Minnesota Hospital Association


January 20, 2014

MHA Newsline

In this issue

Hospital 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 

MHA 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

Basic 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; and
  • 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  

DHS 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 schedule.   

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. 19return to top  

Bush 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