Minnesota Hospital Association


August 05, 2013

MHA Newsline

In this issue

Hospital spotlight: Riverwood Healthcare Center taps Bingo to improve community health

With unhealthy behaviors and lifestyle choices driving up obesity, diabetes, heart disease and other chronic illnesses, wellness education is essential and not just a bonus. In January 2012, Riverwood Healthcare Center in Aitkin launched a year-long wellness campaign in the three primary communities it serves called “BINGO — Win with Wellness in Aitkin, Garrison and McGregor.” Its efforts earned it the MHA Community Benefit Award for a small hospital earlier this year. Tapping the fun and simplicity of the BINGO game, Riverwood developed a series of four quarterly BINGO game cards offering 24 wellness tips each that individuals could do daily, weekly or monthly. Taking a holistic approach, the wellness tips covered activities for mind, body and spirit. Partnering with the local newspaper, schools, grocery stores and other organizations, the BINGO cards were made widely available and used by community residents of all ages. Feedback from participants indicated that the simple steps to wellness motivated people to adopt healthy habits and behaviors that will hopefully last a lifetime. return to top  

MHA members well represented among applicants for MNsure Consumer Assistance Partners

Despite unknown details and many unanswered questions about MNsure's Consumer Assistance Partners (CAP) program, Minnesota's hospitals and health systems throughout the state stepped forward and applied to participate in the program. The CAP program will train and certify organizations to serve as in-person assisters, navigators or certified application counselors to help individuals obtain health coverage through MNsure, the state's new Health Insurance Exchange.  

According to a list provided by MNsure, 61 MHA members operating more than 80 hospitals across Minnesota were among the 280 applicants for the CAP program.  

Lawrence Massa, MHA president and CEO, was pleased to see the Association's members taking steps to participate in the program even though many have questions about the process. Massa said, "We know that hospitals, clinics and especially emergency departments will be some of the most likely places people will go for information about MNsure and the new coverage options. By working with MNsure, we believe our members will help get more residents enrolled in coverage, thereby significantly improving their access to care, increasing the delivery of important preventive care, reducing health disparities in our communities, and decreasing uncompensated care."   

MHA continues to seek more information and details about the CAP program and will pass new information along to members as it becomes available. In the meantime, MHA has scheduled a conference for members to learn more about MNsure, the CAP program and new coverage options for residents. See conference details below.  

For more information about MNsure, the CAP program, or public and private health coverage offered through MNsure, contact Matt Anderson, MHA vice president of strategic and regulatory affairs, 651-659-1421 or Jen McNertney, MHA policy analyst, 651-659-1405. return to top  

Register now: Enrolling patients through MNsure

Hospital financial and patient services reps encouraged to attend Sept. 6 program

Beginning Oct. 1, Minnesota's hospitals and health systems will play important roles in helping our patients enroll in state public programs and new subsidized coverage options through Minnesota's new Health Insurance Exchange. David Van Sant, navigator broker manager, MNsure, will provide the most comprehensive and up-to-date information available about how hospitals and health systems will fulfill these roles. This program offers a unique opportunity for MHA members to learn about MNsure's CAP program, get questions answered, and help prepare for the enrollment and coverage expansion activities on the near horizon. Other trainings from MNsure are expected to be web-based and not in-person, so MHA urges your attendance at this program.  

The program is designed for CEOs, CFOs, financial counselors, business office managers, social workers, patient services and government relations officers. The program begins at 10 a.m. at the Ramada Plaza in Minneapolis. Please share this information with the relevant people within your organization and encourage them to attend. Click here to register. return to top  

MHA committed to helping Minnesota hospitals comply with PSO requirements

The American Hospital Association (AHA) recently issued a member advisory (available online for AHA members) about a little understood provision of the Affordable Care Act (ACA) that requires hospitals with 50 or more beds to participate in a Patient Safety Organization (PSO). In 2005, Congress authorized the creation of patient safety organizations (PSOs) to collect and analyze data from health care providers about adverse events and close calls and issue recommendations on how to improve patient safety.    Since the creation of PSOs, participation has been voluntary for health care providers. The ACA, however, contained language which may be interpreted as requiring hospitals with 50 or more beds to contract with a PSO that has been certified by the Agency for Healthcare Research and Quality (AHRQ).   

AHA has expressed concern about ambiguities in the requirement and potential conflicts with other federal and state laws. For example many states, including Minnesota, have state laws that mandate hospital reporting and aggregation of data on the types of events typically submitted to PSOs. AHA has expressed concern that if the ACA requirement remains in place, hospitals in states with state-mandated reporting systems may be required to submit similar data to two separate entities.  

Based on these concerns, AHA has contacted the federal agency responsible for implementing the PSO requirement. AHA is encouraging the agency to modify the PSO requirement or provide exceptions for hospitals already participating in programs with similar goals to the PSO, including state-mandated reporting programs.   

MHA is working with AHA and the Minnesota congressional delegation to ensure that any PSO-related requirements do not impose a duplicative burden on Minnesota hospitals. MHA is also committed to providing Minnesota hospitals with the tools necessary to ensure compliance with the law, however it may ultimately be interpreted. MHA will continue to move forward with planning for the creation of an MHA-managed PSO or a broad-based license agreement that could provide PSO services to Minnesota hospitals at group-discounted rate.   

For more information regarding proposed PSO data collection and improvement activity, contact Tania Daniels, MHA vice president for patient safety, 651-603-3517. For more information regarding PSO requirements, contact Ben Peltier, MHA vice president of legal services, 651-603-3513. return to top 

Minnesota Court of Appeals overturns problematic guardianship decision

The Minnesota Court of Appeals reversed a lower court ruling that would have limited the ability of Minnesota hospitals to rely on the decision-making authority of court appointed guardians for patients facing decisions about end-of-life care. The appeals court decision, issued July 29, 2013, was consistent with a joint request from MHA and the Minnesota Medical Association (MMA) that asked the court to overturn the lower court decision.  

The underlying case involved the care of a moderately-impaired patient. The patient had no responsible family so a Minnesota court appointed a guardian to manage the patient’s medical care and other affairs. While residing in a group home, the patient suffered respiratory and cardiac arrest. Although he survived, the patient suffered severe and irreversible brain injury and became deeply comatose. The hospital ethics committee determined that no benefit could be achieved with further intensive treatment and notified the guardian of the determination.  

The guardian argued that the general guardian appointment provided the necessary authority to authorize the end of treatment but a Hennepin County judge determined that under Minnesota law only a court could make such an authorization for an incapacitated person in this situation.  

Minnesota providers — including doctors and hospitals — and organizations representing guardians disagreed with the judge’s decision and appealed it to the Court of Appeals. MHA and MMA submitted an Amicus Brief — also known as a “Friend of the Court” brief — explaining that health care providers are the most appropriate sources to evaluate a patient’s health and providing advice to guardians about end-of-life care.   

Ultimately, the Court of Appeals agreed with the MHA/MMA position and overturned the lower court decision. As a result, under Minnesota law, a court-appointed guardian may make end-of-life care decisions for individuals under their guardianship and hospitals may rely on the guardian’s direction in most circumstances.   

For additional information about the case, or guardianship issues in general, contact Ben Peltier, MHA vice president of legal services, 651-603-3513. return to top  

Sen. Klobuchar pens her support for general supervision for outpatient therapy services

MHA extends its thanks to Sen. Amy Klobuchar who joins Sen. Franken in co-authoring the Protecting Access to Rural Therapy Services Act (S.1143; Rep. Collin Peterson (D-MN) introduced the companion bill, H.R 2801). As MHA reported last week, this legislation would allow general supervision by a physician or non-physician practitioner for many outpatient therapy services. The bill would require the Centers for Medicare and Medicaid Services (CMS) to allow a default setting of general supervision, rather than direct supervision, for outpatient therapy services and would create an advisory panel to establish an exceptions process for risky and complex outpatient services. It also would create a special rule for critical access hospitals (CAH) that recognizes their unique size and Medicare conditions of participation; and would hold hospitals and CAHs harmless from civil or criminal action for failing to meet the “direct supervision” requirements applied to services furnished since 2001. If you have any questions, please contact Ann Gibson, MHA vice president of federal relations and workforce, 651-603-3527. return to top  

MN Hospital PAC Silent Auction donations needed

The Minnesota Hospital PAC Silent Auction will take place on Wednesday, Sept. 18 from 8 – 10 p.m. at the MHA Annual Meeting during the Chair’s Reception at Madden’s in the Town Hall Conference Center, lower level. Everyone attending the Annual Meeting is invited to this reception.   

MHA members and associate members are encouraged to personally donate items to be auctioned to raise money for the PAC.  

Suggested items to donate include: tickets to events, hotel stays, gift certificates, spa visit certificates, art work, gift baskets, golf outings — anything that you would like to bid on at a silent auction.  

Deadline for donations is Friday, Sept. 6, 2013. The Minnesota Hospital PAC is a voluntary, bipartisan political action committee PAC that raises campaign funds for candidates running for state and federal office in Minnesota. It is the voice for hospital advocates seeking to help candidates who support the goals of hospitals.   

Please contact Kristin Loncorich, MHA director of government relations, 651-603-3526 with questions and to donate items. return to top    

U.S. senators seek feedback on improving mental health system

Sen. Max Baucus (D-MT) and Sen. Orrin Hatch (R-UT), the chair and ranking member of the U.S. Senate Finance Committee, have sent a letter to mental health providers and advocates seeking input on ways to improve the nation’s mental health system. They are particularly interested in ways Medicaid and Medicare can provide better services and ways in which models of primary and mental health care integration have improved outcomes. Please send your thoughts and ideas to Jen McNertney, MHA policy analyst, for inclusion in MHA’s submission. Members are also encouraged to submit their own letters. return to top 

CentraCare Health names regional hospitals president

Craig BromanCentraCare Health has named Craig Broman as president of Regional Hospitals, effective Jan. 1, 2014. He will continue as St. Cloud Hospital president, a job he has held since December 2002.   

In his new position, Broman will work to coordinate and enhance the operations of the CentraCare hospitals in Long Prairie, Melrose, Monticello and Sauk Centre. Broman has extensive experience with regional systems in the western U.S., where he led hospitals, clinics and nursing homes from 1980 until 2002.   

Until January, responsibility for the regional hospitals will remain with Jim Davis, CentraCare’s vice president corporate services, who will retire at year-end. return to top  

In memoriam

The Minnesota hospital community was saddened with news of the passing of Ed Mehl, longtime CEO of Lake Region Healthcare in Fergus Falls. Ed started his career at St. Francis Hospital in Breckenridge before joining the administrative staff at Lake Region Hospital in 1967. He served as Lake Region’s CEO from 1981 until his retirement in 2007.   Ed passed away on Saturday, July 20. A memorial service was held in Fergus Falls on Monday, July 29.  Memorials can be made in Ed’s honor to the Lake Region Healthcare Cancer Care and Research Center   return to top