Minnesota Hospital Association


April 03, 2017

MHA Newsline: April 3, 2017

In this issue:

Lakeview’s opioid overdose program: A lifesaving partnership

Our nation’s opioid epidemic has been well reported. In 2014, the most recent year on record, more people died from drug overdoses in any previous year, and more than six out of 10 of those deaths involved an opioid. Since 1999, the rate of overdose deaths involving opioids has nearly quadrupled.

Nationwide, hospitals are feeling the surge, with the epidemic having an economic impact of $20 billion in emergency department and inpatient care for opioid poisonings, according to the CDC.

Lakeview Hospital and the Washington County Sheriff’s Office are dealing with the problem head-on, collaborating on a project to reduce accidental opioid overdoses in Washington County. At the center of the project is expanding access for first responders to the medication naloxone, a step that the U.S. Department of Health and Human Services calls “essential” to reversing the epidemic. Naloxone can reverse the effects of an opioid overdose.

Visit the MHA website to learn more and read the full 2016 Community Benefit Report. return to top

HHS finance, reinsurance bills move forward

March 31 was the Finance Committee deadline, the day selected by House and Senate leadership when all finance bills should have passed in all committees. The Senate’s omnibus health and human services bill, SF 800, met this deadline and is scheduled to move to the Senate floor this week. The House’s Health and Human Services Finance bill, HF 945, still must be considered by the Ways and Means Committee.

Senate omnibus HHS bill
Last week, the Senate completed its committee work on its version of the omnibus health and human services bill, SF 800. While the bill contains about $4 million for MHA’s mental health innovation grant program, the bill contains two specific cuts for hospitals. Hospital leaders are urged to contact their legislators regarding these cuts.

  • The Senate bill delays the hospital inpatient fee-for-service update, saving the state $15.405 million for the 2018-19 biennium and $38.925 million for the 2020-21 biennium. The impact of these cuts would be doubled for hospitals because of the loss of federal matching funds. If this provision became law, hospitals would not receive any base increase in Medicaid payments until July 1, 2021 – 14 years since the last base increase in 2007.
  • The Senate bill also contains across-the-board health care provider rate reductions of 2.3 percent on July 1, 2017, and 3 percent on July 1, 2019, saving the state $28.3 million this biennium and $48.2 million in the next biennium. This includes physicians, ambulatory surgical centers, therapists and, as currently written, outpatient hospital services.

House omnibus HHS bill
This week, the House Ways and Means Committee is expected to take up the House’s omnibus health and human services bill, HF 945. The House bill has several items of interest to the hospital community:

  • The inpatient fee-for-service rebasing legislation.
  • $247,000 for a DHS study of outpatient rates.
  • $1 million for Integrated Healthcare Partnership (IHP) start-ups.
  • $6 million for mental health grants.
  • $4.1 million for school-linked mental health grants.
  • $4 million for mental health innovation grants.
  • $3 million for primary care residency expansion.
  • $2 million for loan forgiveness programs.

The bill also includes several items calling for budget savings through new health care delivery reform efforts. These include:

  • $10 million in savings from mandating a new quality reporting system on hospitals, in addition to the current state and federal quality measures.
  • $9.3 million in savings from the work of the IHPs.
  • $144 million in savings from the Health Care Delivery Systems Pilot Project. This is a voluntary direct contracting provision. Provider collaborations would be paid the per member per month rate and not the health plan rate.
  • $50 million in savings from competitive bid reform.
  • $150 million in savings by removing inflation from the forecast.

MHA’s biggest concern with the bill is a provision giving the commissioner of DHS the ability to cut provider payments by as much as $204 million if the various reform items do not produce that amount in savings. MHA expressed opposition to this provision.

Reinsurance bill passed
Today, Gov. Dayton sent legislative leaders a letter saying he will not sign the reinsurance bill, HF 5, but will allow it to become law without his signature. The reinsurance program is to be funded with $200 million from the Health Care Access Fund and $71 million from the general fund in 2018, and another $200 million from the Health Care Access Fund and another $71 million from the general fund in 2019. This money will be used to pay a portion of health claims between $50,000 and $250,000, with the goal that health plans will re-enter the individual insurance market and offer policies that will be approximately 20 percent lower in cost.

An important amendment was added to the bill in conference committee. The commissioner of commerce is instructed to apply for a federal waiver to hold harmless the money that Minnesota receives for our Basic Health Plan (BHP) funding, which is dependent on the price of a silver plan on the individual market. If reinsurance lowers premium prices as intended, significant federal funding for Minnesota could have been jeopardized without this amendment. The language says that without the waiver, the reinsurance program is no longer to be implemented.

With questions, contact Mary Krinkie, vice president of government relations, MHA, 651-659-1465, or Kristin Loncorich, director of state government relations, MHA, 651-603-3526.

Session bill tracker
For a complete list of 2017 legislative bills MHA is tracking, visit the MHA Member Center

For assistance accessing the Member Center, contact Emily Lowther, communications manager, MHA, 651-603-3495. return to top

Call to action: Contact legislators now

MHA members are encouraged to reach out to your state legislators now. Because of the volume of health care issues at the Capitol this session, it is critical that MHA members invite local legislators to hospitals in their home districts for meetings during the legislative spring recess, beginning this Friday and continuing through April 17. Please use the grassroots matching list found on our Member Center to contact your legislators’ offices as soon as possible to schedule a visit.

When speaking with legislators, please ask them to talk to their Caucus leaders and urge them to allocate more money into the Health and Human Services budgets. MHA will provide members with current messages and priorities.

MHA now offers additional grassroots coordination support to help members plan legislative outreach. Karin Johnson, part of our team at Tunheim, is also serving in a contract role as MHA’s grassroots coordinator. Karin will be connecting with MHA members to offer individualized grassroots support, including providing key messages, helping to set up hospital visits or meetings and providing materials that you can use with your employees. Email Karin for assistance with legislative outreach.

For resources to support you as you plan a legislative visit, visit the MHA Member Center. More information will be sent via email to chief executive officers and government relations officers. return to top

Some Republicans say ACA repeal efforts continuing while congressional attention shifts to tax reform

After House Republican leadership withdrew the American Health Care Act (AHCA) from consideration on the House floor on March 24, President Trump and some Republican members of Congress are saying repeal of the Affordable Care Act (ACA) is still a priority and is possible.

It has been reported that Republican leaders are working to secure enough votes to bring the AHCA back to the House floor for a successful approval vote. It is also being reported that the moderate Republican “Tuesday Morning Group” and the conservative Freedom Caucus are working on a legislative package to repeal and replace the ACA. The third reported Republican effort is to reintroduce the reconciliation bill vetoed by President Obama in January 2016. This effort seems to have the most potential, but is still considered to be unlikely. The vetoed reconciliation bill would have:

  • Repealed health care exchanges and eliminated subsidies
  • Terminated the individual mandate and employer mandate
  • Repealed Medicaid expansion (phased-in over two years)
  • Eliminated risk adjustment programs for insurance companies that lose money under the ACA
  • Repealed the ACA taxes, including the over-the-counter medicine tax, “Cadillac tax,” medical device tax, prescription drug tax, annual fee on health insurers and tax on indoor tanning services
  • Reduced the threshold of health care costs that can be deducted from 10 percent to 7.5 percent of adjusted gross income

Even with the ACA remaining in place for the foreseeable future, MHA will continue to advocate for meaningful insurance coverage for all Minnesotans, coverage of all essential health care services and enhanced public health insurance program payments to providers to cover costs associated with caring for public program participants.

While congressional attention on repealing the ACA lingers, many members of Congress have shifted their focus to tax reform. A tax reform legislative package could include hospital-related issues such as charitable contributions, tax-exempt status and the community health needs assessment. MHA will continue to provide updates as congressional discussions begin and will work with Sens. Franken and Klobuchar, the House delegation and other stakeholders on issues important to Minnesota’s hospitals.

With questions, contact Briana Nord Parish, policy analyst, MHA, 651-603-3498, or Ben Peltier, vice president of legal and federal affairs, MHA, 651-603-3513. return to top

Sen. Franken holding workforce summit April 17 in metro

Sen. Al Franken will host the Advancing Career Pathways Summit on April 17 from 8:30 a.m. to noon at the Minnesota Department of Education, 1500 MN-36, Roseville, Minnesota 55113. The summit will explore best practices, models for collaboration and opportunities to help address the skills gap by training students for in-demand 21st-century jobs.

To attend, RSVP online. With questions, contact event organizers Charles Sutton or Dan Solomon. return to top

Deadline for CEO, CFO, CNE salary surveys is April 7

The deadline for submitting this year’s chief executive officer, chief financial officer and chief nurse executive online compensation surveys is Friday, April 7. The survey results will highlight salary averages by budget size, years in health care, geographical region and years in current positions. Summary reports will be sent to participants in mid-May.

Requests were emailed on March 10 to CEOs with information about how to complete the confidential surveys. For assistance with accessing the online survey tool, contact Jenny Sanislo, division assistant, MHA, 651-659-1440.

With questions regarding the surveys, contact Matt Hovila, financial analyst, MHA, 651-603-3536. return to top

PAC golf tournament scheduled for July 31

Registration is now open for the Minnesota Hospital Political Action Committee (PAC) golf tournament. The tournament will be held on July 31 at Territory Golf Club in St. Cloud. Lunch will be served at 11:30 a.m., shotgun start at 12:30 p.m., with a dinner buffet and awards to follow at 5 p.m. Please contact Andrea Wombacher, division assistant, MHA, 651-603-3539, for information and to register. return to top