In this issue:
Fairview Health Services partnered with St. Olaf College since
1999 to create a pipeline of future physicians. The Fairview/St. Olaf J-Term
program provides exposure to St. Olaf students who are considering a career in
health care, particularly as physicians. The efforts earned the partnership the
MHA Health Care Career Promotion Award for a
large hospital earlier this year. The students observe a surgery at the
University of Minnesota Medical Center, Fairview; shadow physicians several
days a week; attend lectures; research and present a health care topic of
interest; keep a journal of their experiences; and write a reflection paper.
This J-term interim course allows students interested in a medical career to
experience the real world of medicine to help them make informed decisions.
Students shadow physicians and other patient care professionals in hospital and
clinic settings, and an attempt is made to place students in their areas of
interest. The program requires each student to spend a portion of his or her
time in a primary care setting. return to top
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 Consumer Assistance Partner
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
The Minnesota Department of Transportation (MnDOT) has
regulatory authority over heliport facilities in the state and has begun more
oversight of heliports recently. Based on conversations with the MnDOT Office
of Aeronautics staff, MHA notified several individual members that MnDOT would
be contacting them to confirm that their hospitals do not operate heliports or
to ensure that all operational heliports are appropriately licensed and comply
with safety regulations. MnDOT plans to inspect all hospital-operated heliports
over time.
In MHA’s communications with members and MnDOT officials, the Association has
emphasized hospitals’ commitment to the safety of helicopter flights for the
patients, pilots and crew, hospital staff and nearby property owners. MHA
committed to help members by researching issues or concerns, clarifying laws
and regulatory interpretations with MnDOT, connecting members with architects
and other consultants familiar with heliport design and regulations to ensure
that their facilities are appropriately licensed, compliant and safe. In
addition, MHA hopes to collaborate with MnDOT to develop guidance for municipal
zoning laws that will protect designated flight paths to and from hospital
heliports from future construction, trees, fences, billboards, or other
potentially dangerous obstructions for helicopters.
Since its communication with members, MHA has received many questions about
hospitals’ responsibility for or compliance obligations with respect to landing
areas that are not located on hospital property; requirements to take remedial
steps, such as cutting trees, lowering fences or installing lights, especially
in areas outside of the hospital campus; and potential funding sources to help
offset hospitals’ costs of remedial actions necessary to continue heliport
operations. The Association is actively working to get the necessary
clarifications and information for members, and is investigating potential
grants or loans to help its members improve the safety of their heliports.
Although MnDOT has had statutory authority to regulate heliports for many
years, the department’s staffing capacity has limited its ability to undertake
routine and ongoing inspections and compliance efforts. With recent staffing
changes, the agency is conducting on-site inspections. Hospitals have 30 days
to address any licensing or safety concerns resulting from the inspection to
retain their heliport license.
MHA members with questions about MnDOT’s heliport licensing or inspection
activities are encouraged to contact Matt Anderson, MHA vice president of strategic
and regulatory affairs, 651-659-1421. State and federal statutes, regulations
and other information about heliport operations can be found on MnDOT’s website. For MHA members seeking
architectural advice about their heliport facilities, several MHA associate
members have experience with such projects and working with MnDOT:
- RSP Architects, Minneapolis,
612-677-7700, www.rsparch.com
- Leo A Daly, Minneapolis,
612-338-8741, www.leoadaly.com
- Horty Elving, Minneapolis,
612-332-4422, www.healthcarearchitects.com
- BWBR, St Paul, 651-222- 3701, www.bwbr.com
- HDR, St Paul, 912-524-5000, www.hdrinc.com
- Pope Architects, St Paul,
651-642-9200, www.popearch.com
returnto top
The Center for Medicare and Medicaid Services (CMS) has
requested feedback on how it should make Medicare’s physician claims data more
transparent, especially for quality and cost improvement initiatives; view
request here. MHA is preparing a comment letter to
provide CMS with members’ perspectives, concerns and suggestions.
In particular, CMS asked for comments on the following issues:
- whether physicians have a
privacy interest in information concerning payments they receive from
Medicare and, if so, how to properly weigh the balance between that
privacy interest and the public interest in disclosure of Medicare payment
information, including physician-identifiable reimbursement data;
- what specific policies CMS
should consider with respect to disclosure of individual physician payment
data that will further the goals of improving the quality and value of
care, enhancing access and availability of CMS data, increasing
transparency in government, and reducing fraud, waste, and abuse within
CMS programs;
- and the form in which CMS should
release information about individual physician payment, should CMS choose
to release it (e.g., line item claim details, aggregated data at the
individual physician level).
MHA encourages members to provide feedback or concerns for MHA
to include in its comment letter by sending them to Matt Anderson, MHA vice president of strategic and regulatory affairs, by
Thursday, Aug. 29. return to top
The new Medicare administrative contractor (MAC) for Minnesota
is National Government Services (NGS). One of their primary functions is
to process claims invoices from hospitals for payment. The change for
hospitals means sending Medicare Part A claims to NGS rather than Noridian Administrative
Services.
As of today, National Government Services announced a successful transition of
the Minnesota Part A Title 18 contractor workload to the new National
Government Services Jurisdiction 6 (J6) MAC on Aug. 10, 2013.
In addition to claims process, NGS will also e handling the reimbursement and
audit functions for processing of the Medicare Cost Reports filed by
hospitals. MHA hosted a meeting on Aug. 5 between hospital reimbursement
managers and the NGS audit lead for Minnesota, Pam Chelf. There was a
good, open discussion of what to expect from the NGS audit team and a sharing
of Minnesota-specific functions that create value for cost report accuracy.
There will be a second cut-over date on Sept. 7 for the Medicare Part B
physicians claims function from Wisconsin Physician Services Insurance (WPS) to
NGS.
For more information, contact Joe Schindler, MHA vice president of finance,
651-659-1415. return to top
The U.S. Department of Veteran Affairs (VA) is engaged in a
campaign to end veteran homelessness by the end of 2015 (see fact sheet). The VA has a number of resources
available to veterans, and is asking for help from community stakeholders to
spread the word on how veterans can access these resources. They have developed
a National Call Center for Homeless Veterans (1-877-4AID-VET) that connects
homeless or at-risk veterans with trained professionals. In addition, several
public service announcements are available for specific professions, including
:
Wallet cards are also available that you can
print out and give to veterans so they know where they can get help. Other outreach
resources can be ordered online. Hospitals are
encouraged to use these resources to help spread the word to let veterans know
that a single call can connect them with the services they have earned. return to top
The Minnesota Board of Nursing and the Emergency Medical Service
Board have posted vacancies. The EMS Board has a vacancy for an emergency
physician certified by the American Board of Emergency Physicians. The Board of
Nursing has an opening for a public member.
It is important for the Board of Nursing to have perspectives from people who
understand care delivery challenges, the emerging importance of team-based care
models, and the need for innovation and flexibility at the local level. MHA
members are encouraged to ask a trustee or other interested person from their
communities to apply.
For more information and to apply, visit the Secretary of State’s website. return to top
MHA appreciates Sen. Al Franken’s support of S. 577, the
Resident Physician Shortage Act of 2013.This legislation would lift the 1996
cap on residency slots and increase the number of Medicare-supported
training positions to at least 15,000 new resident positions. This represents
about a 15 percent increase in residency slots. This legislation is
particularly important to Minnesota’s future health care workforce as
statistics demonstrate that in order for our future doctors to remain in
Minnesota they must first train in Minnesota. The Association of American
Medical Colleges estimates that by 2015 there will be a deficit of 62,900
physicians and by 2025 that shortage is likely to have doubled. MHA continues
to support lifting the 1996 cap on residency slots as a key component to
addressing the projected shortage of physicians. Minnesota Rep. Keith Ellison
is already a co-sponsor of the House companion bill, H.R. 1180. MHA members are
encouraged to contact the rest of the Minnesota delegation to request their
support for the House or Senate version of the bill respectively. If you have
any questions, contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
Invite federal
leaders to your organization during the next five weeks
The U.S. Congress has adjourned for its annual August recess, so
members of the Minnesota congressional delegation are expected to be back in
the state for about the next five weeks. Now is a good time to invite our
federal lawmakers to your organization to see firsthand the nation-leading care
provided in Minnesota hospitals and health systems and showcase the work you do
for, and in partnership with, your communities.
The August recess also provides an opportunity to ask our federal lawmakers to
sign on as co-sponsors to some key pieces of legislation, or in some cases to
thank them for their support. MHA in partnership with the American Hospital
Association is urging our lawmakers to support the following bills:
H.R. 2801/S.1143, the Protecting Access to
Rural Therapy Services Act of 2013 (PARTS), would adopt a default standard
of “general supervision” (rather than “direct supervision”) by a physician
or non-physician practitioner for outpatient therapeutic services. Sens.
Amy Klobuchar (D) and Al Franken (D) have signed on to the Senate version
of the bill and Rep. Collin Peterson (D) introduced the House version of
the bill.
H.R. 1250/S.1012, the Medicare Audit
Improvement Act of 2013, would establish a consolidated limit for medical
record requests, impose financial penalties on Recovery Audit Contractors
(RACs) that fail to comply with program requirements, make RAC performance
evaluations publicly available and allow denied inpatient claims to be
billed as outpatient claims when appropriate. Reps. Betty McCollum (D) and
Peterson have signed onto the House version.
H.R. 1787/S.842, the Rural Hospital Access Act
of 2013, would provide for an extension of the Medicare-dependent hospital
program and increased payments under the Medicare low-volume hospital
program. Reps. Keith Ellison (D) and Peterson have signed onto the House
version and Sens. Klobuchar and Franken have signed onto the Senate
version.
H.R. 2578, the Rural Hospital Fairness
Act of 2013, would reinstate the outpatient “hold harmless” payments to
certain sole community hospitals and rural hospitals with no more than 100
beds. Rep. Peterson has signed onto the House version.
H.R. 1180/S. 577, the Resident Physician
Shortage Act of 2013, would lift the 1996 cap on residency slots and
increase the number of Medicare-supported physician training positions to
at least 15,000 new resident positions. Rep. Ellison has signed onto the
House version and Sen. Franken has signed onto the Senate version.
H.R. 1920, the DSH Reduction Relief Act
of 2013, would eliminate the first two years of the Affordable Care Act’s
cuts to the Medicare and Medicaid DSH programs to allow expansion of
health coverage to become more fully realized.
H.R. 2931, the Fairness in Health Care
Claims Guidance and Investigations Act, would amend the False Claims Act by
assuring that unintentional billing disputes aren’t penalized as harshly
as fraud.
When Congress resumes this fall they will be working to pass a
fiscal year 2014 budget and address the deficit. Our messaging will continue to
focus on how Minnesota hospitals and health systems’ access to care will be
threatened by continued ratcheting of Medicare and Medicaid payments for
hospital services. Instead of blunt, across-the-board cuts, MHA supports
continuing to move the payment system toward one that rewards value over
volume. August recess also provides an opportunity to discuss how recent
federal budget cuts have impacted your facility and the services that you have
had to consider reducing or eliminating.
For more information please contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
The MHA Annual Meeting, which will be held Sept. 18-20 at
Madden’s on Gull Lake in Brainerd, is just over a month away. The deadline to
register for accommodations at Madden’s is Aug. 20.
The program features economist and futurist Lowell Catlett; Blue Zones author
Dan Buettner; and physician and teacher Steve Bedwell.
A favorite at MHA conferences, Lowell Catlett will provide thought-provoking
information on future trends and evolving technologies during his presentation,
“New Game, New Rules, New Reality.”
Through his work as a National Geographic writer Dan Buettner identified best
practices in longevity and well-being in people’s lives. His presentation,
“Blue Zones: Secrets of a Long Life,” will leave you with an action plan for a
longer, healthier life.
Bedwell will outline a psychological blueprint for thinking clearly, involving
powerful and time efficient, evidence-based tactics that you can put to work
immediately. He will share strategies on how to sidestep devastating tactical
mistakes executives sometimes make.
For more information, view the full brochure or visit MHA’s website; click on
Events and log-in to register. Room reservations can be made online at www.maddens.com/mha.html.
Continuing Education
The Minnesota Board of Examiners for Nursing Home Administrators has approved
the conference content for a total of 9.5 clock hours. return to top
The U.S. Department of Health and Human Services recently
recognized 12 Minnesota hospitals for their efforts to
educate and register new organ, eye and tissue donors from September 2012 to
May 2013 as part of the Workplace Partnership for Life Hospital Campaign. The
hospitals increased the number of registered potential donors by educating
staff, patients, visitors and community members about the critical need for
donors. Minnesota hospitals have long been supporters of organ and tissue
donation, working to support families through end-of-life care and honor the
donation decisions of individuals across our state. return to top
Hospitals are invited
to participate in the Sept. 19 Rural Palliative Care Networking Group to discuss
symptom management at the end of life. One of the key pillars of palliative
care is the ability to manage pain and other symptoms. This two-part
educational series will focus on the non-pain symptoms that people experience
at end of life. Part I will cover the gastrointestinal (GI) symptoms of
anorexia and cachexia, dehydration, nausea and vomiting, bowel obstruction,
constipation and diarrhea. Part II (on Jan. 28, 2014) will cover non-GI
symptoms (e.g. anxiety, delirium, depression, dyspnea, fatigue and pressure
ulcers).
The session will convene at 10 a.m. on Sept. 19 in person at St. Gabriel’s
Hospital in Little Falls or via conference call. To learn more, click here, or to register, contact Matt Ellis
at Stratis Health, 952-853-8539. The Rural Palliative Care Networking Group is
coordinated by Stratis Health and supported with funding from UCare. There is
no fee to participate. return to top
The Centers for Medicare & Medicaid Services
(CMS) finalized the fiscal year (FY) 2014 payment rule for inpatient hospital
services. Effective Oct. 1, 2013, the CMS rule finalized a standard
operating payment amount of $5,370.28, a 0.4 percent increase. While the
standardized capital rate is finalized at $429.31, a 0.9 percent increase.
The final FY14 Hospital Inpatient Prospective Payment System (IPPS) rule will increase
hospital payments by $1.2 billion. However, the initial 2.5 percent market
basket update was reduced 0.5 percentage points by a productivity adjustment,
0.3 percentage points by a mandated cut from the Affordable Care Act (ACA), 0.8
percentage points required by the American Taxpayer Relief Act to reclaim
documentation and coding changes from FY10 through FY12, and a 0.2 percentage
point cut to offset projected increases from changes to admission and medical
review criteria for inpatient services.
Some changes sought by hospitals were not included in the final rule. One
example is CMS’ attempt to clarify inpatient admission criteria for reasonable
and necessary payment as an admission spanning two midnights. This however
is counter-balanced with a presumption that admissions spanning less than two
midnights are not medically necessary.
The methodology for calculating Medicare DSH, add-on payments to recognize high
Medicare, Medicaid and uninsured utilization, will be significantly changed in
FY2014. Since the affordable care act’s provision for mandated coverage begins
in 2014, the Medicare DSH formula is being adjusted to better reflect
expectedly higher rates of insured patients. One quarter of the formula
payment will stay the same and 75 percent will be based on a proportion of each
hospitals’ charity care costs. MHA and the hospital field commented that
this provision should be delayed until we have a chance to see the actual
impacts of expanded coverage options.
MHA will send final rule financial impact reports in the next week or so. The
reports will be accompanied by a complete summary of all the major provisions
from this rule. For more information, contact JoeSchindler, vice president of finance, (651) 659-1415. return to top