Minnesota Hospital Association


September 30, 2013

MHA Newsline

In this issue

Hospital spotlight: PrairieCare working to reduce stigma around mental illness

October marks National Depression and Mental Health month as well as Mental Illness Awareness Week Oct. 6-12 to raise awareness of mental illness. In recognition of these efforts, PrairieCare in Maple Grove reminds the health care community that there are free needs assessments offered to screen for depression, increased stress, anxiety and other mental health issues. Determining what level of care is appropriate for a patient can be challenging to non-psychiatrists. To help facilitate access to care, PrairieCare offers the free assessment to any patient/family requesting evaluation. The assessment is focused on establishing a preliminary diagnosis and making the appropriate referral, over half of which are made outside the PrairieCare system. To learn more about PrairieCare’s needs assessment, visit www.prairie-care.com or call 952-826-8424.    

Many hospitals have found through their community health needs assessments that mental health and mental illnesses are growing areas of concern. 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 your communities. Also, for a toolkit to help raise awareness and reduce the stigma of mental illness, visit the National Alliance on Mental Illness website. You can also visit a new website, http://www.mentalhealth.gov for additional resources. return to top  

Long awaited training available from MNsure

In July, hospitals, health systems and other organizations submitted applications to MNsure to become navigators, in-person assisters or certified application counselors (collectively, "assisters") for the new health insurance exchange. Providers expected to have six to eight weeks to complete the online training and certification requirements before being asked to help individuals enroll in coverage. Instead, after weeks of waiting and frustration for members, MNsure made the required training and certification programs available last week, just days before MNsure launched. The training and certification programs are expected to take assisters 15 hours to complete. Although more than 60 MHA members applied to become assisters, many question whether their staff can complete the online programs and certification process before Oct. 1.

MHA members are encouraged to provide feedback about and impressions of the training and certification process to Matt Anderson, MHA vice president of strategic and regulatory affairs, so the Association can communicate needed changes or improvements to MNsure. returnto top  

CMS attempts to clarify new two-midnight rule, but unanswered questions remain

Just days before the Oct. 1 effective date of a new policy to create a presumption of an appropriate inpatient admission if a patient receives care in the hospital over the course of two midnights, the Centers for Medicare and Medicaid Services (CMS) issued brief written guidance and held a nationwide conference call in an attempt to clarify its policy. Nevertheless, as became clear during the conference call, CMS still does not have definitive answers to hospitals' questions about how the new policy will be implemented and enforced.

Aligning with appeals to Congress made by the American Hospital Association, MHA asked Minnesota's Representatives to urge CMS to delay implementation of the new two-midnight policy to give the agency sufficient time to more fully and thoughtfully develop its interpretation of the rule and issue clear guidance for hospitals. MHA thanks Reps. Betty McCollum and Collin Peterson for supporting this effort.

The written clarifications from CMS are available here. During its conference call, CMS stated that it will be posting additional guidance and responses to some of hospitals' questions on its website at www.cms.gov/medical-review. Finally, CMS offered hospitals the opportunity to email additional questions or concerns directly to the agency at IPPSadmissions@hhs.gov. return to top  

CMS administrator responds to MHA letter, rejects OIG recommendation for critical access hospitals

In response to MHA’s letter opposing controversial recommendations made by the Office of the Inspector General to eliminate critical access hospital (CAH) status for almost all CAHs in Minnesota, the Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner responded with a letter of her own. In her response, Tavenner thanked MHA for bringing our concerns to her attention and assured MHA that the agency has no intention of adopting the Office of Inspector General’s recommendations, or of suggesting that Congress adopt them either.  

While CMS rejects the OIG recommendations, Tavenner reiterated CMS’ support for the administration’s position of eliminating CAH status for hospitals that are less than 10 miles from another CAH or hospital. MHA will continue to work with our members of Congress to ensure access to high quality, low cost care for all Minnesotans. return to top 

Health plan administrative cost report released

The Minnesota Department of Health (MDH) Health Economics Program has released its annual report on health plan administrative costs. In 2011, health plans averaged 7.3 percent of their total costs as administrative costs. Across all health plans in Minnesota, $1.3 billion was spent on administrative costs out of a total of $18.4 billion in spending. For all health plans, including non-profit plans, 4 percent of administrative costs was spent on wellness and health education while 18 percent was spent on product management and marketing. MDH emphasized that it relied on self-reported data from the health plans and that the methodology for calculating administrative costs for this report differs from the federal government’s formula used to calculate medical loss ratios. return to top  

Registration now open for public health reporting for meaningful use

The Minnesota Department of Health (MDH) is interested in working with providers on the public health-related meaningful use objectives and is currently able to receive electronic submissions for three of the public health-related objectives: immunization registry, electronic lab reporting and cancer registry (Stage 2 only).   

A new requirement for Stage 2 meaningful use is that providers must register their intent to submit data to MDH. Registration information can be found here. While this is required for Stage 2, MDH will also be using this registration system for Stage 1 meaningful use and non-meaningful use entities wanting to submit electronic data to the immunization registry, electronic lab reporting and/or the cancer registry.  

These meaningful use objectives are part of the CMS Medicare and Medicaid EHR Incentive Programs to provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified electronic health record technology.  

Email health.meaningfuluse@state.mn.us for questions. return to top  

First Contact hospital discharge protocol delayed

First Contact, the new hospital discharge protocol for people discharged to a Medicaid-certified nursing home, has been delayed. It was scheduled to be implemented on Oct. 1. Hospitals are requested to continue using current practice, including referring high-risk seniors to Senior LinkAge Line, until further notice.  

The measure was contingent upon federal approval. As of Thursday, that approval had not been received and therefore the measure will be delayed.  

MHA members are encouraged to continue checking the Minnesota Board on Aging website, www.mnaging.org, for up to date information. MHA will also send out additional information and include updates in Newsline when they are available. return to top 

Road map helps prevent retention of tucked and packed surgical items

While hospitals have made exceptional progress in reducing retained objects, more work is needed to prevent the retention of tucked and packed items. Data from the adverse health event reporting system revealed that packed items account for the majority of retained objects reported. In response, the Surgical Advisory Group developed a "mini road map" of practices related to preventing the retention of tucked and packed items. These practices will help hospitals put in place effective systems to account for the placement and removal of these items. MHA has distributed the Road Map to Preventing the Retention of Tucked and Packed Items to all SAFE ACCOUNT participants and it is available on our website. Hospitals are asked to begin submitting baseline data to MHA’s web-based portal beginning Nov. 1. If you have any questions about this road map or data submission, contact Julie Apold, MHA senior director of patient safety, 651-603-3538. return to top 

Winona Health names chief financial officer

Winona Health recently named Jan Brosnahan as chief financial officer. Brosnahan has more than 20 years of experience in finance and has served on the Winona Health Board and the Finance/Audit Committee.  Prior to joining Winona Health, Brosnahan was the controls division controller for Watlow, an electronic manufacturing company in Winona. As part of Watlow’s top division management team since 1993, she was recognized as a key process leader in Watlow’s lean management transformation, a process which Winona Health began implementing in 2005 to increase health care value and efficiency. return to top