In this issue:
Hospital
spotlight: Fairview Southdale a Minnesota best hospital workplace
Fairview Southdale Hospital in Edina has implemented a variety
of strategies and tactics to transform workplace culture and improve employee
engagement and retention. A positive side benefit is the reduction of employee
injuries and increasing patient satisfaction scores. These programs included
the “Healthy Environment Initiative,” which focuses on transforming workplace
culture and the “Going the Extra Mile Awards Program” that last year recognized
more than 110 employees, volunteers and physicians who have made a significant
achievement that supports Fairview Southdale’s vision and strategic goals. Read more about how Fairview Southdale earned
the large hospital award for MHA’s Best Minnesota Hospital Workplace. return to top
MHA responds to proposed outpatient payment and physician
fee schedule rules
Emphasizing its
continuing opposition to enforcement of new direct physician supervision
requirements and imposition of cuts to physician payments due to the
Sustainable Growth Rate (SGR) legislation, MHA sent two comment letters to the
Centers for Medicare and Medicaid Services (CMS) on behalf of its members. The
first letter addressed issues in the proposed 2014 physician fee schedule rule, and
the other addressed issues in the proposed 2014 outpatient prospective payment system rule.
Each letter addressed aspects of the proposed rules that would have the
greatest impact on Minnesota’s health care delivery system and support
positions taken by the American Hospital Association.
In addition, MHA is working with Minnesota’s congressional delegation to build
support for legislation that would replace CMS’s direct supervision policy for
outpatient therapeutic services with a general supervision standard and to
extend or eliminate implementation of SGR cuts.
For more information, contact Matt Anderson, MHA vice president of regulatory and strategic affairs,
651-659-1421. return to top
MHA
pushes for greater Medicare claims and payment transparency
In response to a request for comments from the Centers for
Medicare and Medicaid Services (CMS), MHA offered support for making Medicare
physician claims and payment data more available for health care cost and
quality improvement efforts. Read the comments here.
A recent court decision overturned a long-standing CMS policy that kept
physician claims and reimbursements from being publicly available. Before
moving forward with making that information more accessible, CMS requested
input on whether physicians had a privacy interest in such data and what
format(s) the agency should use when disclosing the information.
MHA highlighted the transparency and accountability processes that Minnesota’s
hospitals and health systems have championed over the years, including Adverse
Health Event reporting, as well as charge information for the most common
inpatient and outpatient services. MHA stated that these processes have
demonstrated that making information more available for analysis, comparisons
and improvement are appropriate, especially when they pertain to government
programs and spending.
MHA welcomed the release of the data for research and other initiatives aimed
at improving health care quality and reducing the rate of health care cost
growth. However, the Association emphasized that CMS should strive to place the
data in a larger context of the overall value of healthcare services as
measured by cost and quality of care, and to impose appropriate safeguards to
ensure that patient-identifying information remains protected from public
disclosure.
For more information, contact Matt Anderson, MHA vice president of
regulatory and strategic affairs, 651-659-1421. return to top
MHA
supports legislation to require Medicare to pay for follow-up treatment in a
nursing home after observation status
MHA appreciates the support of Sen. Amy Klobuchar and Reps. Tim
Walz, Betty McCollum, Keith Ellison, Collin Peterson and Rick Nolan on
legislation to count a period of observation services in a hospital toward
satisfying the three-day inpatient hospital requirement for coverage of skilled
nursing services under Medicare.
When a patient visits the hospital, physicians and caregivers are required to
follow Medicare’s specific rules and protocols for designating their status as
inpatient or observation. Follow-up treatment in a nursing home is not covered
by Medicare unless someone has been an inpatient for at least three days. To
help hospitals inform patients of their status, MHA partnered with other key
stakeholders to develop a standard consumer-friendly document. However, MHA
believes that these regulations need to be changed to get to the root of the
problem.
H.R. 1179 and S.569, the Improving Access to Medicare Coverage Act of 2013
would resolve the frustrations and hardships that the current outdated Medicare
regulations cause seniors. The bills have support from both political parties.
Members of the MHA staff will be in Washington D.C. this week to meet with
health care staff and will request that remaining Minnesota members of Congress
sign onto the bills. return to top
Choice,
affordability featured in MNsure plans
Last Friday, the Minnesota Department of Commerce released
information about the health plans that will be offered on MNsure, Minnesota’s
health insurance exchange, beginning Oct. 1. Proponents of MNsure quickly
pointed to the number of products being offered and the lower-than-expected
premium costs as early signs of that the exchange will be successful.
Five Minnesota-based health plans — Blue Cross Blue Shield, HealthPartners,
Medica, Preferred One and UCare — will offer approximately 140 different
insurance products. Although residents in Hennepin and Ramsey counties will
have the greatest number of products to choose from, MNsure officials
emphasized that there will be choices and competition throughout the state.
As expected, the premiums for the new plans vary based on nine different
regions of the state. However, the net costs to consumers after factoring in
federal premium subsidies available through MNsure were lower and more
affordable than many had expected.
More information about MNsure, available plans and premium costs can be found
at www.mnsure.org. return to top
MCHA
transition plan announced
The Minnesota Department of Commerce has released its plan for
transitioning enrollees in the state’s high-risk insurance pool, MCHA
(Minnesota Comprehensive Health Association), to other insurance. The
transition is occurring because in 2014 insurance plans will no longer exclude
people with pre-existing conditions, making a separate pool for hard-to-insure
individuals unnecessary.
Current enrollees are encouraged to find new coverage through MNsure, the
state’s health insurance marketplace, or a private broker. Open enrollment
begins Oct. 1, 2013, and MCHA enrollees who choose a plan by Dec. 15, 2013 will see their new
coverage begin Jan. 1, 2014. Current MCHA enrollees who have
trouble finding a new plan that meets their needs will be able to appeal to
MCHA and also seek assistance from the Dept. of Commerce and MNsure. MCHA
coverage will close for all enrollees at the end of 2014.
For more information, click here. return to top
MNsure,
DHS officials address members’ questions at MHA seminar
Just weeks before the launch of MNsure, Minnesota’s health
insurance exchange, hospitals and health systems have many outstanding
questions about the details associated with upcoming changes to state public
programs and new health coverage enrollment activities. Last Friday, MHA
members had raised those questions with the state officials responsible for
implementing the new policies. The seminar was underwritten in part with funds
from a grant provided to MHA by the American Hospital Association.
Susan Hammersten, health care reform implementation manager for the Minnesota
Department of Human Services (DHS), presented information about key elements of
Medical Assistance and MinnesotaCare that will change in 2014. Most
specifically, she discussed new authority for hospitals to presumptively enroll
patients into Medical Assistance, thereby ensuring that they will have coverage
through the following month pending a final eligibility determination.
David Van Sant, navigator broker manager for MNsure, discussed the exchange’s
Consumer Assistance Partners (CAP) program and the roles hospitals and health
systems can play to help patients enroll in health coverage through MNsure. Van
Sant emphasized that the CAP program remains open for organizations interested
in becoming trained and certified navigators or consumer assistance counselors.
He predicted that the online training and certification process for CAP
participants would begin this week.
For more information about MNsure, state public program changes or other health
care reform issues, contact Matt Anderson, MHA vice president of
regulatory and strategic affairs, 651-659-1421 or JenMcNertney, MHA policy analyst, 651-659-1405. return to top
Hospital
inpatient admission order clarification issued
The Centers for Medicare and Medicaid Services (CMS) have issued
a clarification regarding Medicare Part A payment for admission orders given by
non-physicians. Admissions made from an order documented by a physician
assistant (PA) or other qualified non-physician will be covered.
Some members have expressed concern that the recent CMS inpatient payment rule
prohibits Medicare Part A coverage for admissions ordered by a physician
assistant. A Sept. 5 memo from CMS clarifies that Medicare
Part A will reimburse for admissions when the order is documented by an
individual who is not a physician — such as physician assistants, residents or
registered nurses — provided the documentation is consistent with state law,
hospital policies, and medical staff bylaws and rules. MHA believes this rule
does not change current Minnesota law or practice regarding use of PAs in
admitting patients.
return to top
Mental health resource sheet available
MHA and the National
Alliance for Mental Illness (NAMI) Minnesota have produced a resource sheet for raising awareness of or
addressing mental illnesses and behavioral health in their communities. Many
hospitals have found through their community health needs assessments that
mental health and mental illnesses are growing areas of concern. Members are
encouraged to use the resource sheet as a guide for raising awareness within
their communities and hospital settings. The sheet provides helpful tips such
as bringing NAMI MN members into the hospital to raise awareness among staff;
offering patients with a mental illness a “welcome packet” that provides basic
information on what to expect during a mental health stay; and links to free
brochures and booklets that can be downloaded and printed for hospital visitors
and patients.
For more information contact Jen McNertney, MHA policy analyst,
651-659-1405. return to top
IRS
issues large employer insurance reporting requirements proposed rule
The Internal Revenue Service (IRS) has issued proposed rules
implementing the Patient Protection and Affordable Care Act’s information
reporting requirements for minimum essential coverage and for large employers coverage subject to the law’s
shared responsibility provisions, which were recently delayed until 2015. The
ACA requires insurers, self-insuring employers including hospitals that
self-insure for their employees, and others that provide health coverage to
provide a list of covered individuals and the months they were covered. It also
requires employers with more than 50 full-time workers to provide information
about the coverage offered to each, by month, including the cost of self-only
coverage. Among other provisions, IRS said the rules would eliminate the need
to determine whether particular employees are full-time if adequate coverage is
offered to all potentially full-time employees, and allow employers to report
the specific cost to an employee of purchasing employer-sponsored coverage only
if the cost is above a specified dollar amount. The agency is encouraging
covered entities to voluntarily implement information reporting in 2014, when
reporting will be optional, to enable real-world testing of reporting systems
before the provisions are fully implemented in 2015. return to top
LPN
and rural birth hospital representatives needed for statewide boards
The Minnesota Board of Nursing has a vacancy for one licensed
practical nurse member for a term ending Jan. 6, 2014. The board licenses
professional and practical nurses; registers public health nurses; renews
licenses; regulates advanced practice registered nurses (certified nurse
midwives, certified nurse practitioners, certified clinical nurse specialists,
and certified registered nurse anesthetists); provides data services; approves
nursing education programs; processes complaints about nurses; and imposes
disciplinary action against nurse licenses.
There is also a vacancy on the Newborn Hearing Screening Advisory Committee for
a rural birth hospital representative.
View the vacancy announcements here. Application forms are available on the secretary of state website or may be obtained
from the Office of the Secretary of State, Open Appointments, 180 State Office
Building, 100 Rev. Dr. Martin Luther King, Jr. Blvd., St. Paul, MN 55155-1299,
or in person at Room 180 of the State Office Building. return to top
Webinar will discuss coordination of health insurance
exchange messages
Enroll America, a
non-partisan organization aiming to maximize the number of uninsured Americans
who enroll in health coverage made available by the Affordable Care Act, is
hosting a webinar this Thursday, Sept. 12 to discuss how navigators, assistors
and other enrollment stakeholders can coordinate to ensure consumers get the
information they need to enroll. “We’ve got Navigators, Now What?” will address
how groups in different kinds of states and with different roles can work
together. Participants will hear from consortia in different states about how
they’re planning for the coming months, and will offer concrete ways for all
kinds of organizations to get engaged, both with Enroll America and with other
stakeholders. Click here to learn more
or to register for this free event. A recording of the webinar will be
available if you are unable to attend the live event from 12-1:15 p.m. return to top
Choosing
Wisely webinar to address appropriate use of early induction and C-Sections
The Institute for Clinical Systems Improvement
(ICSI) is holding a free webinar on two procedures — early induction of labor
and C-sections — that the ABIM Foundation’s national Choosing Wisely campaign
have indicated are overused and, at times, may be harmful.
Penny Wheeler, MD, Chief Clinical Officer at Allina Health, will discuss
Allina’s quality improvement strategies and patient engagement efforts that
have achieved dramatic improvements in the rates of these two procedures.
This is the first in a series of webinars on 11 Choosing Wisely recommendations that ICSI is
initially focusing on. The goal of Choosing
Wisely is to help providers and patients engage in conversations to
ensure appropriate care on numerous medical conditions. As part of Choosing Wisely, the
American College of Obstetricians and Gynecologists and the American Academy of
Family Physicians have both indicated that these two procedures are not being
used appropriately.
The webinar will take place Wednesday, Sept. 18 from noon-1 p.m. Registration closes Sept. 16; sign up today. Contact Emily Mallen,
ICSI, 952-814-7079 with any questions. return to top