Minnesota Hospital Association


April 24, 2017

MHA Newsline: April 24, 2017

In this issue

Improving community health and well-being through employer engagement

As an organization focused on community health, reaching out to employers is one way for Winona Health to increase awareness of issues that impact people’s health and well-being. A significant portion of many people’s day is spent in the workplace. What happens at work can ultimately play an important part in protecting and improving health and well-being.

Breakfast with the Experts was developed by Winona Health’s Occupational Health team in 2009. Breakfast with the Experts was designed for area business leaders and human resources professionals to help them stay current on trends and issues related to employee safety, health and wellness. 

Winona Health’s Breakfast with the Experts is held quarterly at no charge. Because the program is offered from 7:30 to 9 a.m., business professionals can often fit it into their workday. Events typically draw more than 50 attendees and feedback is consistently positive.

“Our goal is to help employers understand and be better prepared to accommodate their workforce and keep all employees safe and injury-free,” said Cathy Johnson, RN, a Winona Health Occupational Health nurse who was instrumental in developing the program.

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

Continue legislative outreach this week on HHS budget

Health and human services conference committee members will meet this week to resolve the differences in the omnibus bills. The conference committee members are Sens. Michelle Benson (R – Ham Lake), Jim Abeler (R – Anoka), Karin Housely (R – Stillwater), Tony Lourey (DFL – Kerrick) and Paul Utke (R – Park Rapids). The House appointed Reps. Matt Dean (R – Dellwood), Tony Albright (R – Prior Lake), Deb Kiel (R – Crookston), Joe Schomacker (R – Luverne) and Jennifer Schultz (DFL – Duluth).

The House and Senate are expected to announce joint spending targets later this week. The House is proposing to cut $599 million from health and human services and the Senate is proposing to cut $335 million. MHA members are encouraged to continue to talk to their legislators and ask them to protect Medical Assistance hospital payments. Ask your legislators to urge their respective caucus leaders to put more funding into the health and human services budget. MHA has provided information to hospital members regarding our key legislative priorities in the budget bills.

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.

Advocacy resources available
MHA offers resources to help members prepare for conversations with legislators. Visit the MHA Member Center and read MHA’s latest advocacy alerts. If you have questions about your legislative advocacy efforts, please contact MHA’s grassroots coordinator, Karin Johnson

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

CMS releases FY 2018 IPPS proposed rule and RFI

The Centers for Medicare and Medicaid Services (CMS) issued its fiscal year (FY) 2018 proposed rule for the Inpatient Prospective Payment System (IPPS). The proposed rule includes a Request for Information (RFI) for regulatory, sub-regulatory, policy, practice and procedural changes to better achieve transparency, flexibility, program simplification and innovation. According to CMS, the RFI responses provided “will inform the discussion on future regulatory action related to inpatient and long-term hospitals.”

Comments on the proposed rule and RFI are due to CMS on June 13, 2017. MHA will work with members and the American Hospital Association to draft a response to the RFI, identifying potential areas for care delivery reform and reduction of regulatory burden.

MHA members can access a more detailed summary of the proposed rule and the RFI (CMS-1677-P). The full proposed rule and RFI can be found online.

Proposed changes to payment rates under IPPS
The proposed rule would increase IPPS rates by 1.6 percent in FY 2018. The proposed updated included the projected hospital market basket update of 2.9 percent adjusted by -0.4 percentage points required for productivity; -0.75 percentage points mandated by the Affordable Care Act (ACA); and -0.6 percentage points to remove the one-time temporary adjustment made in FY 2017 to restore the two-midnight rule cuts from FYs 2014-16. The proposed rule included an increase of 0.4588 percentage points to partially restore the cuts made by a requirement that CMS recoup what it claims is the effect of documentation and coding changes from FYs 2010-12, which CMS says do not reflect real changes in case mix.

Disproportionate share hospital payment changes
CMS proposed to distribute roughly $7 billion in uncompensated care payments in FY 2018, an increase of approximately $1 billion from the FY 2017 amount, to hospitals receiving disproportionate share hospital (DHS) payments.
CMS also proposed to begin a three-year phase in of incorporating hospitals’ Worksheet S-10 data into the methodology for determining uncompensated care payments. The agency proposed that, beginning in FY 2018, the definition of uncompensated care costs would include the cost of charity care and non-Medicare bad debt

Critical Access Hospital 96-hour certification requirement
In the proposed rule, CMS directed Quality Improvement Organizations (QIOs), Medicare Audit Contractors (MACs), the Supplemental Medical Review Contractor (SMRC) and Recovery Audit Contractors (RACs) to make the requirement that a physician certify that an individual may reasonably be expected to be discharged or transferred within 96 hours after admission to a critical access hospital (CAH) low priority for medical record reviews conducted on or after Oct. 1, 2017. As a result, under the proposed rule, absent concerns of probable fraud, waste or abuse of the coverage requirement, contractors will not conduct medical record reviews to determine compliance with the CAH 96-hour certification requirement.

Hospital Readmission Reduction Program
For the FY 2018 Hospital Readmission Reduction Program (HRRP), CMS proposed to implement the socioeconomic adjustment approach mandated by the 21st Century Cures Act, which requires CMS to assess readmission penalties based on a hospital’s performance relative to other hospitals with a similar proportion of patients who are dually eligible for Medicare and Medicaid. 

Medicare and Medicaid EHR Incentive Program CY 2018 reporting period
For calendar year (CY) 2018, CMS proposed to modify the EHR reporting periods for new and returning participants attesting to the Medicare and Medicaid EHR Incentive Program from the full year to a minimum of any continuous 90-day period within CY 2018. CMS identified two possible approaches to flexibility for eligible hospitals and CAHs: use either the 2014 edition or 2015 edition certified EHR for 2018, or allow a combination of the 2014 edition and the 2015 edition EHR technologies to be used for reporting in 2018.

Survey and certification requirements
CMS proposed to require accrediting organizations (AOs) with CMS-approved accreditation programs to make hospital survey reports and acceptable plans of correction (PoCs) public. Under the provisions of the proposed rule, each national AO that applies or reapplies for CMS approval of its Medicare provider or supplier accreditation program must agree to make all Medicare provider or supplier final accreditation survey reports and PoCs within the last three years publicly available on its website.

MHA will be working with its Quality and Patient Safety Committee to determine the impact of the CMS proposal to make hospital survey reports and PoCs public and will submit comments if needed.

With questions, contact Joe Schindler, vice president of finance, MHA, 651-659-1415, or Briana Nord Parish, policy analyst, MHA, 651-603-3498. return to top