Minnesota Hospital Association


August 19, 2013

MHA Newsline

In this issue:

Hospital spotlight: Gillette Children’s Specialty Healthcare nurse leader recognized for advocacy

Earlier this year, MHA named Karen Brill of Gillette Children’s Specialty Healthcare the recipient of this year’s Spirit of Advocacy Award. Karen lent her knowledge and expertise from 26 years as a nurse to further legislative outcomes during the 2013 session that will ensure staffing decisions remain with the state’s hospitals and health care professionals. As chair of MHA’s Nurse Staffing Steering Committee, Karen mobilized nurse leaders to oppose the House and Senate bills supporting government‐mandated nurse staffing ratios. In addition to Karen’s work with MHA, she has championed numerous safety and quality initiatives at Gillette Children’s Specialty Healthcare as the vice president of nursing and patient services. return to top

DHS OIG recommendations could eliminate CAH status for many hospitals

In a letter to Minnesota’s congressional delegation, MHA voiced strong opposition to the U.S. Department of Health & Human Services Office of Inspector General (OIG) report that recommends that the Centers for Medicare & Medicaid Services (CMS) seek legislative authority to remove necessary provider critical access hospitals’ (CAHs) permanent exemption from the 35-mile distance requirement.  

Prior to January 2006, states had the discretion to designate hospitals that did not meet the distance requirement as “necessary provider” CAHs. At least 40 states, including Minnesota, created their own mileages requirements. If necessary provider status was eliminated, approximately 75 percent of CAHs would be impacted nationwide. In Minnesota, only eight of our 79 CAHs are more than 35 miles from the next nearest hospital. 

MHA, along with the American Hospital Association, continues to strongly advocate for maintaining the current CAH program. Both organizations have expressed that the OIG report demonstrates a lack of understanding of how health care is provided in rural America. The CAH program provides essential, high-quality access to care for Medicare beneficiaries living in rural areas. The OIG report inappropriately focuses on potential savings Medicare could realize with mileage restrictions, instead of the needs of individual communities.  

MHA plans to reinforce these messages with our delegation during in-person meetings with the health care staff in September. Members are encouraged to speak with members of Minnesota’s congressional delegation while they are home in their districts during the August recess.  

Please contact Ann Gibson, vice president, federal relations and workforce, MHA at (651) 603-3527 with any questions. return to top

Additional MNsure consumer assistance information expected soon

MNsure, Minnesota’s health insurance exchange, is developing a Consumer Assistance Partners (CAP) program to help residents enroll in state public programs and subsidized commercial health plans. MNsure expects to have additional information and details soon for hospitals, health systems and other community organizations that applied to participate in the CAP program.  

MNsure will provide CAP program applicants, including more than 60 members of the Minnesota Hospital Association (MHA), with the ability to create a roster of designated staff who will be trained and certified as navigators, in-person assisters or certified application counselors. After the rosters are submitted, those designated staff members will receive login passwords and instructions to access on-line training modules, which are projected to be available later this month. Although the training modules are still in development, MNsure estimates that the training required for certification will take an individual 15 to 20 hours to complete.  

On Friday, September 6, David Van Sant, who is leading the effort to develop and launch the CAP program for MNsure, will be the featured speaker at an MHA conference (see below for more information). return to top

Register now: enrolling patients through MNsure

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

Susan Hammersten, health care reform program manager, Minnesota Department of Human Services, has been added as a speaker on enrolling patients in MinnesotaCare and Medicaid at the Sept. 6 MHA event on MNsure.  

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. Hammensten will join David Van Sant, navigator broker manager, MNsure, who will provide the most comprehensive and up-to-date information available about how hospitals and health systems will fulfill these roles. 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 calls for appeals rule changes to MNsure

MNsure has released proposed rules that would govern how people can appeal eligibility, coverage and subsidy decisions made by MNsure. In response, MHA has submitted recommendations for changes and improvements to the appeals process before MNsure finalizes the rules.

Some of the changes suggested by MHA include extending the window for filing an appeal from 90 days to 120 days to give lower-income residents more time to get legal advice and navigate the appeals filing process; allowing people who win their appeals to receive retroactive coverage or subsidies; and imposing some limits on the discretion of the MNsure board to reject the recommended decisions from appeals examiners who reviewed the testimony, evidence and legal arguments submitted by the parties.  

MHA expects that MNsure will finalize the rules governing its appeals process before October 1. For more information about the proposed rules, contact Matt Anderson, MHA vice president of regulatory & strategic affairs, 651-659-1421. return to top

MHA, MMA and MMGMA oppose CMS rule that shifts new financial risk to providers

The Affordable Care Act (ACA) requires that federally subsidized health plans give enrollees a 90-day grace period before dropping their coverage for failing to pay premiums. In its final rule implementing this provision of the law, the Centers for Medicare and Medicaid Services (CMS) requires those plans to pay for care and services during the first 30 days of the grace period, but it allows plans to withhold payment to providers pending the payment of premiums during the last 60 days of the grace period. As a result, health care providers will have a considerable amount of new financial risk associated with services and treatment provided during the last two months of the grace period unless the rule is changed.  

MHA, the Minnesota Medical Association (MMA) and the Minnesota Medical Group Management Association (MMGMA) are submitting joint letters to CMS and to Minnesota’s congressional delegation objecting to the final rule and proposing alternative solutions to be adopted.  

MHA, MMA and MMGMA suggest that the rule be changed to require the federal government to continue paying its subsidies toward a portion of the premium during the 90-day grace period, so the health plan would continue to receive a significant portion of its expected monthly revenues, and to require the health plan to continue to pay for care received during the 90-day grace period.   

Another suggestion put forward by provider groups from Missouri -- and supported as a less desirable alternative by the three Minnesota associations -- would change the CMS rule to require health plans to deliver eligibility information, including whether an enrollee is in a grace period, to providers electronically within 20 seconds in most cases.  

For more information about the CMS rule or for a copy of the associations’ joint letter, contact Matt Anderson, MHA vice president of regulatory & strategic affairs, 651-659-1421. return to top

RARE Campaign prevents 5,441 avoidable readmissions

Minnesota hospitals participating in the RARE Campaign have prevented 5,441 readmissions, resulting in 21,764 more nights of sleep at home for patients. These results are from 2011 through the first quarter of 2013. The RARE Campaign continues in 2013 with the goals to:

  • Prevent an additional 2,000 avoidable readmissions in 2013 for a total of 6,000;
  • Continue to make progress toward our goal of reducing the percentage of avoidable readmissions by 20 percent;
  • Help Minnesota residents sleep in their own beds 8,000 more nights this year, for a total of 24,000 more nights in their own beds; and
  • Save an additional estimated $20 million in health care expenditures.

To learn more about the RARE Campaign, visit www.rarereadmissions.org. return to top

MN Hospital PAC Silent Auction donations needed

MHA Annual Meeting attendees are invited to the Chair’s Reception and Minnesota Hospital PAC Silent Auction on Wednesday, Sept. 18 from 8-10 p.m. at Madden’s in the Town Hall Conference Center, lower level.   

MHA is also seeking donation items from members and associate members to be auctioned to raise money for the PAC which supports MHA’s advocacy efforts.    

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

MDH rural hospital planning and transition grants available

The Minnesota Department of Health Office of Rural Health and Primary Care is taking applications for the Rural Hospital Planning and Transition Grant Program. The program helps small hospitals (50 or fewer beds) preserve or enhance access to health services through planning or implementation projects. The grant program supports small hospitals in: (1) developing strategic plans for improving access to health services, or (2) implementing transition projects to modify the type and extent of services provided, based on an existing plan. Coordination with local community organizations is a key component of this grant program. Applicants may apply for grants of up to $50,000, and approximately $300,000 is available in the program as a whole.  

Applications are due October 11, 2013. Application forms and guidance are available on the Office of Rural Health & Primary Care (ORHPC) web site at: http://www.health.state.mn.us/divs/cfh/orhpc/grant/home.htm.  

For more information, contact Will Wilson, MDH, Office of Rural Health and Primary Care, at (651) 201-3842. return to top

MHA members asked to share examples on the impact of federal budget cuts

MHA members are asked to provide examples to the American Hospital Association (AHA) of how your organization’s services and/or programs will be negatively affected by further Medicare and Medicaid cuts. Examples can be shared at www.aha.org/accessexamples.  

Industries, organizations and interests compete for the attention of lawmakers, and one of the most effective ways to ensure that the voice of the hospital community is heard is to make the issues real and personal. When Congress resumes in September, attention will quickly turn to passing a fiscal year 2014 budget and addressing the deficit. Cuts to Medicare and Medicaid reimbursement for hospitals will once again be on the table.  

AHA and MHA will be strong advocates for protecting hospitals’ ability to continue providing critical services and programs to their patients and communities. To accomplish this, we will need to support our message with specific examples of how federal budget cuts have impacted your services.  

For questions regarding MHA’s federal advocacy efforts, please contact Ann Gibson, vice president, federal relations and workforce, MHA at 651-603-3527. return to top

MHA Board discusses new strategic plan

The MHA board of directors met over two days in Minneapolis to lay the groundwork for a new three-year strategic plan.   

MHA’s membership provided input through a member satisfaction survey, environmental assessment, and focus groups. Advocacy and in-depth expertise in issues concerning health care reform and helping members harness the power of data to improve care quality and population health emerged as some of the key strategic priorities for the association.  

The MHA board will continue to develop and refine a strategic plan over the next several months. return to top

NAMI offering adult foster care mental health certification training 

NAMI Minnesota is offering mental health certification training for staff working in adult foster care facilities. The training is scheduled for Monday, Sept. 23 from 8:30 a.m. to 5 p.m. at the University of Minnesota Continuing Education and Conference Center in St. Paul. This mental health certification training meets the seven hours of annual training as required under the law. The $75 registration includes lunch and materials. Legislation passed in 2012 provides adult foster care providers with the option of becoming certified in mental health; it is not mandatory.  

For more information see https://adultmhfostercaretraining.eventbrite.com. return to top