In this issue
spotlight: Redwood Area Hospital works to reduce harm across the board
Redwood Area Hospital is a 25-bed city owned critical access
hospital in southwest Minnesota. When challenged with the work of the MHA
hospital engagement network, the hospital seized the opportunity to evaluate
its current processes and implement new processes to reduce adverse events.
Realizing front-line staff is critical to safety improvement efforts the
hospital uses the principles of Transforming Care at the Bedside (TCAB) to
reduce harm across the board. Read more about Redwood Area Hospital’s
efforts. return to top
meets with congressional delegation on key hospital issues
Lawrence Massa and members of the MHA staff met with Minnesota’s
congressional members and staff last week in Washington, DC, on key federal
issues affecting Minnesota hospitals and health systems.
MHA shared results from our members’ Partnerships for Patients work that has
saved 7,000 patients from harm and saved $58 million in health care costs. In
addition, MHA told congressional offices that for a second year in a row, the
Agency for Healthcare Quality and Research has ranked Minnesota the best for overall
health care quality in the nation.
MHA also requested the following federal action:
96 hour requirement — support legislative language
that removes the condition of payment for critical access hospitals (CAHs)
requiring a physician to certify that each patient will be
discharged/transferred in less than 96 hours.
- Two-midnight requirement — support legislation (H.R. 3698)
delaying enforcement of the two-midnight requirement and call for the
Centers for Medicare and Medicaid Services (CMS) to implement a new
payment methodology for short inpatient stays.
- Proposed rule to calculating
federal share of MinnesotaCare costs — join MHA and the Minnesota
Department of Human Services in urging CMS to modify its proposed method
of calculating the federal share of MinnesotaCare costs so Minnesota is
not disadvantaged for its leadership (see below for more on this topic).
- Across-the-board cuts and
efforts to extend sequestration — oppose using Medicare reductions for non-Medicare
spending and oppose other proposed across-the-board cuts to graduate
medical education funding; CAH funding; Medicare bad debt; and reducing
the difference in compensation rates between hospital outpatient
departments and physician offices.
- Recovery Audit Contractor (RAC)
Program — support
legislation (H.R. 1250/S.1012) making necessary improvements to the RAC
program in light of the recent memorandum from the Office of Medicare
Hearings and Appeals stating a significant delay (at least 24 months) in
assignment of hospital appeals to Administrative Law Judges.
Click here for MHA’s key messages and requests for
the delegation. For questions contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
Health Program proposed funding puts new MinnesotaCare in jeopardy
The Centers for Medicare and Medicaid Services (CMS) recently
published the proposed 2015 funding methodology for the
Basic Health Program. The proposed methodology puts Minnesota’s Basic Health
Program (BHP), MinnesotaCare, in jeopardy due to potential federal
underfunding of the program.
The proposal fails to take into account Minnesota’s unique health insurance
market and history of innovation. It would not allow for use of state-specific
data, such as the cost savings MinnesotaCare and the transition of the state's
high risk pool generate for the plans sold on MNsure. Under the proposed rule,
Minnesota's previous investment of state resources to ensure affordable
coverage for lower-income residents would result in less federal support for
MinnesotaCare going forward.
MHA, the Minnesota Department of Human Services, most of Minnesota's
congressional delegation and other groups will submit comment letters in
support of the following modifications to the proposed funding methodology:
- Actual, state-specific data
should be used in place of prospective estimates generated by CMS;
- Retrospectively reconcile
federal subsidies of the BHP in a manner that accounts for the impact on
commercial premiums resulting from MinnesotaCare and other state policies;
- Include a reinsurance payment
in the BHP funding methodology.
MHA members are encouraged to submit comment letters in support
of modifying the funding formula. Comments are due Wednesday, Jan. 22.
For more information contact Matt Anderson, MHA vice president of
regulatory and strategic affairs, 651-659-1421 or Jen McNertney, MHA policy analyst, 651-659-1405. return to top
implementing 2 percent sequestration cuts to Medicaid
With limited communication or notice, the Minnesota Department
of Human Services (DHS) began implementing retroactive 2 percent Medicaid
payment recoveries for remittances dated Dec. 31, 2013. This applies to
Medicaid payments on/or after April 1, 2013, the effective date of Medicare
sequestration. MHA staff and hospitals have been attempting to obtain more
information about this take-back, which took everyone by surprise. DHS
cites that several services paid by Medicaid are tied to a Medicare fee
schedule. The department has further stated that since the Medicare fee
schedule has been reduced 2 percent by the Budget Control Act of 2011 they need
to correspondingly reduce Medicaid payments that are tied to this fee
The services cited as subject to the cuts includes: outpatient hospital
facility, laboratory, radiology, medical supplies and durable medical
equipment, orthotics and prosthetics, anesthesia, transportation and ambulance,
ambulatory surgery centers and hospice services. Hospital inpatient and physician
payments are not subject to the cuts since they are already paid below
Medicare’s fee structure. MHA will be pursuing further legal and operational
review of this cut. For more information, contact Joe Schindler,
MHA vice president of finance, 651-659-1415. return to top
MHA to submit
comments on emergency preparedness standards
The Centers for Medicare and Medicaid Services (CMS) released proposed emergency preparedness standards as
conditions of participation on Dec. 27. These proposed new emergency
preparedness standards apply to hospitals, long-term care facilities,
ambulatory surgery centers, and other health facilities and suppliers. MHA is
seeking member input to include in the association’s comment letter. Please
send comments and feedback to Matt Anderson, MHA vice president of
regulatory and strategic affairs or Jen McNertney, MHA policy analyst by Wednesday, Feb. 19. return to top
Foundation offering Community Innovation Grants
The Bush Foundation is accepting applications
for Community Innovation Grants. Last year, the foundation provided more than
$4 million to support 34 organizations working to create or implement a
breakthrough in addressing a community need across Minnesota, North
Dakota, South Dakota and the 23 Native Nations that share the same geography.
Nonprofit organizations and government entities of all sizes are eligible to
apply for Community Innovation Grants ranging from $10,000 to $200,000. The
grants support communities to use problem-solving processes that lead to more
effective, equitable and sustainable solutions. These grants could be used as a
way to further the implementation plans of community health needs assessments.
Applications will be accepted through March 13, 2014.
For more information about Community Innovation Grants, including how to apply,
visit the Bush Foundation website. return to top