Minnesota Hospital Association


May 08, 2017

MHA Newsline: May 8, 2017

In this issue 

National Hospital Week is May 7-13

This year, National Hospital Week comes at a time of debate about the future of health care.   

Minnesota’s hospitals and health systems have long supported meaningful coverage for all Minnesotans where patients can afford to use their insurance, receive care close to home and have access to preventive and wellness care that keeps them healthy. Minnesota’s hospitals are engaged in conversations about health care with state and federal lawmakers.   

Recently, Congress and the Minnesota Legislature have proposed reforms to health care coverage – so we asked Minnesotans how these proposals could affect their families. We will be sharing what we learned this week on the Minnesota’s Hospitals: Strengthening Healthy Communities Facebook page. Like our page to learn more about our findings. return to top  

Improving wellness in Long Prairie

CentraCare Health – Long Prairie is creating community well-being and promoting healthy lifestyles. The hospital’s goal is to provide programs, services and amenities designed to support well-being through the six dimensions of wellness: occupational, physical, social, intellectual, spiritual and emotional. In collaboration with community members, regional organizations, area businesses and foundations, CentraCare Health – Long Prairie and BLEND (Better Living, Exercise, Nutrition Daily) have taken the lead role to help the nearly 24,000 residents in Todd County make the healthy choice the easy choice everywhere, every day. Recent initiatives include:   

Intentional Social Interaction (ISI)
CentraCare Health – Long Prairie has been learning the value of intentional social interaction (ISI) through a yearlong project funded by a CentraCare Health Foundation grant. Through the ISI events that started in October 2015, CentraCare Health – Long Prairie has learned more about different cultures in the community and strengthened relationships.   

Community Wellness Fair and 5K/1K
CentraCare Health – Long Prairie hosted a Wellness Fair in June 2016 attended by over 300 community members. Attendees could visit more than 40 booths covering various area health initiatives and participate in a 5K, 1K, a fitness workout station and a bike rodeo.   

Share Health Community Supported Agriculture (CSA) pilot project
CentraCare Health – Long Prairie has committed to invest $10,000 annually for three years to provide CSA shares to 25 local families self-identified with food insecurities. Biweekly CSA shares were provided by SPROUT in Little Falls and distributed to families at the farmers market. Since the majority were Spanish-speaking families, materials were translated and interpreters helped with communication at food pick-up. A SNAP-Ed grant was awarded to BLEND to hire a part-time program manager and a SNAP-Ed educator provided cooking demonstrations.   

Visit the MHA website to learn more and read the full 2016 Community Benefit Reportreturn to top

Conference committee considers HHS budget bill

Last week, the health and human services omnibus budget bill conference committee adopted a joint position on the spending bill. Conference committee members did not vote on final passage of the bill, so the bill still remains with the conference committee to consider input from the governor as budget negotiations continue.     

Significant progress was made and key issues to MHA received favorable action: 

  • Full funding for hospital rebasing beginning on July 1, 2017.  
  • Removal of provider payment rate cuts to physicians, outpatient hospital services, therapists, etc.   
  • Removal of the $204 million in contingent provider rate cuts if reform ideas did not produce that amount of state savings. 

MHA has concerns with two policy items currently in the bill and will continue to work with the conferees in an effort to remove or amend these items: 

  • A new hospital outcome quality initiative based on Medicaid claims with the stated goal of reducing avoidable complications. MHA has opposed this provision for being duplicative, complicated and proprietary. Hospitals already have numerous quality measures that are publicly reported under the State Quality Reporting Measurement System (SQRMS) and new federal Centers for Medicare and Medicaid Services (CMS) measures. This legislation would likely result in hospitals needing to purchase a proprietary software product from 3M to assist with data analytics. The legislation also calls for the Department of Human Services (DHS) to establish incentive and penalty payments for hospitals in a budget-neutral manner.  
  • A clinic transparency requirement for health care providers to maintain a list of the 35 most frequent procedures and the 10 most frequent preventive services, along with the provider’s charge for each. (Hospitals and surgical centers are not included because they are subject to a similar requirement under Minnesota Statutes, section 62J.82.) This information is to be updated annually, available on-site and posted on the provider’s website. This provision has an effective date of July 1, 2017. MHA expressed that – at a minimum – the effective date should be extended to July 1, 2018. 

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 still needed
MHA asks members to remain vigilant with legislative contacts. It is important to thank legislators for greatly improving the health and human services bill and for not making any cuts to health care providers at this crucial time. Please encourage legislators to invest additional resources into the HHS bill to support Minnesota’s mental health infrastructure.   

Visit the MHA Member Center for legislative resources. 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 Ashley Beno, member services and communications specialist, 651-603-3545. return to top   

House approves American Health Care Act

The House on May 4 approved the American Health Care Act (AHCA) by a party-line vote of 217-213. Twenty Republicans joined all House Democrats in opposing the bill. Minnesota’s three Republican representatives voted in support of the bill.   

The Senate will likely consider the AHCA in June after the Congressional Budget Office (CBO) releases a new estimate of the cost and impact on coverage. The previous CBO score predicted that under the AHCA, 24 million more individuals will be uninsured relative to the number of uninsured under the Affordable Care Act (ACA). It also estimated that federal Medicaid spending will be reduced by approximately $880 billion over the next 10 years.   

The House-passed bill will likely be modified to secure enough Senate Republican support to be approved. Some Senate Republicans have expressed concerns about how the AHCA would affect Medicaid expansion states and whether it would raise premiums to unaffordable levels for older Americans and those with expensive health conditions. Additionally, the AHCA will likely require modification to comply with reconciliation’s budgetary rules. The AHCA will be considered under the reconciliation process, allowing it to be passed with only 51 votes, not the 60 needed under regular order. Assuming no Senate Democrats vote for the AHCA, only two Senate Republicans can vote against the bill with Vice President Mike Pence voting to break a tie.   

MHA remains opposed to the AHCA
MHA maintains its position of opposing the AHCA and will continue to advocate for meaningful insurance coverage for all Minnesotans; coverage of all essential health care services; and for enhanced public health insurance program payments to providers to cover costs associated with caring for public program participants. MHA will continue to work with Sens. Klobuchar and Franken to protect the interests of Minnesota’s hospitals and the patients they serve, including federal funding for MinnesotaCare, as the Senate considers the AHCA.   

Amendments to the AHCA
House Republicans secured enough votes to pass the AHCA after two additional amendments were offered. The first allows states to apply for waivers that would allow them to establish state-specific essential health benefit (EHB) standards, meaning insurers will not be required to cover the ten EHBs required under the ACA; to waive the community rating rules with respect to age, under which insurers are currently capped at charging older consumers three times more than what they charge younger consumers and under the AHCA a 5:1 ratio would be allowed; and to waive the 30 percent premium penalty for individuals who fail to maintain continuous coverage and instead allow insurers to medically underwrite the premiums for such individuals, which will enable insurers to charge individuals with pre-existing conditions significantly more.   

The second amendment provides $8 billion over five years to help states establish high-risk pools aimed at reducing premiums and other out-of-pocket expenses for people with pre-existing conditions. States granted a waiver from the EHB coverage requirements, community rating requirements and pre-existing condition protections would be eligible for the funding.  

AHCA provisions
The House-passed AHCA maintains the original bill’s repeal of the Medicaid expansion and the transformation of Medicaid from an open entitlement to a per capita cap payment system, both beginning on Jan. 1, 2020.   

The bill would essentially eliminate federal funding for Minnesota’s Basic Health Plan, MinnesotaCare, in 2020, reducing federal payments by $500 million per year and shifting the responsibility to the state for covering MinnesotaCare’s 100,000 individuals with only state resources.    

The AHCA would repeal the individual and employer mandates and replace the ACA's cost-sharing subsidies based largely on consumers’ incomes and premium costs with tax credits that increase with age.   

The bill would charge individuals, including those with pre-existing conditions, who let their coverage lapse for more than 63 days in a year a 30 percent surcharge to regain insurance coverage.   

The AHCA provides $130 billion over 10 years aimed at stabilizing the insurance market. States could use the funding to establish reinsurance programs; provide direct financial assistance to consumers, insurers and providers; or fund health care delivery or wellness promotion programs.   

The Cadillac Tax, an excise tax on high-cost insurance plans provided by employers to workers, is delayed through 2025.   

In 2017, the AHCA repeals the ACA’s taxes on medical devices, prescription and over-the-counter drugs, tanning services and HSAs.   

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   

Register for May 18 patient and family engagement webinar

MHA will present a webinar on May 18 from 11 a.m. – noon focusing on helping patient partners succeed in their role as Patient and Family Advisory Council (PFAC) members. Kelly Parent, a nationally recognized PFAC expert from the Institute for Patient- and Family-Centered Care will present on recruiting, training and orienting patient partners. She will be joined by Georgiann Ziegler, a patient partner, who will share the value of training from a patient perspective.   

Participants will have the opportunity to respond to the networking question, “What is your process for onboarding new patient partners?”   

This networking webinar of the MHA Community of Patient Partners is open to all leaders, staff and patient partners who are interested in PFAC implementation and management. Participants need to register in advance. To learn more, contact Joy Benn, quality and patient safety specialist, MHA, 651-659-1441. return to top