Minnesota Hospital Association


August 08, 2016

MHA Newsline: Aug. 8, 2016

In this issue 

River’s Edge Hospital and Clinic honored with MHA Patient Safety Improvement Award

River’s Edge Hospital & Clinic in St. Peter received the Minnesota Hospital Association (MHA) 2016 Patient Safety Improvement Award in the small hospital category, which recognizes hospitals that have taken extraordinary and innovative steps to make patient safety a top priority throughout the hospital.   

In 2015, River's Edge experienced a significant increase in admissions, and this growth prompted a need to address patient falls. In the second quarter of 2015, River's Edge had a 10.04 fall rate. The Falls Steering Committee was formed, comprised of staff from the medical/surgical, quality and emergency departments, and pharmacy and physical therapy, and set a goal of having an average of less than 3.5 falls per quarter.   

Improvement was made soon after the committee started implementing some best practices and training staff to reduce falls. Upon arrival at River's Edge Hospital, patients are assessed and, if noted to be a high risk for falls, a yellow banner appears on the resident summary in the electronic health record. Assessments are performed on each shift and status changes are noted. Family members and the patient are notified of the fall risk and are educated by staff through discussion and printed material. In the fourth quarter of 2015, River's Edge reduced its fall rate to 3.94, closing in on its goal.   

Additional award winners will be profiled in upcoming issues of Newsline. To learn more about the award winners, visit the MHA websitereturn to top   

Minnesota Flex Program, CAHs honored for excellence in quality improvement

For the second year in a row, the Minnesota Flex Program at MDH in July was awarded a Certificate of Excellence from the Federal Office of Rural Health Policy in recognition of outstanding state quality performance, indicating a statewide commitment to Critical Access Hospital (CAH) quality reporting and performance. The award reflects the commitment of Minnesota’s 78 CAHs to improving quality of care and reporting quality measures, as well as the support of MHA and Stratis Health staff who assist the CAHs with the Flex Program.   

The award recognizes excellence in MBQIP (Medicare Beneficiary Quality Improvement Program), a quality improvement activity under the Medicare Rural Hospital Flexibility (Flex) grant program. The goal of MBQIP is to improve the quality of care provided in CAHs by increasing quality data reporting and then driving quality improvement activities based on the data.   

Ten states received the certificate, out of 45 eligible states. Judy Bergh, Flex Program coordinator, accepted the award on behalf of Minnesota’s CAHs, MHA and Stratis Health. return to top   

MHA receives patient safety grant funding from Cardinal Health Foundation

The Cardinal Health Foundation announced that it has awarded MHA grant funding of nearly $150,000 over three years from its E3 Patient Safety Grant Program. MHA is one of 13 grantees who have received multiyear grants to support their work in improving health outcomes for high-risk patients.   

Through the grant, MHA will convene a team of health care providers and patient and family stakeholders to develop a “universal protocol” aimed at reducing medication-related readmissions and adverse events. The new protocol will close gaps in the existing medication safety road map and will include best practices to ensure medication accuracy during transitions to and from the hospital and across the continuum of care. Patients, family members or caregivers who are interested in serving on this team should contact Joy Benn, quality and patient safety specialist, MHA, 651-659-1441.   

MHA will also join other 2016 E3 Patient Safety grantees in a learning collaborative facilitated by the Alliance for Integrated Medication Management (AIMM). The collaborative is designed to help the organizations share their learning and more quickly implement evidence-based practices.   

Since 2008, the Cardinal Health Foundation has invested $16 million to hundreds of health care organizations through its E3 Patient Safety Grant Program. Because of the complexities in health care and health care systems, it takes an average of 17 years for evidence-based practices to be fully implemented into health care practices, according to the National Institutes of Health. 

“Within a year or two, recent grantees are affecting change, eliminating errors and creating lasting improvement,” said Dianne Radigan, vice president of Community Relations at Cardinal Health. “They are reducing readmissions to hospitals, reducing lengths of stay and, most importantly, saving lives. On behalf of Cardinal Health, we are pleased to support the work of MHA.” return to top   

Gov. Dayton, Lt. Gov. Smith to tour state’s 87 counties

Gov. Mark Dayton and Lt. Gov. Tina Smith on Aug. 1 began an 86-day statewide tour of Minnesota’s 87 counties. According to the governor’s press release: “Over the next 11 weeks, they will travel to every county in the state, meeting face-to-face with community leaders, farmers, business owners and others to hear ideas and concerns; discuss their priorities; and celebrate the achievements and aspirations of Minnesota families, businesses, schools and communities.”   

State leaders appreciate hearing from local hospital stakeholders with personal expertise about health care issues and issues affecting their community’s hospitals and clinics. If the statewide tour visits your community, MHA encourages you to participate in the events as you are able. Visit the governor’s newsroom website to access press releases announcing the tour schedule as it becomes available.   

Meeting resources, including handouts that can be printed and shared, are available on the MHA Member Center, which is username and password protected. For help resetting your username and/or password, contact Ashley Beno, member services and communication specialist, MHA. return to top   

MHA to convene discussion with Minnesota Board of Medical Practice around timelines of physician credentialing

Member hospitals and health systems have informed MHA that they are experiencing challenges with securing timely licensure for new physicians recruited to Minnesota from out of state. To help with this issue, MHA plans to convene a meeting with interested members and the Minnesota Board of Medical Practice to discuss ways to improve the physician credentialing process.   

MHA is currently in the early stages of planning this meeting. More detailed information, once available, will be shared with hospital and health system leaders. To learn more, contact Dr. Rahul Koranne, chief medical officer, MHA, 651-659-1445. return to top   

CMS finalizes FY2017 Medicare inpatient rule

The Centers for Medicare and Medicaid Services (CMS) on Aug. 3 released the FY2017 final Inpatient Prospective Payment System (IPPS) rule, which takes effect Oct. 1. MHA advocated for several changes to the proposed rule in its comment letter.   

One major positive outcome is CMS’ reversal of the 0.2 percent annual reduction it implemented as part of its “two-midnight” policy. Historical cuts associated with this cut are also reversed. In addition, CMS abandoned its proposal to modify the Medicare disproportionate share (DSH) uncompensated care formula beginning in 2018.   

CMS had included a modification to the formula in the proposed IPPS rule that would have cost hospitals in Minnesota about $40 million in Medicare funds in 2018. The proposed formula would have shifted dollars from states with low uninsured rates to states that did not expand Medicaid. MHA worked with Sen. Amy Klobuchar and other Minnesota legislators including Sen. Al Franken; Reps. Collin Peterson, Betty McCollum, Keith Ellison and Rick Nolan; state Sen. Tony Lourey; and state Rep. Matt Dean to ensure Minnesota hospitals were not punished for the state’s aggressive efforts to reduce the number of uninsured.   

“The proposed Medicare DSH formula would have penalized Minnesota as well as other states that have done the right thing by expanding health insurance coverage for low-income residents,” said Lawrence Massa, president and CEO, MHA. “We appreciate the work of our state congressional delegation and state legislative leaders who raised concerns that $40 million a year in Medicare funds would have been shifted from Minnesota to states that have not been as successful in reducing the number of uninsured patients. DSH has provided some relief for hospitals serving uninsured and underinsured patients.”   

The final rule will increase the inpatient prospective payment system (PPS) rate by 0.95 percent in FY2017 after accounting for inflation and various negative adjustments required by law. MHA is concerned about the -1.5 percent adjustment to account for “documentation and coding,” as it is nearly double what has been applied in previous years.   

CMS finalized its proposal to implement the Medicare Outpatient Observation Notice (MOON) to a Medicare beneficiary receiving greater than 24 hours of services in Observation status. It also delayed the implementation date for this requirement by four months from its original Aug. 6 date. This requirement to provide both written and verbal notification to Medicare beneficiaries applies to both PPS hospitals and CAHs.   

MHA will be sending financial impact reports to member hospitals in mid-August. For more information, contact Joe Schindler, vice president of finance, MHA, 651-659-1415, or Ben Peltier, vice president of legal services, MHA, 651-603-3513. return to top   

2016 Minnesota Hospital Financial Ratio book now available for MHA members

The 2016 Minnesota Hospital Financial Ratio Book, based on 2015 financial statements, is now available for MHA members. The book contains 27 key financial ratios that hospital administrators, board members and financial officers need to understand their hospital’s financial standing compared to their peer groups in Minnesota.   

The in-depth report, produced from hospitals’ audited financial statements, provides unique insight into the current trends different hospital groups face in Minnesota. The book also includes common-sized financial statements, allowing hospitals to compare their own statements against those with similar characteristics. Further, a system-level section is included showing the same 27 key financial ratios for hospital systems operating in the state.   

The following are some of the key summary points in this year’s ratio book: 

  • Between fiscal year (FY) 2014 and FY 2015, the statewide median operating margin increased from 2.2 percent to 3.3 percent. 
  • The statewide median net margin decreased from 5.4 percent to 3.8 percent. 
  • Liquidity ratios slightly increased and days in patient accounts receivable decreased from 51.87 days in 2014 to 51.10 days in 2015. 
  • The days-cash-on-hand ratio saw a slight increase, from 34.61 days in 2014 to 37.78 days in 2015. 

MHA members may purchase the standard ratio book for $100. For more information, contact Lucas Hovila, financial analyst, MHA, 651-603-3536. To order the book or customized reports, contact Jennifer Sanislo, division assistant, MHA, 651-659-1440. return to top