updates DSH audit timeline

The Minnesota Department of Human Services (DHS) has published an updated timeline for 2010 Medicaid Disproportionate Share Hospital (DSH) audits. Hospitals subject to the Medicaid DSH audit will need to complete the following actions by Aug. 1, 2013:
  • Complete MA DSH Spreadsheet using FFS and PMAP data files.
  • Upload to MN-ITS or email.

DHS held a webinar on June 27 to review the components of the DSH audit. The recorded webinar is available here for hospital staff that may have missed the presentation. MHA staff is available to assist with some of the data requirements of the process. For questions or more information, contact Joe Schindler, MHA vice president of finance, 651-659-1415.

Noridian Administrative Services will conduct its audit of the submissions in the September through November timeframe. DHS is required to submit the audit to the Centers for Medicare and Medicaid Services (CMS) by the end of this year. ^top of page

HCMC earns award for population health

Hennepin County Medical Center (HCMC) in Minneapolis has received the National Association of Public Hospitals’ 2013 Gage Award for Improving Population Health for its Coordinated Care Center — a program that has significantly reduced emergency department visits and inpatient stays. By carefully studying utilization patterns, HCMC found that 3 percent of its patient population represented 50 percent of the cost of care. To improve patients’ overall health, decrease the total cost of care and avoid preventable readmissions, HCMC created the Coordinated Care Center to provide multidisciplinary, team-based care and complex care coordination. The center’s efforts reduced the rate of emergency department visits by 37 percent and inpatient care stays by 25 percent after one year.

The Coordinated Care Center is HCMC’s “Ambulatory Intensive Care Unit” and is designed for patients with complex health problems that result in frequent hospitalization. Clinic interventions include walk-in access for new issues, close medical follow-up after hospitalization, regular oversight by clinic pharmacists, and intensive attention to behavioral and social determinants of health. To read more, click here. ^top of page

MHA seeks patient safety/quality data analyst-biostatistician

MHA is accepting applications for the position of patient safety and quality data analyst-biostatistician. The position is responsible for coordinating MHA patient safety/quality transparency strategies, including the collection and analysis of data. He or she will work closely with the Partnership for Patients Hospital Engagement Network team to align metrics and improvement efforts in Minnesota hospitals. Click here for a complete job description. Interested parties should submit a cover letter and resume to Tania Daniels, MHA vice president of patient safety. ^top of page

Program focuses on latest case management practices for critical access hospitals

Ensuring quality clinical outcomes and time-efficient care processes are essential for critical access hospital success. Popular MHA speaker, Louisiana-based case management consultant Linda Easterly, will present “Critical Access Hospital (CAH) Case Management” in August. The course is designed to help bring both new and experienced case managers up-to-date on the most effective case management processes. It details required case management functions and demonstrates how to incorporate these functions into daily CAH case management processes. 
While this program was designed specifically for CAHs, the program will be applicable to all small and/or rural hospitals regardless of CAH or PPS designation.

The two-day program will take place Aug. 21-22 at the Best Western Plus Kelly Inn in St. Cloud. For more information or to register, download the brochure or visit www.mnhospitals.org.

Continuing Education
MHA has applied for 11 continuing education credit hours through the Minnesota Board of Social Work. The program was also designed to meet the Minnesota Board of Nursing continuing education requirements for a total of 13.2 credits. ^top of page

Task forces to help guide State Innovation Model health care reforms

The Minnesota Departments of Health and Human Services have appointed two task forces to support the Minnesota Accountable Health Model initiative. Minnesota was awarded $45 million from the Centers for Medicare and Medicaid Services (CMS) to develop new ways of creating healthy communities and delivering and paying for health care.

The first task force, the Community Advisory Task Force, is focused on community and patient engagement, integration across the continuum of care and population health improvement. Cathy VonRueden, vice president of payor contracting and strategy for Essentia Health, is the hospital representative on the task force. It will hold a community meeting on Friday, July 19 from 10 a.m. – noon at the Wellstone Center in St. Paul, followed by its initial meeting.

The Multi-Payer Alignment Task Force is made up of representatives of commercial and public payers. It will help develop and implement alignment across payers. Its first meeting will be Tuesday, July 16 from 1-4 p.m. at the Minnesota Department of Human Services in St. Paul. ^top of page

Professional Development for Physician Leaders conference rescheduled for Oct. 18-19

The one-and-a-half day “Professional Development for Physician Leaders” conference, originally scheduled for July 19-20, has been rescheduled for Oct. 18-19.

The conference is designed to transform physician leadership at all levels and help build the next generation of physicians who will successfully lead health care in Minnesota. This year’s conference will feature new content on the challenges of physician burnout from highly sought after speakers, including Val Ulsted, M.D. and Kathy Ogle, M.D.

MHA’s second-annual physician leadership conference will take place Oct. 18-19, 2013 at the Minneapolis Marriott Northwest. For registration materials, download the conference brochure.

Continuing Education
Co-sponsor Stratis Health, accredited by the Minnesota Medical Association to provide continuing medical education for physicians, designates this continuing medical education activity for a maximum of 9 AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity. ^top of page