Minnesota Hospital Association


September 10, 2012

MHA Newsline

In this issue

MHA comments on proposed physician fee schedule

Letter focuses on new value-based modifier

The Minnesota Hospital Association (MHA) submitted a comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding proposed changes to the Medicare Physician Fee Schedule. Although the association addressed multiple aspects of the proposed rule, much of the letter addressed the agency’s proposal for implementing a new modifier to reward physicians that deliver high quality, low cost care.

The value-based modifier (VBM) was a high priority for MHA during the congressional deliberations leading up to the enactment of the Affordable Care Act (ACA) in 2010. Minnesota’s congressional delegation was unanimous in its support of moving Medicare’s payment methodology from one that rewards the volume of services and procedures delivered by health care providers to one that rewards high quality, low cost care. Minnesota’s senior senator, Amy Klobuchar, helped ensure that the VBM for physician payments was included in the ACA.

MHA’s letter to CMS expressed strong support for the VBM and encouraged the agency to push the new payment mechanism even farther and faster than currently planned. The proposed rule, for example, would apply the VBM to group practices with 25 or more providers. MHA suggested that CMS expand the VBM’s applicability to groups with 10 or more providers and to develop a VBM program for hospital- based physicians.

Lawrence Massa, president and CEO of MHA, explained that “as the largest purchaser of health care, Medicare should be aggressive in using its buying clout to create strong incentives for providers to deliver high quality, low cost care.”

For more information about MHA’s comments, the proposed physician fee schedule rule or the VBM, contact Matt Anderson, MHA vice president of regulatory and strategic affairs, 651-659-1421.^top of page

MHA regional trustee meetings scheduled for October

In October, the Minnesota Hospital Association will offer a series of regional trustee meetings at locations throughout the state. The meetings will feature a presentation focusing on year-end federal budget issues and health reform implementation issues for Minnesota by Matt Anderson, MHA’s vice president of regulatory and strategic affairs.

Health reform, demographic changes and dire budgetary outlooks are upon us, bringing challenges and much uncertainty. Regardless of the outcomes of the November elections, substantial cuts to health care spending are almost certain. The transition period for implementing health care reform, changing care delivery and payment models, and absorbing potentially significant reimbursement cuts will be punctuated by tension, market turbulence and economic risk. As we approach the November elections, this presentation and discussion will focus on policy issues that health care leaders need to be aware of to prepare for the potential changes and challenges in the health care environment in 2013 and beyond.

The meetings will take place:

  • Tuesday, Oct. 16 — Redwood Area Hospital, Redwood Falls
  • Wednesday, Oct. 17 — St. Francis Healthcare Campus, Breckenridge
  • Thursday, Oct. 18 — Essentia Health St. Mary's Hospital - Detroit Lakes
  • Tuesday, Oct. 23 — Mercy Hospital, Moose Lake

Trustees working toward MHA board education certification will earn 1.0 credit hour under the effective governance (EG) component. < ahref="http://www.mnhospitals.org/Portals/0/Documents/Trustees/797200.pdf" target="new window">Click here for further information and a registration form. ^top of page

IOM report calls for transformational changes to health care system

A report from the Institute of Medicine (IOM), Best Care at Lower Cost: The Path to Continuously Learning Health Care in America, concludes that incremental upgrades and changes by individual hospitals and providers will not produce the outcomes needed to achieve higher quality care at lower cost. The report provides a high-level look at the nation’s health system and advocates for “continuously learning” in order to increase knowledge of best practices and evidence-based care among providers. This knowledge will lead to lower utilization of unnecessary tests and procedures, which will save money and improve patient care.

The report calls out $750 billion in unnecessary services, excessive administrative costs, fraud and other problems and says America’s health care system has become too complex and costly; however, it also uses the Minnesota Community Measurement as a positive example of public reporting initiatives and how those initiatives can help translate measurement into patient empowerment and better quality. According to IOM, better use of data is a critical element of a continuously improving health system. The report identifies the following as characteristics of a continuously learning health care system:

  • Real-time access to knowledge and early adoption of new medical technologies
  • Digital capture of the care experience, enabling the sharing of health data
  • Engage and empower patients in care decisions
  • Incentives aligned for value over volume
  • Full transparency about costs and outcomes of care
  • Leadership-instilled culture of learning
  • Support for training, skill building and continuous learning

While the IOM report highlights some very troubling information that should be a wake-up call to all providers, including those in Minnesota, we can be proud that our hospitals are ranked highest quality, lowest-cost in the nation. Minnesota’s hospitals have been leading the nation in implementing best practices, evidenced-based medicine, and patient safety and quality initiatives that are excellent examples of the recommendations submitted by the IOM.^top of page

Minnesota Physician recognizes 100 Influential Health Care Leaders

In its August issue, Minnesota Physician Publishing honored 100 Influential Health Care Leaders. The leaders selected represent a cross section of Minnesota’s health care delivery system, from clinical care to health care policy, research and management. Congratulations to 14 leaders of MHA’s member hospitals and health systems, which are among the honorees. MHA President and CEO Lawrence Massa was also recognized.

Nominees are selected once every four years from submissions by readers of Minnesota Physician. Click here to read about the 100 Influential Health Care Leaders. ^top of page

MDH grant available for Minnesota clinic-based safety net providers

The Minnesota Department of Health (MDH) is seeking applications from eligible community clinics through the Community Clinic Grant Program. The purpose of these grants is to improve the ongoing viability of Minnesota’s clinic-based safety net providers. Grants help clinics serve people with low incomes, reduce current or future uncompensated care burdens, or improve care delivery infrastructure.

The level of funding for the community clinic grant program is approximately $561,000 for fiscal year 2013. An eligible community clinic means a nonprofit clinic, government entity, Indian tribal government or Indian health service unit; or a consortium of these entities. Applicants must provide or plan to provide clinical services and use a sliding fee scale or other procedure to determine eligibility for charity care or to ensure that no person will be denied services because of inability to pay. The Office of Rural Health and Primary Care expects that successful applicants will be able to begin their grant projects by April 2013.

Because of limited funding, applicants will be required to submit pre-applications and only the strongest of these will be invited to submit a final application. Prospective applicants who have questions and/or would like a copy of the application forms may contact Debra Jahnke at 651-201-3845 or 800-366- 5424.The pre-application and final application forms are also available on the Office of Rural Health and Primary Care website.

Pre-applications must be received by 4 p.m. on Oct. 24. Final applications must be received by 4 p.m. on Jan. 23, 2013.^top of page