In this issue
Hospital
spotlight: FirstLight Health System works to reduce CAUTIs
Health care-associated infections are the most common
complication of hospital care. Hospitals across Minnesota are engaged in reducing
catheter-associated urinary tract infections, and, as a result, there has been
a 23 percent reduction among MHA hospital engagement network participating
hospitals. FirstLight Health System in Mora sought to implement a nurse-driven
protocol to remove catheters when no longer necessary and engage staff to
ensure they were removed in a timely manner. Read more about FirstLight’s efforts. return to top
Congress
passes budget including a short-term patch to prevent cuts to physician’s
payment rates
In a separate bill
Congress is working toward a permanent legislative fix for the physician payment
formula that currently contains relief for supervision rules related to
outpatient therapeutic services
On Thursday, Dec. 12, Congress passed a bipartisan budget deal
by 332-94, reducing the risk of a government shutdown. The deal contains
several hospital-related provisions and is a mixed bag of news with some big
disappointments.
Minnesota Reps. Walz, Kline, Paulsen, McCollum, Peterson and Nolan voted in
favor of the bill, and Minnesota Reps. Ellison and Bachmann voted against the
measure.
The Bipartisan Budget Act of 2013 contains $85 billion in spending cuts and new
revenue to replace $63 billion in sequester cuts. In addition, an amendment to
the bill allows for a three-month patch to prevent cuts to physician’s Medicare
rates that are scheduled to be reduced by 20.1 percent on Jan. 1. The following
hospital-related provisions were included in the bill:
- Disproportionate Share Hospital
(DSH) payments – Eliminates
Medicaid DSH payment cuts in Fiscal Year (FY) 2014 and delays the
scheduled FY 2015 DSH reductions until FY 2016. However, Medicaid DSH cuts
would also be extended by one year to FY 2023.
- Medicare sequester cuts – Extends the 2 percent sequester
cuts to Medicare providers through 2023 — two years longer than cuts set
by the Budget Control Act of 2011. This results in an estimated $154.7
million loss for Minnesota hospitals.
- Long-term Care Hospital
payments – New
criteria requiring that patients who stay longer than three days in an
intensive care unit or are on a ventilator, will qualify for a higher
payment rate, while all other cases will be reimbursed at the equivalent
of an inpatient stay.
- Extender provisions – Retroactively extends the
Medicare-dependent hospital program payments through March 2014; extends
the Medicare low-volume hospital payment through March 2014; extends the
Medicare therapy cap exceptions process through March 31, 2014; extends
increased Medicare rates for ambulance services, including those in “super
rural” areas, until April 1, 2014. The Medicare-dependent hospital program
extension is worth $555,000 to Minnesota hospitals and the low-volume
extension is worth $5 million.
As of Dec. 16, the Senate is expected to approve the bill early
in the week and President Obama has indicated he will sign the bill into law.
In the meantime, the House Ways and Means Committee and the Senate Finance
Committee approved different versions of bipartisan legislation to permanently
repeal and replace the Medicare Sustainable Growth Rate (SGR) formula for
physician payments. Both bills would replace the SGR with a value-based program
starting in 2017. The House bill would provide for a 0.5 percent annual update
through 2017, and the Senate bill would freeze current payment levels through
2023.
The Senate bill contains a provision that has been long-supported by MHA and
American Hospital Association to address the issue of direct supervision of
outpatient therapeutic services.
The Congressional Budget Office estimates that replacing the SGR will cost
about $116 billion over 10 years, and, at this time, neither bill specifies a
funding source for the changes. The House and Senate will take the bills back
up after the holiday recess. For questions, contact Ann Gibson,
MHA vice president of federal relations and workforce, 651-603-3527. return to top
2013
amendments to SQRMS published
The Minnesota Department of Health published the 2013 amendments
to the Statewide Quality Reporting and Measurement System (SQRMS), a
standardized set of quality measures for health care providers across the
state. The Commissioner of Health is required to annually evaluate the measures
included in the standardized set of quality measures. These rules were adopted
in December 2009 and amended in November 2010, 2011, 2012 and 2013. The 2013
amendments to Minnesota Rules, Chapter 4654, Permanent Rules Relating to Health
Care Quality Measures, were approved by the Office of Administrative Hearings
on Oct. 25. A summary of the changes can be found here. The final and adopted rule and
appendices as well as frequently asked questions can be found here. return to top
CMS
updates Hospital Compare data
Last Thursday the Centers for Medicare & Medicaid Services
updated the Hospital Compare website with new measures, as
well as refreshed performance data on some existing measures. CMS is publicly
reporting new measures of hospital performance on stroke and venous
thromboembolism care, as well as the rates of two new healthcare-associated
infection measures – methicillin-resistant Staphylococcus
aureus (MRSA) and Clostridium
difficile (C. diff). MRSA and C. diff data is not reported for all
hospitals because some hospitals may not have a sufficient sample size to
report statistically meaningful rates. The agency also updated data on five
readmission measures and one complication measure that it had previously
suppressed due to issues with calculating performance benchmarks. The affected
measures are heart attack, heart failure, pneumonia, hip and knee replacement,
and hospital-wide readmissions; and hip and knee replacement complications. Click here to view the data updates. return to top
Attorney
general to clarify hospital trustees’ fiduciary duties at upcoming conference
Minnesota Attorney General Lori Swanson will discuss the unique
fiduciary duties of nonprofit hospitals and health system trustees, including
oversight of patient safety and care quality performance, financial assistance
and charity care policies, and billing and collections practices during a
presentation at the January Trustee Conference.
Pressures for greater collaboration and financial sustainability often put
trustees in the position of sorting through the merits and drawbacks of
mergers, acquisitions and affiliations. As one of the state’s regulatory and
enforcement authorities with respect to charities and nonprofit organizations,
Attorney General Swanson’s presentation aims to clarify her perspectives on
these duties and the important role hospital and health system trustees play in
health care.
The conference has been approved for up to 14.75 clock hours Minnesota Board of
Examiners for Nursing Home Administrators.
The Winter Trustee Conference takes place Jan. 10-12, 2014 at the Minneapolis
Marriott Northwest in Brooklyn Park. Click here to learn more about the conference sessions or to register.
The deadline for accommodations at the Marriott is Dec. 19. Click here to reserve your room
online. return to top
Newsline
holiday schedule
Newsline will publish next Monday, Dec. 23 and
take a holiday break until Monday, Jan. 6. return to top