June 14, 2013
MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.
It’s fair to say that “the ship has sailed” on who will manage Missouri’s health insurance exchange. Missouri voters cast their ballots in November 2012 prohibiting the governor from establishing an exchange without specific authorization from the legislature or voters. Lawmakers have not authorized or budgeted for a state exchange, and the state’s executive branch is essentially barred from assisting in the process. As a result, Missouri will have a federal exchange.
At this point, the Missouri federal exchange isn’t fully organized. That doesn’t mean important work isn’t occurring. The pieces are being put in place that will determine whether the new “marketplace” for Missourians will succeed. MHA is working to build the partnerships necessary to reach Missourians during open enrollment this fall. That’s the target. And, who runs the exchange is ultimately less important than whether Missourians enroll.
MHA recently submitted an application to the Centers for Medicare & Medicaid Services, in conjunction with the Missouri Association for Community Action, to seek federal funding for efforts to assist in the enrollment process. The Affordable Care Act authorizes “navigators” to assist eligible Missourians in their exchange plan decision making. Our application — which was endorsed by the Health Care Foundation of Greater Kansas City; the Missouri Foundation for Health; the Community Action Partnership; the Missouri Department of Insurance, Financial Institutions and Professional Registration; and the Missouri Primary Care Association — is statewide in scope.
Our partnership, the Enroll Missouri Consortium, was designed to take advantage of not only geography but hospitals’ connection to the uninsured and MACA’s existing network of advocates in communities throughout the state. CMS will award a minimum of two navigator grants in Missouri. The consortium has requested $1.1 million of the $1.3 million available.
Navigators are important to the success of the state’s exchange. Their job is to provide balanced information about plans and help consumers make informed decisions. These will be important tasks in building enrollment. And, having a partner with deep roots in community outreach should help both our application and the effectiveness of the navigator effort.
In the coming months, MHA and its partners will be working to educate the public about how these marketplaces work. Currently, there is a very low level of public understanding about the structure and process, and even eligibility. The consortium and our partners will have our hands full. Success in enrollment is vital to the hospital community.
As I said, when it comes to who will run the state’s new health insurance marketplace, the ship has sailed. However, if our choice is to wave from the pier or swim out to the boat, that decision is easy — we’re diving in.
I’ll share more information about our efforts in the coming weeks. In the meantime, if you have thoughts or questions, send me an email.
Herb B. Kuhn
MHA President and CEO
In This Issue
MedPAC Releases June 2013 Report To Congress
CMS Issues Program Integrity Proposed Rule For Health Insurance Exchange
CMS Announces HCAHPS Review, Correction Period
CMS Posts Outpatient Quality Reporting For Benchmarks Of Care
Listserv Available For HVBP
Advocate state and federal health policy developmentsMedPAC Releases June 2013 Report To Congress
MHA Staff Contact: Andrew Wheeler
The Medicare Payment Advisory Commission released its June 2013 report to Congress on Medicare and the health care delivery system. MedPAC Commission Chair Glenn Hackbarth said, “This report can inform a dialogue about the future directions for the Medicare program, as well as about technical refinements to existing Medicare payment policy. Whether broad or narrow, the commission’s work aims to balance the interests of Medicare beneficiaries, health care providers and tax payers.” The report addresses the following.
- redesigning Medicare benefits
- reducing Medicare payment differences across sites of care
- bundling post-acute care services
- reducing hospital readmissions
- payments for hospice services
- improving care for dual-eligible beneficiaries
- mandated reports
Regulatory News the latest actions of agencies monitoring health care CMS Issues Program Integrity Proposed Rule For Health Insurance Exchange
MHA Staff Contact: Andrew Wheeler
The Centers for Medicare & Medicaid Services announced a proposed rule outlining program integrity guidelines for the health insurance marketplace and premium stabilization programs. The policies offer clarity on oversight of various premium stabilization and affordability programs, build on state options for the Small Business Health Options Program (SHOP) and provide technical clarification. CMS Administrator Marilyn Tavenner said, “In just a few months, consumers across the country will have access to a new marketplace in their state where they can easily shop for health insurance that meets their needs and the needs of their families. The release of these guidelines signals that we’re ready to build on our ongoing efforts and ensure that the new systems are fiscally sound.”
CMS Announces HCAHPS Review, Correction Period
MHA Staff Contact: Wanda Marvel
The deadline to submit data on patient satisfaction for first quarter 2013 is Wednesday, July 3. This data is part of the Hospital Consumer Assessment of Healthcare Providers and Systems patient perspectives of care. The Centers for Medicare & Medicaid Services strongly encourages all hospitals, whether they self-administer the HCAHPS survey or use a vendor, to submit data at least two days before the deadline to allow time for addressing any submission issues. All inpatient PPS hospitals participating in the Hospital Inpatient Quality Reporting Program must collect and submit HCAHPS data to receive their full annual payment update.
Immediately following the data submission deadline, participating hospitals and survey vendors can review the HCAHPS Data Review and Correction Report for one week, from Thursday, July 4, to Wednesday, July 10. The report includes a summary of the data accepted into the warehouse for the quarter. New data are not accepted into the warehouse during this period, but errors in data accepted into the warehouse by July 3 can be corrected. During the one-week period, the corrected data can be resubmitted to the warehouse to replace the incorrect data.
For questions on specific HCAHPS hospital data, contact the HCAHPS Project Team at 888/884-4007 or hcahps@azqio.sdps.org.
CMS Posts Outpatient Quality Reporting For Benchmarks Of Care
MHA Staff Contact: Wanda Marvel
The Benchmarks of Care for third quarter 2012 have been posted on QualityNet. The Centers for Medicare & Medicaid Services calculates quarterly benchmarks of care based on hospital data submitted to its clinical data warehouses. These benchmarks were developed using the Achievable Benchmarks of Care™ methodology and are based on the reported performance of the top facilities. ABC benchmarks identify superior performance and encourage performance improvement. These benchmarks may be accessed on QualityNet by selecting “Benchmarks of Care” under the “Hospitals – Inpatient or Hospitals – Outpatient” tabs. Options are available to download the PDF or Excel versions.
For further assistance, please contact the Hospital Outpatient Quality Reporting Program Support Contractor at 866/800-8756 or https://cms-ocsq.custhelp.com/.
Listserv Available For HVBP
MHA Staff Contact: Wanda Marvel
The new Hospital Inpatient Value-Based Purchasing and Improvement listserve is now available on QualityNet for hospitals and other stakeholders. The listserve will be used for notifications on the HVBP program and to allow hospitals to discuss improvement opportunities on the HVBP topics. Information to join the listserv is available online. Questions about the HVBP program can be sent to HVBPimprovement_resource@sdps.org.
The following articles were published in this week’s issues of MHA Today and are available online.
June 13, 2013
CMS Posts Guidance For Long-Term Care Facilities
CMS Issues Updates To MLN Matters, e-News
June 12, 2013
Blunt Fights Medicare Bad Debt Payment Reduction Proposal
Medicare Advantage Enrollment Continues To Increase
MHA Distributes Analysis For FY 2014 Proposed Inpatient PPS
MHA Distributes Analysis For FY 2014 Proposed LTCH PPS
Webinar To Feature Outpatient Measures, Annual Payment Update
June 11, 2013
State Senate Committee To Study Medicaid Reform
MHA Distributes Physician Bona Fide Employment Guide
June 10, 2013
Guide Discusses Rural Hospitals’ Partnerships On Population Health
HHS Files Motion To Dismiss In Hospital Billing Case
MHD Posts Claims Processing Schedule
Consider This ... More than 300,000 men in the United States die from heart disease each year. That’s one out of every four men who die each year.
Missouri Hospital Association
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Phone: 573/893-3700 • Fax: 573/893-2809 • MHAnet
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