In this issue
Critical Access Hospitals and rural hospitals advance use of EHRs
Minnesota’s 85 participating Critical
Access Hospitals and rural hospitals were among those recognized by the
Regional Extension Assistance Center for HIT (REACH) for successfully
advancing their ability to use electronic health records (EHRs) to
improve patient care.
As the national regional extension center program and REACH concluded
on April 7, 99 percent of Minnesota’s participating hospitals had
adopted a certified EHR and were using it for computerized physician
order entry (CPOE) and quality reporting. In addition, 96 percent had
achieved Stage 1 meaningful use, which involves using EHR technology to
capture and share data in an effort to:
quality, safety and efficiency and reduce health disparities
patients and families in their health care
population and public health
privacy and security
REACH used a process consultation
approach, focused on providing tools and building clinicians' skills to
make their own changes in an informed and sustainable way. The program
focused on meaningful use as a way to improve health and health care,
to reduce disparities and to engage patients and their families. The
final program report is available online. return to top
committee work completed
Last Thursday marked the deadline by
which all bills still under consideration need to have passed in the
policy and finance committees. Both the House Ways and Means Committee
and the Senate Finance Committee have completed work on this session’s
supplemental spending bills.
MHA has been closely monitoring the health and human services bills
authored by Sen. Tony Lourey (DFL-Kerrick) and HF 3467, authored by
Rep. Matt Dean (R-Dellwood). Both bills were approved and are
included in larger omnibus spending bills.
Key provisions in HF 3467 include:
bill allocates minimal new money, about $12.1 million this
biennium and $25 million in FY 2018-19, made possible through
small MNsure cuts and DHS technology cuts.
Excellence in Mental Health Act
is fully funded: $188,000 this biennium and $8.4 million in
the next biennium.
of the governor’s recommendations for direct care and treatment
were no changes in the provider tax or uses of funds from the
Health Care Access Fund (HCAF).
bill seeks a waiver to move Minnesota from a state-based exchange
to the federal exchange.
Key provisions in the Senate include:
for the Excellence in Mental Health Act: $188,000 and $8.4 million
for Community Behavioral Health Hospitals: full staffing for six
locations, with the current St. Peter location becoming the
competency restoration site; $13.7 million and $32.9 million (FY
for competency restoration: moves approximately 20 people out of
the Anoka Metro Regional Treatment Center (AMRTC), freeing up some
bed capacity; $6.3 million and $14.9 million (FY 18-19).
for AMRTC: weekend nurse staffing at $788,000 and $3 million (FY
18-19) and clinical oversight at $336,000 and $1.2 million (FY
a 5 percent Medical Assistance rate increase for preventive medical,
dental and outpatient mental health services: $13 million and $58
million (FY 18-19).
changes in the provider tax or sunset.
MHA’s urging, the bill does not include the governor’s
recommendation to shift a portion of the Medicaid costs associated
with coverage for adults without children from the general fund to
the HCAF. This provision would have cost the HCAF $239
million in the next biennium.
Senate HHS bill includes a waiver request to have the
MinnesotaCare program increase its income eligibility up to 275
percent of the federal poverty guidelines (FPG). MHA
expressed concerns, reiterating the board’s position of keeping
MinnesotaCare at the current eligibility threshold of 200 percent
of the FPG.
The Senate bill allocates
approximately $123 million for this upcoming fiscal year. With
additional resources, more money is made available to advance MHA’s
mental health initiatives. MHA has testified that funding each of
these mental health provisions together will allow patients to get the
right care at the right place.
The omnibus spending bills will now be considered by the full House and
Senate, with a conference committee working out the differences between
Topics for legislative
Legislators appreciate hearing from constituents with personal
expertise about health care issues and issues affecting their
community’s hospital. Our session priorities handout can provide
a discussion guide.
MHA members are encouraged to discuss the following topics with their
legislators to adopt a spending target for the health and human
services budget that is greater than the House target of no new
legislators to continue to make mental health a priority this
session. The community need for mental health services is great
and the topic has bipartisan support.
that legislators pass a health and human services supplemental budget
that includes funding for mental health before the session
For additional support, contact Mary Krinkie, vice president of government relations, MHA, or Kristin Loncorich, director of state government relations, MHA.
Session bill tracker
For a complete list of 2016 legislative bills MHA is tracking, visit
the MHA Member Center. For assistance
accessing the Member Center, contact Ashley Beno, member services and communications specialist, MHA,
651-603-3545. return to top
issues survey on drug prices
The American Hospital Association
(AHA) on April 18 sent a national survey to all hospital chief
executive officers to collect information about pharmaceutical price
increases in recent years. Patients and hospitals have expressed deep
concerns about the effects of high drug costs, including unexpected
price increases for older drugs.
The AHA survey was created in coordination with pharmacy experts to
gather hospital-level information. The survey will help provide a
diverse range of hospitals’ experience with inpatient prescription drug
The survey deadline is May 6. With questions about the survey,
contact Joe Schindler, vice president of
finance, MHA, 651-659-1415. return to top
Certified Application Counselors, Navigators to renew contracts by July
MNsure Certified Application
Counselors (CACs) and Navigators will need to renew their contracts by
July 1, 2016. Current contracts expire June 30. A notice will be sent
by MNsure to CAC and Navigator contacts the first week in May with
The renewal application is more streamlined than previous applications.
Contracts will be renewed for a three-year period. Another change to
the contract is the requirement of an immediate notice to MNsure of any
roster changes, in order to protect client data that is accessed
through the assister portal. MNsure connects the sharing of private
client data to individual assisters, not organizations. Therefore, if
an assister leaves, another assistor will need permission to access
For more information, visit the MNsure website. return to top
releases proposed Medicare inpatient rule for FY 2017
The Centers for Medicare and Medicaid
Services (CMS) released its inpatient prospective payment system (IPPS)
and long-term care hospital proposed rules on April 18. The net
increase to hospital payments is expected to be 0.85 percent after
various mandated cuts. There is proposed relief of +0.8 percent for
hospitals related to the two-midnight rule. In recent years, CMS has
implemented a -0.2 percent annual cut associated with the two-midnight
Hospitals may be concerned about CMS’ ongoing penalty on hospitals for
what it terms “systematic up-coding,” which CMS maintains has occurred
with the implementation of the more severity-sensitive MS-DRG payment
mechanism. A documentation and coding adjustment of -1.5 percent aims
to recoup funds from fiscal years 2010, 2011 and 2012 as mandated by
the American Taxpayer Relief Act (ATRA) of 2012.
Modifications are proposed for the Disproportionate Share Hospital
(DSH) adjustment and a new notification requirement for outpatients
receiving observation services is outlined. The quality programs will
have the following percentages of Medicare payment at risk for FY 2017:
1.0 percent for the Hospital-Acquired Conditions (HAC) program, 2.0
percent for value-based purchasing and 3.0 percent for the Hospital
Readmissions Reduction Program (HRRP).
MHA staff will be analyzing the proposed rule over the next several
weeks. MHA members will receive customized hospital impact reports
after a full review of the proposed rule has been completed.
Comments on the proposed rule are due by June 17. MHA will be writing a
comment letter and invites member hospitals to share concerns with the
proposed rule over the next two months.
For questions or comments, contact Joe Schindler, vice president of finance, MHA,
651-659-1415. return to top