Minnesota Hospital Association


July 22, 2013

MHA Newsline

In this issue:

Hospital spotlight: Klimp deserving of Distinguished Service Award

Mary Klimp, chief administrative officer at Mayo Clinic Health System in New Prague, was honored earlier this year with the 2013 MHA Distinguished Service Award. Klimp is the very definition of a “servant leader.” She has the ability to appreciate the needs of others, especially the patient. Her focus and dedication to the improvement of health care delivery make her a role model for stewardship and advocacy.

As chief administrative officer of Mayo Clinic Health System in New Prague she has carried a vision that reaches far beyond the walls of the organization. To serve patients close to home, she recognizes that it’s imperative to engage in broad examination of our health care system as a whole, to ensure that high quality, safe and affordable care can be delivered to those in need.

Her commitment goes beyond her own organization, dedicating herself to leadership on behalf of her community. ^top of page

Resources available to help with your community health needs assessment

Under the Affordable Care Act (ACA) of 2010, charitable hospitals are required to perform a community health needs assessment (CHNA) at least once every three years. As MHA reported in April, the IRS has issued its proposed rule for the CHNA requirement. With the final rule still pending, hospitals have been left to move forward with their CHNA without definitive guidance. However, the direction the proposed rule takes is overall positive and helpful for hospitals:

  • The proposed rule states that hospitals can determine their own definitions of the communities they serve. The IRS expects most hospitals will define community on a geographic basis, with some opting for a demographic definition (e.g. children’s hospitals) or a condition-specific definition (e.g. specialty hospitals).
  • The proposed rule clarifies that the CHNA does not need to measure and address every health need in the community, but rather the hospital is responsible for defining and assessing “the most significant” needs of a community.
  • The rule allows for multiple hospitals — either in a single system or serving a single community — to collaborate with one another on CHNAs to minimize administrative burden and potential duplication. MHA has several resources on its website to assist you in conducting your community health needs assessment. Among those resources is a community health needs assessment tool kit, developed by Community Commons. The tool kit is a Web-based platform designed to assist hospitals and organizations with their CHNA. It provides free and easy access to important health data indicators to free up hospitals’ time to perform meaningful analysis and priority setting to address the needs identified.

In addition, MHA has requested that members send their completed CHNAs to Matt Anderson, MHA vice president of strategic and regulatory affairs. MHA is analyzing CHNAs for common themes, potential alignments for collaboration among hospital members, and opportunities for greater public education and awareness of hospitals’ efforts to serve their communities.

MHA submitted comments to the IRS regarding the proposed rules. If you have questions, contact Matt Anderson, 651-659-1421. ^top of page

MHA seeks hospitals to participate in exploratory group

MHA has submitted a proposal to the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI) to participate in the Partnership for Patients Hospital Engagement Network Leading Edge Advanced Practice Topics (LEAPT). The LEAPT project addresses specific hospital-acquired conditions which are above and beyond that which is currently being addressed through the MHA HEN. MHA is seeking hospitals for an exploratory group to participate in the LEAPT work, implement processes and best practices identified by the group, and share their experience and expertise with other hospitals. Exploratory group hospitals will help MHA and members determine the scope of the topic, the potential to reduce patient harm, and to identify best practices and tools to share with other Partnership for Patients hospitals. MHA’s LEAPT contract will focus on the five topics below. Exploratory group hospitals will share their progress on one or more of the topics:

  1. Severe sepsis and septic shock
  2. C. Difficile
  3. Latrogenic delirium
  4. A safety culture that fully integrates patient safety with worker safety
  5. Expanding readmission reduction and harm prevention activity into the community

MHA members in the Partnership for Patients are eligible to apply and funding will be available for participation as an exploratory group hospital. If you are interested in serving on one or more of the exploratory workgroups, email Karen Olson at MHA. ^top of page

State Innovation Model task forces convene

Earlier this year, the federal government awarded Minnesota a $45 million State Innovation Model (SIM) grant to test strategies for advancing and aligning Accountable Care Organization models, support providers’ data analytics efforts, and create 15 new “Accountable Communities for Health.” Last week, two task forces charged with advising state agencies in implementing the three-year project held their first meetings.

The first task force is comprised of representatives from various health care insurers and payers. The SIM grant requires the state to demonstrate that public and private payers participate in the tested models and strategies, so this task force will help ensure multi-payer alignment.

The other task force is larger and intended to provide a more community-wide perspective on the projects and initiatives funded through the grant.

The Minnesota Departments of Health and Human Services used both meetings, as well as a third public town hall-style meeting, to describe the broad goals and concepts underlying the grant and to solicit perceptions of how community members define success for overall health and health system improvement. No particular decisions were made and the projects to be tested, including the concept of Accountable Communities of Health, remain largely undefined. The projects to be tested are scheduled to begin Oct. 1, 2013.

MHA supported the efforts to secure the SIM grant to fund enhanced data sharing and analytics with providers, expand and share total-cost-of-care strategies developed through the Health Care Delivery System demonstration projects, and fuel integration of mental and behavioral health integration with primary care.

For more information about the State Innovation Model grant, click here; the state’s press release regarding the two task forces can be found here. MHA members with questions about the SIM grant are encouraged to contact Matt Anderson, MHA vice president of strategic and regulatory affairs, 651-659-1421. ^top of page

Lakewood Health System hosts DHS Commissioner Lucinda Jesson

Senior leadership and board members from Lakewood Health System in Staples hosted Department of Human Services Commissioner Lucinda Jesson for a roundtable discussion on issues affecting rural health systems. MHA President and CEO Lawrence Massa also participated in the roundtable.

In his opening remarks, Massa noted that rural health systems are often overlooked as new payment and delivery system experiments and demonstrations are planned by the state. “Integrated rural delivery systems like Lakewood have many of the same attributes for delivering high quality, coordinated, efficient care as larger health systems, only on a smaller scale,” Massa said.

“It is critical to be aware of the reimbursement and industry challenges facing rural hospitals which are committed to creating value and ensuring access to meet rural needs,” said Lakewood President and CEO Tim Rice. “We play a key role in Minnesota health care delivery and we must be able to be included in the payment and delivery systems that are being developed.”

Rice, along with Dr. John Halfen, Lakewood’s medical director, provided an overview of the system’s capabilities and accomplishments, including its long standing health care home delivery model. Dr. Halfen pointed out that Lakewood had implemented a medical home model of care delivery well before the state began its program. He also provided data on the successes they have had in treating patients with diabetes and pulmonary disease.

Commissioner Jesson stated her interest in developing rural demonstrations in Medical Assistance and MinnesotaCare and encouraged the system to learn more about the Health Care Delivery System (HCDS) program. “This program is not just for the large, urban systems,” Jesson said. She noted that although the first HCDS agreements were in larger communities, each one was negotiated individually, taking the needs and characteristics of the providers and the community to be served into consideration. She also pledged to continue the discussion on how to provide opportunities for rural systems to innovate and lead in the transformation to value versus volume. ^top of page

Hospital discharge changes under First Contact

The Minnesota Board on Aging hosted a stakeholder meeting last week to discuss discharge planning and preadmission screening changes taking place under the new First Contact program. Three changes affect hospitals:

  • Hospital discharge staff will have a longer form to fill out before referring older adults to the Senior LinkAge Line for follow-up services and preadmission screening.
  • Patients on a 30-day stay in a Medicaid-certified nursing home are no longer exempt from the preadmission screening. This means rehab patients in Medicaid-certified nursing homes will need preadmission screening.
  • Patients discharged to a swing bed will also have to undergo preadmission screening. Subsequent transfer to a nursing facility is considered a transfer and will not require an additional screening.

    MHA encourages hospital and health system staff to attend the upcoming statewide meetings to learn more about the changes and provide input into the development process. First Contact becomes effective Oct. 1, 2013.

For more information contact Jen McNertney, MHA policy analyst, 651-659-1405. ^top of page

Video explains changes coming for Americans under the ACA

The Kaiser Family Foundation released a new animated video to help people understand the health care system changes on the horizon. "The YouToons Get Ready for Obamacare" explains the basic changes in the way Americans will get health coverage and what it will cost starting in 2014, whether it's through their employer, Medicaid, Medicare or buying insurance on their own with the help of federal tax credits. This video is a great resource to use to help your audiences understand upcoming changes to health care. Hospitals are encouraged to embed the video on your websites and share via social media. ^top of page

Members of Congress show support for Minnesota’s rural hospitals

MHA thanks Rep. Peterson for helping maintain rural access to quality health care Two pieces of legislation important to Minnesota’s rural hospitals have gained support from several of the state’s members of congress. H.R. 1787, the Rural Hospital Access Act of 2013, provides for an extension of the Medicare-dependent hospital (MDH) program and increased payments under the Medicare low-volume hospital program. Minnesota currently has three MDHs and 24 low-volume hospitals in the state. The MDH program supports facilities for which Medicare patients make up a significant percentage of inpatient days or discharges. Reps. Ellison and Peterson are co-sponsors of the bill while Sens. Franken and Klobuchar are sponsoring its Senate counterpart.

The second piece of legislation, which Rep. Peterson is co-sponsoring, is H.R. 2578 the Rural Hospital Fairness Act of 2013. This bill would reinstate the outpatient “hold harmless” payments to certain eligible sole community hospitals (SCH) and rural hospitals with no more than 100 beds through Dec. 31, 2013. Minnesota has 13 SCHs.

Thanks to Minnesota’s members of Congress for their support of important legislation that will help maintain access to quality health care in rural Minnesota. ^top of page

Heart of New Ulm project featured on Twin Cities Public Television

Twin Cities Public Television is highlighting an innovative project in southern Minnesota that is redefining health care delivery as part of its Redesigning Minnesota series. The Hearts Beat Back: Heart of New Ulm is a collaborative partnership of Allina Health, New Ulm Medical Center, the Minneapolis Heart Institute Foundation and the community of New Ulm. The project is a 10-year initiative to significantly reduce heart attacks to help New Ulm residents live longer, healthier lives. As a population-based prevention demonstration project, it applies evidence-informed health improvement practices in the community, health care, work sites and the environment.

The website describes the episode in this way: “In an era of 'government redesign,' no challenge is greater than health care. Costs are huge and growing fast. Our population is aging and the current payment incentives for the health care system seem to be part of the problem. But the good news is that Minnesota is on the cutting edge of experiments designed to get us all headed in the right direction. From Hennepin County to New Ulm to Willmar, Minnesotans are exploring ways to make our health care ... and health ... better, even as we reduce costs and give people more direct control of their overall health. It's important work going on across our state and this program gives you a glimpse into the future possibilities."

A schedule of air times is available at http://www.redesigningmn.org. The entire show will also be posted on the website, along with Web extras.

To learn more about the Heart of New Ulm, visit www.heartsbeatback.org. ^top of page

Sanford Health of Northern Minnesota names new president

Dan Olson, the current chief operations officer of Sanford Bemidji Clinics, has been named the president of Sanford Health of Northern Minnesota, effective Aug. 1.

Sanford Health of Northern Minnesota includes Sanford Bemidji Medical Center and Sanford Bagley Medical Center as well as eight clinics. Olson has more than 26 years experience in health care administration and leadership and has directly overseen Sanford Bemidji Clinics since 2009. He replaces Paul Hanson, who became the new president of Sanford USD Medical Center in Sioux Falls, S.D. In addition, Joy Johnson, current chief operating officer of Sanford Bemidji Medical Center, has been promoted to chief operating officer for Sanford Health of Northern Minnesota also effective Aug. 1. ^top of page