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January
16, 2006
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Michigan Health & Hospital Association 6215 West St. Joseph Highway Lansing, MI 48917 (517) 323-3443 Fax: (517) 323-0946 |
IN THIS ISSUE Michigan
Revenues Grow Slowly
The results of the last week’s revenue estimating conference included revenue forecasts that indicated both growth and continued economic challenge. Fiscal year (FY) 2005 finished with a positive balance of $220 million in the general fund and $93 million in the School Aid Fund. According to state economists, Michigan’s FY 2007 revenues will be approximately $170 million higher than those in FY 2006. While this growth is not adequate to keep pace with state spending necessary to maintain FY 2006 program levels, for the first time in several years, no mid-budget-year executive orders to cut state spending are expected. State Budget Director Mary Lannoye is scheduled to present Gov. Granholm’s 2007 budget proposal to the legislature Feb. 9, approximately two weeks after the governor’s Jan. 25 State of the State address. The MHA will continue to work to protect state health care funding in the current fiscal year and in FY 2007. For more information about state spending and revenues, contact Laura Appel at the MHA. Training Opportunity Available for Patient Care Survey
The Centers for Medicare & Medicaid Services (CMS) will begin surveying patient perspectives on care this fall. A random sample of patients from each hospital will be asked to complete the CAHPS® Hospital Survey, commonly known as HCAHPS. Results will be available at the Hospital Compare Web site, where other hospital quality measures are already posted. While participation in HCAHPS is voluntary, patient satisfaction reports from the first nine months of the survey will be publicly reported in late 2007. Hospitals may conduct these surveys on their own, or may use a survey vendor. Any entity that wishes to conduct these surveys must complete the free HCAHPS training, which will be mainly Web-based. Training registration will close Jan. 27 and a trial run of the survey will be implemented following training. All hospitals that intend to participate in the national implementation of HCAHPS in fall 2006 must take part in a trial run. A fact sheet is available for more information and members with questions should contact Laura Appel at the MHA. Social Security Number Privacy Act Provisions Take Effect
As explained in a memo from the MHA’s general counsel distributed to MHA members last year, certain provisions of the Social Security Number Privacy Act (Public Act 454 of 2004) took effect Jan. 1. These provisions apply to numerous hospital operations and prohibit the display of more than four digits of a Social Security number. Any person or legal entity that “obtains” Social Security numbers in the ordinary course of business is obligated to create a privacy policy that, at a minimum, accomplishes all of the following:
It is crucial that health care providers comply with the new law, especially where Social Security numbers are being used as account numbers, employee numbers or on employee identification badges. The required privacy policy must be in place and published in the hospital’s policies and procedures manuals for patients and employees. Members with questions should contact their organization’s legal counsel; Gregory W. Moore at Hall, Render, Killian, Heath & Lyman; or David Finkbeiner at the MHA. Call to Review Inpatient Rehabilitation Facility Reimbursement
The Centers for Medicare & Medicaid Services’ Provider Communications Group is hosting a conference call from 2 to 4 p.m. Feb. 2 to review refinements for inpatient rehabilitation facilities (IRFs) based on the fiscal year 2006 final rule to update the IRF prospective payment system. In addition, the call will review how compliance with the 75 percent rule is determined. Participants must register for the call by 5 p.m. Jan. 30, and dial-in information will be provided upon registration. Registration is also available by calling (800) 289-0579 and supplying the passcode 1437704. A PowerPoint slide presentation can be viewed during the call and the presentation will be followed by a question-and-answer session. For more information regarding the IRF 75 percent rule or the conference call, contact Vickie Seal at the MHA. Implementation of Medicaid APC System Is Delayed
Last week, the Medical Services Administration (MSA) announced that implementation of the Medicaid ambulatory payment classification (APC) payment system, which will replace the existing Medicaid outpatient fee-for-service (FFS) payment system, has been delayed. The postponement from July 1 to Oct. 1, 2006, is necessary to help ensure that the Michigan Department of Community Health, Medicaid health plans and hospitals have sufficient time to develop and test their systems prior to implementation. As a result of the delay, the expected December release of a draft policy regarding the APC system is also on hold. Meanwhile, the MSA continues to research, analyze and make policy decisions related to coverage, billing and reimbursement differences between Medicare and Medicaid. The Medicaid APC system will closely mirror the Medicare APC system, with modifications to address payment for services to maternity and pediatric beneficiaries, who comprise a significant portion of the Medicaid population. As previously reported, the different claims formats currently used by Medicare and Medicaid cause the MSA data to be inadequate to model the hospital-specific impact of the change from the current Medicaid outpatient FFS rates to APCs. Although the MSA intends to implement the APC system on a budget-neutral basis statewide, the hospital-specific impact may vary depending upon the mix of services provided and the APC rates used. Members should submit specific questions or concerns to the MSA via e-mail or contact Vickie Seal at the MHA. Excel Impact Analysis Available for OPPS Final Rule On Nov. 10, the Centers for Medicare & Medicaid Services issued the final rule to update the Medicare outpatient prospective payment system, effective Jan. 1, 2006. To assist hospitals in analyzing the impact on their operations, the MHA electronically distributed PDF files containing hospital-specific impact reports to chief executive and financial officers at MHA-member hospitals. To further assist in making the best use of these reports, an Excel version of the file is also available by contacting Vickie Seal at the MHA. These reports provide an estimate of the 2006 impact for each hospital based on 2004 Medicare paid claims data and reflect hospital information for Medicare payments, charges and estimated costs for the hospital’s highest volume procedures and Michigan statewide averages. CMS Makes First Awards to Medicare Administrative Contractors
As part of contracting reform provisions of the Medicare Modernization Act of 2003, the Centers for Medicare & Medicaid Services (CMS) recently awarded contracts for four specialty contractors that will be responsible for handling the administration of Medicare claims from suppliers of durable medical equipment, prosthetics and orthotics. The new Durable Medical Equipment Medicare Administrative Contractors (DME MACs), which were selected through a competitive bidding process, will replace the Durable Medical Equipment Regional Carriers (DMERCs). The geographical jurisdictions are slightly realigned from those serviced by the DMERCs, with Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin to be serviced by AdminaStar Federal. Under the current system, fiscal intermediaries process claims for Medicare Part A providers, including hospitals, skilled nursing facilities and other institutional providers, while carriers process claims for physicians, laboratories and other suppliers under Medicare Part B. Upon full implementation of contracting reform, the fiscal intermediaries and carriers will be replaced by MACs that will be responsible for both Part A and Part B claims. The new structure will result in separate single points of contact with the Medicare program for beneficiaries and providers. The DME MACs will begin transition immediately and assume full responsibility for claims processing duties currently performed by the DMERCs on July 1, 2006. However, the DME MACs will not perform any pre-pay or post-pay medical review function or benefit integrity function, since the CMS awarded separate payment safeguard contacts for these functions in early December. For further information regarding Medicare contracting reform, contact Vickie Seal at the MHA.
After 21 years with Traverse City-based Munson Healthcare, Jay Zrimec retired last week from his position as Munson Healthcare Regional Foundation president and vice president for governmental affairs and volunteer services. Zrimec joined Munson in 1984, has overseen the foundation since its establishment in 1994, and directed five major fundraising campaigns during his tenure. The most recent campaign, which will allow an expanded Munson Medical Center emergency room to open in January 2007, was completed two months ahead of schedule.
Trinity Health, Novi, recently announced the appointment of Morley M. Robbins to the position of senior vice president, strategy, marketing and communications. Robbins has held senior planning and marketing positions at various major health systems and served as a health care consultant with several national consulting organizations before starting his own firm. He holds an undergraduate degree from Denison University, Granville, OH, and a master’s of business administration in health care administration from George Washington University, Washington, DC. Emergency Physicians Issue Report Card
The American College of Emergency Physicians (ACEP) has released a new report on the condition of the nation’s emergency health care system. Giving the country an overall score of C-minus, the report indicates that the system is overcrowded, provides limited access to care, faces soaring liability costs, and has a limited capacity to deal with public health or terrorist disasters. Michigan’s emergency care system overall was rated at a B-minus, ranking the state’s emergency services at sixth in the nation. No state received an overall grade of A or F. The study highlights the role that hospitals play on the front lines of the health care crisis, serving as America’s health safety net. It also underscores the need for state and federal governments to provide sufficient support for hospitals to do their jobs well. Researchers used a range of available data to develop 50 measures for grading each state on its support in four areas: access to emergency care, quality and patient safety, public health and injury prevention, and medical liability environment. The national score is an average of the grades for all 50 states and the District of Columbia. Visits to the emergency departments in Michigan’s nonprofit hospitals increased by more than 20 percent from 1998 to 2004, largely fueled by the growing number of uninsured residents who forego treatment until more extensive and expensive health care becomes necessary after their condition worsens. The ACEP report indicates that Michigan offers 12.76 emergency departments per 1 million people, although it does not measure the capacity of those facilities. Across the state, hospitals are working to expand and upgrade their emergency departments to accommodate the growing number of annual visits, since existing facilities were designed years ago to accommodate from half to a third the number of current patients. Members with questions should contact Sherry Mirasola at the MHA. Program Focuses on National Patient Safety Goals, JCAHO Surveys The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) National Patient Safety Goals (NPSGs) are a priority focus area for 2006 JCAHO surveys. This is also the inaugural year for JCAHO unannounced surveys. Hospitals can assess compliance with the JCAHO NPSGs and be prepared for an unannounced survey by attending the MHA Health Foundation education program The JCAHO’s National Patient Safety Goals: What to Expect, How to Comply. The program will outline methods to enhance processes and communication among caregivers to improve medication safety; examine how JCAHO surveyors will assess compliance with the NPSGs; and present ideas to create a rapid response team or criteria to evaluate existing team responses and interventions. The program will also provide samples and templates that demonstrate proactive risk-reduction policies and methods to keep patients safe. The program is scheduled for Feb. 28 in East Lansing and an early registration discount is available through Jan 31. To learn more, contact Leigh Anne Jewison at the MHA. Prebook Influenza Vaccine for 2006-2007 Season
To ensure adequate supplies of vaccine for the 2006-2007 influenza season, MHA members are encouraged to order their influenza vaccine on a timely basis. An excellent online source is available for information on ordering and prebooking flu vaccine from various distributors for the 2006-2007 season. Although there are numerous distributors that sell influenza vaccine, only one manufacturer, sanofi pasteur, sells directly to practices. The Fluzone influenza vaccine from sanofi pasteur will be made available for prebooking at noon Jan. 31. In 2005, all vaccine supplies were prebooked in less than 12 hours. To prebook with sanofi pasteur, customers can call (800) VACCINE (or 822-2463) to place orders at the standard price or place orders online to receive a 2 percent savings. Physicians must have established accounts with the company before they may place orders. To create an account with sanofi pasteur online, visit the Web site or call (800) VACCINE. Flu season in Michigan is expected to peak in February, so vaccinations given now can still help prevent spread of the disease. A map demonstrating influenza surveillance trends in the country is currently available through the Centers for Disease Control and Prevention and additional information on the influenza virus and vaccine is accessible through the Michigan Department of Community Health. Members with questions should contact Cassandra Dowling at the MHA. The Michigan Council of Directors of Volunteer Services (MCDVS), a nonprofit organization advancing volunteer service management in MHA-member hospitals, recently installed its 2006 officers. Kathy Praedel, director, volunteer services, Borgess Medical Center, Kalamazoo, was installed as president; Penny Brown, marketing and public relations specialist/volunteer coordinator, Allegan General Hospital, as president-elect; Nancy Day, manager, volunteer services, Bon Secours Cottage Health Services, Grosse Pointe, as secretary; and Cindy McPherson, volunteer services coordinator, Zeeland Community Hospital, as treasurer. Kristyn Ireland, manager, volunteer services, North Ottawa Community Hospital, Grand Haven, will serve as advisor. Members with questions should contact Lori Latham at the MHA.
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