Minnesota Hospital Association


December 23, 2013

MHA Newsline

In this issue

Holiday greetings from MHA

Season’s greetings from the Minnesota Hospital Association! We send our best wishes to you and hope you enjoy this holiday e-card:


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MDH releases report on obstetric services in rural Minnesota

The Minnesota Department of Health’s (MDH) Rural Health Advisory Committee (RHAC) recently released a report with 18 recommendations for improving obstetric services in rural Minnesota.  

An RHAC workgroup was formed to produce this report after identifying a need to address declining obstetric services in rural areas. For example, data contained in the report demonstrate that while there was very little net change in the number of births in Minnesota from 2000-2010, the number of physicians who performed the births decreased 15 percent.  

The report illustrates that strong obstetric services benefit rural communities by providing access to pregnancy planning and prenatal care; increased patient satisfaction; and providing coverage for high-risk and emergency obstetric care.  

However, the report notes the following barriers to providing these services including the economic impact on rural hospitals; rural obstetric workforce shortages; training and residency limitations; on-call and lifestyle considerations; and infrastructure needs.  

The 18 recommendations contained in the report are a call to action for rural hospitals and health systems, medical schools, policy makers and other stakeholders. They are as follows:

  • Ensure the inclusion of obstetrics as a required service in health payment and care delivery models such as Accountable Care Organizations.
  • Address smoking in childbearing-age women in rural areas with a special focus on women who are young, uninsured or publicly insured, and those most likely to have an unintended pregnancy.
  • Encourage collaboration between rural obstetric providers and public health nurses to maximize the use of local resources available to pregnant women and new parents.
  • Educate rural providers and hospital staff about ways to better serve American Indian women.
  • Support a system for medical school admission that considers rural provider perspectives and a prospective student’s inclination toward a rural obstetrics practice.
  • Provide more opportunities for rural family physicians to receive training in natural births and Cesarean sections.
  • Analyze and address the impact of 2011 federal work hour restrictions on medical residents.
  • Support an appropriate number of new medical graduates to meet future rural obstetric care needs.
  • Address regulatory barriers to practice at federal, state and hospital levels for certified nurse-midwives.
  • Support rural obstetric teams’ involvement in educational offerings that supplement their labor and delivery skills.
  • Support loan forgiveness programs for obstetric providers in small and isolated rural areas.
  • Address ongoing challenges related to workforce shortages in rural obstetrics.
  • Educate rural providers and hospital staff about the role of doulas.
  • Develop and promote a set of best practices for rural hospitals that encounter obstetric emergencies with limited obstetric staff or resources.
  • Support improvements to Medicaid reimbursement for rural obstetrics.
  • Protect Minnesota’s low-cost liability and malpractice insurance environment for obstetric providers.
  • Support collaborative efforts to maintain local obstetric services and share successful models.
  • Develop and pilot a rural obstetrics telehealth program in Minnesota.

The RHAC is a 15-member, governor-appointed committee charged with advising the Commissioner of Health and other state agencies on rural health issues. Click here to read the full report. return to top  

CMS announces training on two-midnight policy

The Centers for Medicare & Medicaid Services (CMS) will host a telephone training session on the medical review criteria for the new “two-midnight” policy for inpatient hospital admission and medical review on Jan. 14, 2014 at 12:30 p.m. Central Standard Time. The call will provide an overview of the policy and use case scenarios to describe its application to sample medical records. CMS also will answer questions on the policy. Details on the call will be posted at www.cms.gov. return to top  

Minnesota physician named Country Doctor of the Year

Dr. Robert Bösl, a physician at Stevens Community Medical Center in Morris, was named Country Doctor of the Year by Staff Care, a company that provides health care workforce solutions. The award is given annually to physicians in communities with 30,000 or fewer residents. This is the first time a Minnesotan has earned the award.  

Bösl is the only doctor in the town of Starbuck, where he operates his clinic, and makes the 40-mile round trip journey to Morris multiple times per day to see patients at Stevens Community Medical Center and perform surgeries.  

John Rau, president and CEO of Stevens Community Medical Center, told USA Today that Bösl is “without question one of the finest physicians and individuals I’ve ever had the opportunity to work with.”  

Congratulations, Dr. Bösl, and thank you for helping ensure access to quality care in Minnesota’s rural communities! return to top  

Newsline holiday schedule

Just a reminder that Newsline will take a holiday break next week and will return to its normal publishing schedule on Monday, Jan. 6. return to top