Minnesota Hospital Association


March 17, 2014


In this issue

Hospital spotlight: HCMC program makes exercise fun and food delicious

Over the past five years, Hennepin County Medical Center’s (HCMC) Taking Steps Together (TST): Nutrition and Healthy Lifestyle Program has served more than 450 HCMC patients and family members. TST offers community-based, culturally appropriate, bilingual programming. Each week, families cook, eat, play and learn together. They also work together to develop strategies for healthful decisions at home. TST is evidence based, rigorously analyzed and has demonstrated positive results for participants. Everything about TST is patient centered; from the program’s location at neighborhood community centers, to the recipes, languages and activities that are selected. HCMC’s efforts are another example of how hospitals recognize that health also happens outside of the doctor’s office. Learn more here. return to top  

Progress made at Capitol on Provider Peer Grouping bill

Even though the 2014 legislative session has just begun, the pace is already frantic with the first committee deadline on Friday, March 21. That is the date by which policy bills are supposed to pass in all policy committees of either the House or Senate. MHA is pleased to report progress is being made on at least one of our priority issues — a bill that would suspend the Provider Peer Grouping (PPG) program and open up the All-Payer Claims Database (APCD) for limited study purposes.     

Last week, SF 2106 was heard and given approval in the Senate Health, Human Services and Housing Policy Committee and the Senate Judiciary Committee. The bill is now headed to the Senate floor. The House version of the bill, HF 2656, has been heard and approved in the House Health and Human Services Policy Committee but awaits consideration by the House Civil Law Committee. MHA has testified on behalf of the legislation at three committee hearings, joining with representatives from the Minnesota Medical Association and the Minnesota Department of Health (MDH). 

The bill does the following:

  1. Suspends the Provider Peer Grouping program indefinitely unless or until the Legislature takes affirmative action to lift the suspension;
  2. Establishes a work group comprised of representatives from multiple stakeholders to develop recommendations for legislation establishing the future governance and expanded uses of the APCD; and
  3. Authorizes MDH to use the APCD for four new purposes, including: evaluating the Health Care Home initiative; studying readmission trends and rates in consultation with the Reducing Avoidable Readmissions Effectively (RARE) Campaign; studying variation in health care cost, quality, utilization and illness burden on the basis of geography or populations until July 2016; and evaluating the State Innovation Model (SIM) initiative. MDH is not allowed to publish any reports or studies from its work that identify individual providers, clinics or hospitals.

MHA is hopeful that thoughtful uses of the APCD will support hospitals’ goal of advancing the Triple Aim: better care, lower cost per capita and a healthier population.

For questions, contact Mary Krinkie, MHA vice president of government relations, 651-659-1465 or Kristin Loncorich, MHA director of government relations, 651-603-3526. return to top  

Governor’s supplemental budget proposal skimpy on health care dollars

Last week, Gov. Dayton released his recommendations for supplemental spending to the current 2014-15 biennial budget. Mary Krinkie, MHA vice president of government relations, testified in both the Senate and House Health and Human Services Finance Committees regarding MHA’s concerns with the governor’s health and human services initiatives, specifically the “Health Care Payment Modernization” proposal.  

“This is a very complex initiative that represents significant changes in how inpatient Medicaid fee-for- service hospital payment rates are calculated,” said Krinkie. “Regretfully, this proposal will be arriving late in the legislative process and will be extremely difficult for hospitals and the health care community to evaluate its impact.”   

The testimony explained that the legislation coming from the Minnesota Department of Human Services (DHS) will likely contain five components, including:

  1. As mandated by the federal government, implementation of the ICD-10 codes, starting on Oct.1, 2014.
  2. Potentially moving forward with a new “grouper” which will allow Minnesota’s Medicaid program to bill more similarly to the Medicare program; using what is known as an All Patient Refined — Diagnosis Related Group.
  3. Implementing budget neutral rebasing. This would likely result in some hospitals having an improved Medical Assistance rate of payment and other hospitals having a negative financial impact from this process. This provision was part of the 2011 Omnibus Health and Human Services legislation and was supposed to have had an implementation date of January 2013.
  4. Possible elimination of some of the various add-on payments currently in law for inpatient fee-for-service rates. DHS is looking at how those payments could potentially be embedded into new rates.
  5. Discussion of hospitals’ good work in meeting readmission targets. Krinkie noted that current law calls for half of the most recent 10 percent ratable reduction to be eliminated if hospitals collectively meet specific readmission targets. This “buy back” of the rate reduction was supposed to have started July 1, 2013. Implementing it now could help mitigate some of the negative impact of budget neutral rebasing.

Joe Schindler, MHA vice president of finance, will be working very closely with DHS staff on how best to construct this legislation. While the Department has missed several deadlines, there is a sincere effort to involve MHA and its members in this complex process. Some of the impacts will be initially unknown and follow-up changes and additional resources may be needed in 2015. 

Contact Mary Krinkie, 651-659-1465, about the legislative process or Joe Schindler, 651-659-1415, about the DHS rebasing outreach efforts. return to top  

CMS delays PSO requirement until at least 2017

The Centers for Medicare & Medicaid Services (CMS) issued a final rule delaying until at least 2017 an Affordable Care Act provision that some believe requires hospitals with more than 50 beds to contract with a Patient Safety Organization (PSO) that has been certified by the Agency for Healthcare Research and Quality (AHRQ).  

The CMS final rule is consistent with advice provided by the American Hospital Association and supported by MHA. Some hospitals had expressed concern about the PSO requirement and potential conflicts with other federal and state laws.   

A copy of the final rule is available here. For questions, contact Ben Peltier, MHA vice president of legal services, 651-603-3513. return to top  

Upcoming education sessions designed specifically for critical access hospitals

MHA will hold its annual “Health Care Delivery Strategies for Critical Access Hospitals” throughout the state April 29 – May 1.

Topics include state/federal reimbursement, cost report issues, billing/payment updates, recovery audit contractor strategies, reporting requirements, and physician/clinic concerns.

Following each daily general session, separate breakout sessions will be provided for both billing and finance issues. MHA Vice President of Finance Joe Schindler and McGladrey LLP Director Sue Ankeny will present the finance breakout session and National Government Services provider outreach and education staff Kim Thomas will speak at the billing breakout session.   

The programs are co-sponsored by the Minnesota Chapter of the Healthcare Financial Management Association. The locations are as follows:

  • Tuesday, April 29, Timberlake Lodge, Grand Rapids
  • Wednesday, April 30, Best Western Plus Kelly Inn, St. Cloud
  • Thursday, May 1, Jackpot Junction, Morton

More information and registration materials are available on the MHA website or click here for the full brochure. For questions, contact Christy Brager, MHA education specialist, 651-659-1412. return to top  

Fairview Health Services names Carolyn Wilson executive vice president and COO

Fairview Health Services has named Carolyn Wilson, RN, to the newly-created position of executive vice president and chief operating officer (COO), as of March 1. As COO, Wilson has operational accountability for the entire Fairview system, including its five community hospitals and the University of Minnesota Medical Center, Fairview in Minneapolis.  

Wilson also serves as co-president of University of Minnesota Health with Bobbi Daniels, MD, University of Minnesota Physicians. University of Minnesota Health is a recently announced name for all the University of Minnesota-branded facilities and services jointly operated by University of Minnesota Physicians and Fairview. MHA congratulates Wilson on her new position. return to top  

In memoriam: Former MHA employee Dan Malone

Former MHA employee, Dan Malone passed away last week after battling an aggressive form of Leukemia.  Dan worked at MHA for over 10 years auditing hospital annual reports. He spent most of his career in hospitals, starting with Gillette’s Children’s Specialty Hospital. He is remembered by MHA Vice President of Finance Joe Schindler as a man with a great sense of humor, great character and a positive attitude. Last fall he was diagnosed with Leukemia and had a bone marrow transplant in November.  After being discharged just before Christmas, he was readmitted in February with an aggressive return of the cancer. You can read Dan’s obituary in the Star Tribune. return to top