Minnesota Hospital Association


May 12, 2014

MHA Newsline: May 12, 2014

In this issue

Celebrate Minnesota hospitals during National Hospital Week May 11-17

It’s National Hospital Week (#HospitalWeek), the largest national celebration of health care and a time to recognize the hard working professionals in our hospitals who support the health of their communities through compassionate care, constant innovation and unwavering dedication. National Hospital Week is the perfect opportunity for your hospital to promote its good work within your community and celebrate the dedicated women and men who make it all happen. MHA created this video highlighting the importance of Minnesota hospitals. We encourage you to share it with your staff and patients and on your website and social media channels. MHA salutes its 143 member hospitals and health systems for your continued commitment to improving the delivery of health care. return to top  

Fairview Southdale President Brad Beard earns AHA Grassroots Champion Award

The American Hospital Association (AHA) presented its Grassroots Champion Award to Bradley Beard, president of Fairview Southdale Hospital in Edina, at its annual meeting last week in Washington, D.C. Brad was recognized by AHA for his effectiveness in educating elected officials on how major issues affect hospitals’ vital role in the community and for broadening the base of community support for hospitals. Brad has been an ardent advocate for hospitals in our state and regularly meets with legislators. During the 2012 election season and the 2013 legislative session, Brad worked hard to develop a relationship with his community’s newest member of the legislature.   He is an active participant on several MHA committees and task forces, including Nurse Staffing, Patient Safety, and the Hospital PAC board. In addition to his service on the MHA Board of Directors, he has lent his expertise to the Policy and Advocacy Committee and serves as the Region 4 chair. Congratulations Brad! return to top  

New law suspends provider peer grouping

Gov. Dayton has signed into law a suspension of the provider peer grouping program (PPG). The new law  (Chapter 178) recognizes that there have been additional quality and transparency initiatives created since the original law was passed and establishes a work group to recommend expanded uses of the state’s all-payer claims database (APCD). Thanks to the bill’s chief authors: Rep. Tom Huntley (DFL–Duluth) and Sen. Tony Lourey (DFL–Kerrick).  

The bill was one of the Minnesota Hospital Association’s (MHA) key priorities going into the 2014 session. MHA worked through a stakeholder coalition that included the Minnesota Council of Health Plans (MCHP), Minnesota Medical Association (MMA) and Minnesota Department of Health (MDH).  

The new law suspends the PPG program immediately; none of the information in the confidential draft reports that MDH sent to hospitals in April will be publicly reported. MDH will also be sending a communication to hospitals to this effect. The law also authorizes MDH to use the APCD to work on four studies pertaining to health care homes, readmissions, geographic disparities, and the impacts of the State Innovation Model (SIM) grant.  

Also, by Feb. 1, 2015, a work group will submit recommendations to the legislature regarding a governance or oversight structure for the APCD, as well as how the data collected from payers can be used to improve care delivered to Minnesotans. Representatives from multiple stakeholders, including MHA, will be appointed to the work group.  

The goal of PPG – to help define value in healthcare – is still worthwhile. There were challenges with how PPG was implemented, but MHA looks forward to its participation on the APCD workgroup in alignment with the association’s strategic goals of  improving health care quality and reducing costs. return to top 

Newborn screening program modified

Gov. Dayton has signed a bill to modify Minnesota's newborn screening program, although there are no operational changes for hospitals.    

The legislation, Chapter 203, gives the Minnesota Department of Health (MDH) the authority to maintain newborn screening blood spots and test results indefinitely. It was sponsored by the Minnesota American Academy of Pediatrics and authored by Sen. John Marty (DFL–Roseville) and Rep. Kim Norton (DFL–Rochester). The legislation does not change parental rights to opt-out of the test all together and allows parents to refuse to grant the state permission to keep their infants' samples. The Newborn Screening program tests for more than 50 rare and heritable diseases that can cause serious disability or even death if not caught early. Once a hospital completes the newborn screening test, hospitals are reminded that they are required to send the blood spot card to the MDH within 24 hours.    

For questions, contact Kristin Loncorich, MHA director of government relations, 651-603-3526. return to top  

MHA continues criticism of direct supervision policy

MHA submitted a letter to the Centers for Medicare and Medicaid Services (CMS) critiquing the agency’s policy requiring direct supervision of outpatient therapeutic services delivered in a hospital. The letter responded to CMS’s recent announcement that it intends to reject 11 of 18 changes to the direct supervision policy recommended by its own Hospital Outpatient Payment (HOP) Panel.  

In particular, MHA opposed the agency’s intention to retain direct supervision standards for several outpatient chemotherapy services. The direct supervision standard could make chemotherapy less accessible, especially in rural communities where it is difficult to recruit and retain sufficient numbers of physicians and other non-physician practitioners.  

In the meantime, MHA continues to support federal legislation (S. 1954) to reinstate an expired moratorium on CMS’s enforcement of the direct supervision requirement, as well as the Protecting Access to Rural Therapy Services (PARTS) bill (S. 778, H.R. 2801), which would replace the agency’s default policy of direct supervision with general supervision.  

For more information about the direct supervision policy, contact Matt Anderson, MHA vice president of regulatory and strategic affairs, 651-659-1421. For more information about federal legislative efforts to address the negative repercussions of the direct supervision standard, contact Ann Gibson, MHA vice president of federal relations and workforce, 651-603-3527. return to top  

Hospital leaders visit the Minnesota congressional delegation during AHA Annual Meeting

Minnesota hospital leaders, auxilians and MHA staff advocated on behalf of Minnesota hospitals and health systems last week in Washington D.C. Visits with the Minnesota congressional delegation were among the activities that occurred as part of the American Hospital Association’s Annual Meeting.  

The group highlighted the ongoing success of the Hospital Engagement Network and Minnesota’s recent number one ranking in the nation for health care access, quality and outcomes by the Commonwealth Fund. We encouraged our delegation to support removing “red tape” that prevents hospitals, physicians and other caregivers from working as a team, such as reining in the Recovery Audit Contractor program.  

Minnesota hospitals also encouraged our delegation to help provide more predictability by rejecting further cuts to Medicare and Medicaid funding including site-neutral payment policies for hospital outpatient departments; graduate medical education funding; changes to the 340B program; and reductions to critical access hospitals (CAHs). The group also asked our delegation to sign onto legislation to take a more thoughtful approach to the two-midnight rule.  

Last, MHA members encouraged the delegation to protect our nation’s most vulnerable populations — the uninsured, poor, elderly and disabled, by supporting specific changes in regulation and funding for essential services. This includes: removing the 96-hour physician certification requirement as a condition of payment for CAHs; adopting a default standard of “general supervision” for outpatient therapeutic services; and establishing beneficiary equity in the Hospital Readmissions Program.  

  • More information on MHA’s federal policy priorities can be found on the MHA website. MHA thanks the following members who participated in the visit to Washington D.C.: David Albrecht, president, Owatonna Hospital
  • Deborah Anderson, Health Care Auxiliary of Minnesota, Brainerd
  • Brad Beard, president, Fairview Southdale Hospital, Edina
  • Jody Bjerke, Health Care Auxiliary of Minnesota, Dawson
  • David Borgert, director, community and government relations, CentraCare Health, St. Cloud
  • Lee Boyles, incoming CEO, St. Gabriel’s Hospital, Little Falls
  • Jason Breuer, president, LakeWood Healthcare Center, Baudette
  • Mary Edwards, vice president, public policy, Fairview Health Services, Minneapolis
  • Mark Johnston, vice president health policy, Sanford Health, Sioux Falls, S.D.
  • Ben Koppelman, president and CEO, St. Joseph’s Area Health Services, Inc., Park Rapids         
  • Carol Machovsky, Health Care Auxiliary of Minnesota, Park Rapids
  • Michael Mahoney, vice president, public policy, Essentia Health, Duluth
  • Bill Nelson, chief executive officer, Mille Lacs Health System, Onamia
  • David Nelson, president and CEO, St. Francis Healthcare Campus, Breckenridge
  • John Solheim, CEO, Cuyuna Regional Medical Center, Crosby
  • Matt Anderson, vice president, regulatory and strategic affairs, MHA
  • Ann Gibson, vice president, federal relations/workforce, MHA
  • Lawrence Massa, president and CEO, MHA
  • Ben Peltier, vice president, legal services, MHA

For more information please contact Ann Gibson, MHA vice president of federal relations and workforce, 651-603-3527. return to top   

Hospitals encouraged to join statewide efforts to prevent hospital-acquired delirium

MHA is recruiting hospitals to participate in the pilot to prevent hospital-acquired delirium that is underway in Minnesota. The pilot aims to develop a streamlined approach to screening, assessing and mitigating risk factors for geriatric patients in the hospital. The pilot has two goals:

  • To decrease the number of patients in the target population who are administered benzodiazepines or antihistamines by December 2014; and
  • Increase the percentage of best practices implemented from the Delirium Road Map by December 2014.

Funding is available for hospitals that have experience with delirium practices in the intensive care unit and for hospitals that wish to pilot a delirium screening process in the emergency department.  

Click here to view a video highlighting the work of HealthEast Care System, St. John’s Hospital in Maplewood to prevent patients from developing delirium.  

To learn more or to join the pilot, contact Karen Olson, MHA HEN patient safety/quality coordinator, 651-603-3521. return to top  

Gov't report shows hospitals are improving patient safety

A report from the Department of Health and Human Services (HHS) finds an overall 9 percent decrease in hospital-acquired conditions nationally during 2011 and 2012. Nationally, hospitals have reduced early elective deliveries by 65 percent, ventilator-associated pneumonia by 53 percent, pressure ulcers by 25 percent, patient falls by 15 percent and venous thromboembolisms by 13 percent. Medicare 30-day readmissions have declined by 8 percent since 2010. HHS estimates the improvements announced prevented 560,000 hospital-acquired conditions and saved 15,000 lives and $4.1 billion. Hospitals have been working to reduce harm in 10 patient safety focus areas as part of the national Partnership for Patients. return to top 

MHA program to help communities create partnerships to meet the needs of patients with mental illnesses

MHA will host a program to explore the roles of hospitals and the state in responding to the needs of people with severe and persistent mental illnesses and complex co-occurring conditions. “Community Partnerships for Community Solutions” will address ideas for building capacity in our communities with community providers and will provide examples of community partnerships for participants to take back to their facilities.  

The program will be held on Aug. 1 at the Crowne Plaza Minneapolis West in Plymouth. For more information view the full program brochure or click here and log in to register. return to top  

MHA seeking proposals to study improvements to bathroom layout that create safer patient environments

Historical data from the Adverse Health Care Events Report finds that approximately 40 percent of falls that result in serious harm or death to the patient involve toileting—getting out of bed to go the bathroom, falling on the way to the bathroom, or falling in the bathroom. Although a number of strategies have been instituted to prevent these types of falls from occurring — such as “staying within arm’s reach” of high risk patients — there has not been a significant reduction in toileting-related falls.  

MHA is accepting proposals to study and develop recommendations for workflow and structural design to create a set of recommendations and guidelines for an “ideal” bathroom layout and pathways to the bathroom that can assist hospitals in creating a safer environment for patients and potentially reduce toileting-related falls. Consideration should be given to layout, materials and other design elements and should include direct observation of existing hospital bathrooms and staff interviews to determine work flow and existing safety gaps.     

Click here for the RFP. Proposals are due to MHA by 5 p.m. (CST) Friday, May 30, 2014. For questions, contact Julie Apold, MHA senior director of patient safety, 651-603-3538. return to top 

Understanding the new regulatory and legal changes affecting hospitals

“Health Care Regulatory and Reform Update” features experienced attorneys and other experts who will discuss recent changes in the regulatory and legal fields that affect hospitals as well as expected changes that may have an impact in the near future. Specific topics include:

  • Billing compliance;
  • Medical malpractice;
  • Employment law;
  • Government fraud and abuse enforcement;
  • Contracting models related to population health; and
  • Special requirements faced by public hospitals.

MHA has applied for 5 continuing legal education credit hours through the Minnesota State Board of Continuing Legal Education.  

The program will take place on June 19 at the Crowne Plaza Minneapolis West in Plymouth. For more information, view the full brochure or click here and login to register and online. return to top