Minnesota Hospital Association


May 07, 2018

MHA Newsline: May 7, 2018

In this issue 

MHA honored with MHSCN award

The Minnesota Health Strategy and Communications Network (MHSCN) on April 20 honored MHA with the 2018 Award of Excellence for Best in Digital for a video campaign featuring opioid abuse prevention and treatment efforts at CHI St. Gabriel’s Health.   

Health systems, hospitals and physicians across Minnesota are on the front lines of the opioid crisis. MHA identified an opportunity to highlight local solutions to substance abuse disorder and opioid misuse by profiling the work of a member hospital, CHI St. Gabriel’s Health, through a series of short and full-length videos.   

Awards were judged based on situation analysis, objectives/strategy/tactics, results, overall quality and submission.   

MHA is pleased to share this award with CHI St. Gabriel’s Health and all hospital and health system members supporting the Minnesota’s Hospitals: Strengthening Healthy Communities campaign. return to top   

National Hospital Week is May 6-12

National Hospital Week, May 6-12, celebrates hospitals, health systems and their care team members who support the health and well-being of their communities through dedication and care from the heart. MHA thanks Minnesota’s physicians, nurses, therapists, engineers, food service workers, volunteers, administrators and so many more for their contributions to delivering safe, high-quality care and strengthening healthy communities across our state. return to top   

Legislative update

With adjournment of the legislative session just a little over two weeks away, the Senate Finance Committee passed a significant amendment to SF 730, removing the "penny-a-pill" provision from the opioid manufacturer responsibility legislation and instead adding a new licensure fee on both opioid manufacturers and distributors. The new license fees are not to exceed $12 million a year on manufacturers and $8 million a year on opioid wholesalers. While there are numerous exceptions, the legislation also mandates the use of the Prescription Monitoring Program (PMP) and calls for prescribers who want to use an enhanced vendor-supported PMP to pay a fee of no more than $50 a year. As of now, the House companion bill, HF 1440, does not mandate the PMP. The Senate bill was sent to Rules Committee and the House bill awaits action in the Ways and Means Committee.   

The House passed its version of the omnibus supplemental health and human services bill, HF 3138. This bill also includes provisions relating to transportation funding. It is unclear whether there will be one conference committee addressing all areas of the budget like the Senate has done in SF 3656 or whether there will be topic-specific conference committees. Regardless of the approach, the work will be swift with little time remaining and limited expenditures in the health and human services area.   

Last week the House released its $800 million capital investment bill. MHA is pleased with the inclusion of $25.1 million for behavioral health crisis program facilities. These facilities will be developed by the counties with one priority for selection being a detailed service plan outlining staffing. MHA is hopeful that a similar provision will be included in the Senate bonding bill. Several MHA members are currently working with their counties on the development of these new facilities, addressing both services to be provided and staffing needs. MHA has long recognized the need for more community-based mental health services and hope these new crisis facilities will address some of the unmet demand for mental health services. The House bonding bill also includes $50 million in infrastructure bonds for affordable housing and $16.75 million for asset preservation projects at the Anoka Metro Regional Treatment Center.  

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 2018 legislative bills MHA is tracking, visit the MHA Member Center. For assistance accessing the Member Center, contact Ashley Beno, member services and communications specialist, MHA, 651-603-3545. return to top   

MHA to host Level IV trauma guidelines webinar

Proposed Level IV trauma designation guidelines have been under development for two years. The draft recommendations are now available for public comment. More information was shared in the April 30 issue of Newsline. There are 90 hospitals in Minnesota designated as Level IV trauma centers.   

MHA will host a webinar on May 16 from 11 a.m. – noon during which Minnesota Department of Health staff will outline the development process and principles behind the draft guidelines. Webinar participants can ask questions and share comments. To register for the webinar, contact Andrea Wombacher, division assistant, MHA, 651-603-3539.  

For more information, contact Joe Schindler, vice president of finance, MHA, 651-659-1415. return to top  

MDH requests reports on all hospital-treated drug overdose deaths beginning June 1

The Minnesota Department of Health (MDH) on May 3 issued a request that beginning June 1, all hospital-treated fatal cases of drug overdose should be reported to MDH within 1-2 business days. This includes deaths occurring in the emergency department and inpatient areas, such as intensive care units.   

Drug overdose deaths continue to rise in Minnesota. In 2016, the number of drug overdose deaths was nearly six times higher than in 2000. Between 2015 and 2016 alone, there was a 16 percent increase in fatal drug overdoses. Prescription opioids continue to account for the greatest number of fatal overdoses, with 194 deaths in 2016. The fatal drug overdose epidemic is not limited to opioids – overdose deaths increased in almost all drug categories from 2015 to 2016, revealing an urgent public health problem.   

In response to this crisis, the commissioner of health ordered MDH to investigate “drug overdose, substance abuse, and other poisoning” in Minnesota. Last fall, MDH initiated a pilot project at select hospitals in Minnesota to track all emergency department-treated cases of recreational drug use, both fatal and nonfatal. These data – as well as data from all hospitals to be reported beginning June 1 – will be used to better understand the patterns of substance abuse and drug overdose in Minnesota and inform a public health response.   

To learn more, read the full request from MDHreturn to top   

CMS releases proposed Medicare inpatient rule for FY 2019

The Centers for Medicare and Medicaid Services (CMS) released its inpatient prospective payment system (IPPS) proposed rule on April 24. MHA will analyze the proposed rule, write a comment letter and respond to the proposed rule’s Request for Information (RFI). MHA invites member hospitals to share concerns with the proposed rule and RFI over the next two months. Comments are due to CMS by June 25. The final rule will be published around Aug. 1, with the policies and payment rates effective Oct. 1.  

The net increase to hospital payments in fiscal year (FY) 2019 is expected to be 1.75 percent for hospitals that were meaningful users of electronic health records (EHR) in FY 2017 and that submit data on quality measures. The proposed rule includes a market-basket update of 2.8 percent, minus 0.8 percentage points for productivity and 0.75 percentage points as required by the Affordable Care Act. It also includes an increase of 0.5 percentage points to partially restore documentation and coding cuts mandated by the American Taxpayer Relief Act of 2012.   

The proposed rule retroactively implements portions of the Bipartisan Budget Act of 2018 (BBA), which extended the low-volume payment adjustment and the Medicare Dependent Hospital program. The proposed rule states that in order to receive the enhanced payments for FY 2018, a hospital must notify its Medicare Administrative Contractor that it qualifies by May 24, per the instructions outlined in the notice. Under the proposed rule, the inpatient PPS post-acute care transfer policy will apply to discharges to hospice care beginning in FY 2019 as mandated by the BBA.   

DSH payment changes
CMS proposed to increase Medicare disproportionate share hospital (DSH) payments by $1.5 billion. Under the DSH program, 75 percent of Medicare DSH funds flow into a separate funding pool for DSH hospitals that is adjusted as the percentage of uninsured declines and is distributed based on the proportion of total uncompensated care each Medicare DSH hospital provides. CMS proposed to increase the amount of the 75 percent pool to reflect increases in the percentage of uninsured.   

Hospital quality reporting program and EHR incentive program changes
The IPPS proposed rule took several steps that would ease regulatory barriers and allow hospitals and health systems to better provide high-quality, efficient patient care. CMS proposed implementation of interoperability and regulatory relief reforms.   

The agency proposed to begin implementing its Meaningful Measures initiative across its hospital quality reporting and pay-for-performance programs. CMS' proposal would result in the removal of 18 measures from the inpatient quality reporting program and the deduplication of 21 measures. CMS proposed updating the scoring approach for the hospital-acquired conditions, readmissions and value-based purchasing programs.   

In addition, CMS proposed to rename the EHR Incentive Programs to "Promoting Interoperability Programs" and introduce a more flexible, performance-based approach to determining whether a hospital has met the requirements to avoid a payment penalty under Medicare. Under the proposed rule, hospitals would have to use 2015 Edition Certified EHR Technology and report performance for a 90-day reporting period in both 2019 and 2020. Additionally, CMS proposed to require that hospitals report only four electronic clinical quality measures for one quarter and reduce the number of eligible eCQMs.   

Efforts to improve transparency
The proposed rule would require hospitals to publish their standard charges online to improve transparency. Charges would have to be posted by Jan. 1, 2019, and updated at least annually. The CMS-proposed transparency guidelines largely align with the information provided on MHA Hospital Price Check website.   

As part of the proposed rule, CMS issued a request for information (RFI) on barriers preventing providers from informing patients of their out-of-pocket costs. The RFI asked what changes are needed to support greater transparency around patient obligations for their out-of-pocket costs; what can be done to better inform patients of these obligations; and what role providers should play in this initiative.   

With questions or comments, contact Joe Schindler, vice president of finance, MHA, 651-659-1415. return to top   

March of Dimes accepting Nurse of the Year nominations

The March of Dimes will host the annual Minnesota Nurse of the Year Awards on Sept. 28 to celebrate nursing excellence and recognize leaders in nursing from across the state.   

Award nominations are due July 1. Patients, families and colleagues are encouraged to nominate nurses in 17 categories. Individuals may choose to nominate more than one person or nominate the same person in more than one category.   

MHA members sponsoring the awards include CentraCare Health, Children’s Minnesota, Fairview Health Services, Gillette Children’s Specialty Healthcare, HealthEast Care System, HealthPartners and Hennepin Healthcare.   

Learn more and complete a nomination onlinereturn to top