Minnesota Hospital Association


November 18, 2013

MHA Newsline

In this issue

Hospital spotlight: RARE Campaign prevents 6,211 avoidable hospital readmissions

A broad-based coalition of hospitals and care providers participating in the RARE Campaign—Reducing Avoidable Readmissions Effectively—have prevented 6,211 avoidable readmissions through second quarter 2013. The RARE Campaign involves 83 hospitals and 93 community partners across Minnesota and is one of the largest coordinated improvement initiatives undertaken by the Minnesota health care community. These results are attributed to participants in the campaign honing their work on five key areas that, if not managed well, are known to be main contributors to avoidable hospital readmissions:

  1. Comprehensive discharge planning
  2. Medication management
  3. Patient and family engagement
  4. Transition care support
  5. Transition communications

The RARE Campaign was recently honored with a Gold Award of Excellence, the top prize in its category, from the Minnesota Health Strategies and Communications Network (MHSCN). The MHSCN Awards of Excellence recognize excellence in health care marketing, communications, web-based strategies and public relations. return to top  

Gov. Dayton proclaims Nov. 21 National Rural Health Day

Thursday, Nov. 21 is National Rural Health Day, a day to highlight the unique health care challenges and opportunities in rural areas. In his proclamation, Gov. Dayton recognized that rural hospitals and health systems are often the largest employers and the core economic foundation of rural communities. For ideas on celebrating National Rural Health Day, visit the Minnesota Department of Health Office of Rural Health and Primary Care website. You’ll also find recognition and celebration examples from last year.

Free webinars will be offered throughout the day. Topics include “The Affordable Care Act in Rural America” and “Rural 101 — The Basics of Rural Health.” Find the full schedule on the National Rural Health Day webinars page. return to top

Raise awareness of preventing pressure ulcers on Nov. 21

Hospitals are invited to join the National Pressure Ulcer Advisory Panel (NPUAP) in promoting World Wide Pressure Ulcer Prevention Day on Thursday, Nov. 21. NPUAP encourages health care providers, patients, families, businesses, public and private agencies, media and educational institutions to increase awareness of pressure ulcers and to participate in pressure ulcer awareness activities throughout the week. Learn more about safe skin practices with MHA’s Road Map to a Comprehensive Skin Safety Program. return to top  

MHA applauds Congressional interest in pay-for-value

A bipartisan group of congressional leaders from key committees in both the House and Senate issued a “discussion draft” outlining the framework for legislation to repeal the Sustainable Growth Rate (SGR) cuts to Medicare physician payments. The discussion draft included a proposal to move Medicare’s physician payment system away from its current fee-for-service (FFS) design and toward methodologies that reimburse providers based on the value of services they deliver as measured by quality, patient satisfaction and cost.  

MHA’s comment letter commended the policymakers for heeding the association’s long-standing call for Medicare payment reforms that reward high-quality, low-cost care delivery systems, like those in Minnesota. While expressing strong support for permanently repealing the SGR cuts to physician payments, MHA withheld its “unfettered support pending further information about how the costs associated with SGR repeal will be addressed.” In particular, MHA emphasized its opposition to additional cuts to hospitals, rural health or the critical access hospital programs, graduate medical education or Medicaid as mechanisms for financing the SGR repeal.

Lawrence Massa, MHA president and CEO, said that the discussion draft is “encouraging on multiple levels. It’s bipartisan and bi-cameral, so it might have a real chance of getting enacted. It shifts away from Congress’s historical approach of just kicking the SGR deadline down the road rather than facing the fact that SGR is a failed policy. And,” Massa continued, “it offers the promise of a dramatic step toward one of our highest priorities for federal health reform: moving away from pay-for-volume and toward paying for value in health care.”   For more information, contact Matt Anderson, MHA vice president of regulatory and strategic affairs, 651-659-1421. return to top  

MHA provides members with direct supervision tool kit

MHA released a new tool for its members seeking to better understand and adapt to Medicare’s new policy requiring direct supervision of outpatient therapeutic services delivered in a hospital. Although the Centers for Medicare and Medicaid Services (CMS) claims that the new policy is merely a clarification of long-standing requirements, the agency has agreed to a moratorium on enforcing the policy through 2013. Although CMS has not issued its final outpatient payment rule for 2014, its 2013 final rule and its proposed rule for 2014 both stated that CMS intends to end the moratorium.  

The whitepaper provides a detailed flow chart to help hospital staff walk through the various elements of the direct supervision standard to determine if it applies to a particular service and, if so, what kind of staffing is required by Medicare.  

MHA and the American Hospital Association continue to seek congressional and regulatory interventions to change the direct supervision standard to a more practical, real-world approach that protects patient safety while recognizing the need for hospitals to innovate how care teams provide services to patients, or in the alternative, to extend the moratorium on enforcement that has been in place for several years.  

In the meantime, MHA believes the whitepaper will help Minnesota hospitals adapt to the new standard if necessary.   For more information, contact Matt Anderson, MHA vice president of regulatory and strategic affairs, 651-659-1421. return to top 

MNsure’s lowest premiums paired with nation’s highest deductibles

As state and federal health insurance exchanges released the premium rates for their qualified health plans in September, Minnesota claimed bragging rights for having the lowest average premium costs in the country. A recent report from the Robert Wood Johnson Foundation (RWJF) and Breakaway Policy Strategies looked beyond premium rates and compared health plans’ deductibles. According to the report, Minnesota’s low premium rates for consumers come with the highest average deductibles in the country.  

Higher deductibles present a challenge for providers when patients cannot afford their out-of-pocket costs for needed care. Minnesota’s hospitals and health systems have seen a greater portion of their uncompensated care expenses coming from insured patients with high deductibles.  

At this time, MNsure has not provided detailed statistics about the plans consumers are selecting, the size of their deductibles, or other information that will allow providers to assess the impacts that the state’s new health insurance exchange will have on residents’ medical and financial health.  

For more information about MNsure, contact Matt Anderson, MHA vice president of regulatory and strategic affairs, 651-659-1421. return to top  

Applicants sought for Minnesota EHR Revolving Loan Program

The Minnesota Department of Health (MDH) is seeking applications for the Minnesota Electronic Health Record (EHR) Revolving Loan Program to support expanded adoption and effective use of interoperable EHR systems and electronic health information exchange (HIE).  

Eligible applicants include federally qualified health centers, community clinics, nonprofit or local units of government hospitals, individual or small group physician practices focused on primary care, nursing facilities and local public health departments. In addition, other providers of health or health care services where interoperable EHR capability would improve quality of care, patient safety or community health may be eligible. Priority applicants include critical access hospitals; federally qualified health centers; entities that serve uninsured, underinsured and medically underserved individuals (urban or rural); individual or small group practices that are focused on primary care; nursing facilities and elderly waiver facilities.

The total EHR Loan Program funding is estimated at $2.5 million. The no-interest loan is for a six-year period beginning after loan fund disbursement, with the first year deferred. Between five and 15 loans will be approved with an estimated award range between $100,000 and $500,000.  

More information on the program and the full application is available here. Applications are due Dec. 19. Contact Anne Schloegel, 651-201-3850, with any questions. return to top  

2014 Value-Based Purchasing (VBP) factors released 

The Centers for Medicare and Medicaid Services (CMS) released the factors that impact Medicare payment for Prospective Payment System (PPS) hospitals on Nov. 14. These factors are used to adjusted PPS hospital payments beginning with Oct. 1, 2013 claims. The VBP program is in its second year. The program is funded by an upfront reduction to hospital payments of 1.25 percent and distributed back to hospitals based on their consolidated VBP score.  

The VBP program for 2014 is composed of three quality domains consisting of 13 process measures, eight consumer engagement (patient satisfaction) measures and three outcome measures of mortality.  The impact to Minnesota hospitals is: half were positive, meaning they earned back their 1.25 percent or more; half did not earn back their full contribution; and eight did not have adequate measures counts to participate. For more information, contact Joe Schindler, MHA vice president of finance, 651-659-1415. return to top

MnSCU begins drafting a statewide plan to increase number of mental health professionals

The 2013 legislature required the Minnesota State Colleges and Universities (MnSCU) system to convene a mental health summit and write a plan to increase the number of mental health professionals working at all levels of the mental health system (SF 1236). HealthForce, Minnesota’s Center of Excellence focused on healthcare innovation, housed at MNSCU, is leading this effort and convened the first steering committee meeting last week.

Specifically, HealthForce is charged with convening a summit involving the Department of Human Services, MNSCU, University of Minnesota, private colleges, mental health professionals, special education representatives, child and adult mental health advocates and providers, and community mental health centers. The purpose of the summit is to:

  • Develop a comprehensive plan to increase the number of qualified people working at all levels of our mental health system;
  • Ensure appropriate coursework and training; and
  • Create a more culturally diverse mental health workforce.

Dr. Joel V. Oberstar, CEO & medical officer, PrairieCare, Maple Grove and Kathe Dellacecca, LICSW, psychiatric service director, Lakewood Health System, Staples are representing MHA on the steering committee.  

The steering committee will meet once a month leading up to the summit in late May 2014. The final plan is due to the Legislature by Jan. 15, 2015.  

For more information, please contact Jennifer McNertney, MHA policy analyst,  651-659-1405. return to top  

Trustee Conference helps hospital trustees set goals and priorities to sustain high performance

This year’s Winter Trustee Conference will feature a keynote presentation from popular national speaker Quint Studer. In his presentation, “The Role of a Trustee in Setting and Measuring Organizational Performance,” Studer will focus on the trustee’s responsibility to assure patients receive the highest quality of care; the medical staff is practicing in an environment that is effective and efficient; and that the staff work in an organization with a culture that promotes quality and safety. He will share information on what metrics to follow and what excellence looks like. He will share the best benchmarks to utilize as well as recommended steps in setting goals and priorities to accelerate performance and sustain high performance.

Studer, is the founder of Studer Group, Inc. and a proponent of Evidence-Based LeadershipSM (EBL). EBL creates a culture of execution that empowers organizations to move quickly and effectively. He works with health care organizations nationwide to implement EBL, many of which have won multiple performance awards. Studer Group was the recipient of the Malcolm Baldrige National Quality Award in 2010 and for six consecutive years—the last three being in the top 10—was named one of the Best Small and Medium Workplaces in the United States by Great Place to Work®.  

The Winter Trustee Conference takes place Jan. 10-12, 2014 at the Marriott Northwest Minneapolis in Brooklyn Park. Click here to learn more about the conference sessions or to register. The cut-off date for accommodations at the Marriott is Dec. 19 so be sure to make your reservations online at the Marriott website or by calling 763-536-8300. Mention you are with the Minnesota Hospital Association for the group rate. return to top  

Honoring Choices promotes advanced care planning this Thanksgiving

In its second annual Thanksgiving campaign, Honoring Choices Minnesota is promoting "Have the Conversation." This campaign encourages all Minnesotans age 18 and over to begin an end-of-life care planning conversation with their loved ones during this Thanksgiving holiday season. For ideas on how your organization can help encourage individuals and families to “Have the Conversation,” visit www.honoringchoices.org. return to top

Continuing education opportunity for progressive care nurses

Winona State University is offering an online preparation course for registered nurses working in progressive care nursing units (telemetry, step-down, trauma) who are seeking PCCN certification, CNEs or credit toward a RN-BSN degree. Please share this opportunity with your nurse managers and ask them to share it with their staff. Learning activities will address clinical hematology/immunology, neurology, gastrointestinal, renal, multisystem and psychosocial/behavioral. The course explores concepts of professional caring and ethical practice in nursing. The online class begins in January 2014. For course and registration information, click here. return to top