Minnesota Hospital Association


April 25, 2016

MHA Newsline: April 25, 2016

In this issue 

Minnesota’s 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: 

  • Improve quality, safety and efficiency and reduce health disparities 
  • Engage patients and families in their health care 
  • Improve care coordination 
  • Improve population and public health 
  • Maintain 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 onlinereturn to top   

Legislative 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: 

  • The 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. 
  • The Excellence in Mental Health Act is fully funded: $188,000 this biennium and $8.4 million in the next biennium. 
  • None of the governor’s recommendations for direct care and treatment were funded. 
  • There were no changes in the provider tax or uses of funds from the Health Care Access Fund (HCAF). 
  • The bill seeks a waiver to move Minnesota from a state-based exchange to the federal exchange. 

Key provisions in the Senate include: 

  • Funding for the Excellence in Mental Health Act: $188,000 and $8.4 million (FY 18-19). 
  • Funding 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 18-19). 
  • Funding 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). 
  • Funding 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 18-19). 
  • Funding a 5 percent Medical Assistance rate increase for preventive medical, dental and outpatient mental health services: $13 million and $58 million (FY 18-19). 
  • No changes in the provider tax or sunset. 
  • At 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. 
  • The 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 the bills.   

Topics for legislative advocacy
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: 

  • Urge legislators to adopt a spending target for the health and human services budget that is greater than the House target of no new spending. 
  • Encourage 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. 
  • Request that legislators pass a health and human services supplemental budget that includes funding for mental health before the session adjourns. 

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   

AHA 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 prices.   

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   

MNsure Certified Application Counselors, Navigators to renew contracts by July 1

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 additional information.   

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 client information.   

For more information, visit the MNsure websitereturn to top  

CMS 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 rule.   

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