On Nov. 18, the Michigan Health Council (MHC) recognized the MHA and several MHA-member hospitals and health systems at its 65th Anniversary Luncheon, Special Presentation and Awards Ceremony in East Lansing. The luncheon featured a special presentation on "Patient Safety and Workforce Retention; Lessons Learned from Simulation Research in Healthcare" by guest speaker William Hamman, MD, PhD. Recipients of the MHC's 2008 Building Michigan's Healthcare Workforce Awards were then announced, and included:

• The MHA - Building Michigan's Healthcare Workforce Award: Regional Collaboration to Build Michigan's Workforce
• Beaumont Hospitals, Royal Oak - Building Michigan's Healthcare Workforce Award: Regional Collaboration to Build Michigan's Workforce
• Detroit Medical Center - Building Michigan's Healthcare Workforce Award: Regional Collaboration to Build Michigan's Workforce
• Henry Ford Health System, Detroit - Building Michigan's Healthcare Workforce Award: Regional Collaboration to Build Michigan's Workforce and Building Michigan Healthcare Workforce Award for Education and Training
• Oaklawn Hospital, Marshall - Building Michigan's Healthcare Workforce Award for Workforce Retention
• Oakwood Healthcare Inc., Dearborn - Building Michigan's Healthcare Workforce Award: Regional Collaboration to Build Michigan's Workforce and Building Michigan's Healthcare Workforce Award for Workforce Recruitment
• St. John Health, Warren - Building Michigan's Healthcare Workforce Award: Regional Collaboration to Build Michigan's Workforce
• Trinity Health, Novi - Building Michigan's Healthcare Workforce Award: Regional Collaboration to Build Michigan's Workforce
• University of Michigan Health System, Ann Arbor - Building Michigan's Healthcare Workforce Award for Workforce Retention

Congratulations to those members recognized by the MHC as outstanding participants in building and maintaining Michigan's health care workforce in 2008. For more information, contact David Seaman at the MHA.

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Last week, President-elect Barack Obama tapped former U.S. Senate Majority Leader Tom Daschle (D-SD) to lead the Health and Human Services Department (HHS). Consisting of 11 different agencies, HHS oversees federal health care policy on children, mental health, public health, disease prevention, health information technology, substance abuse and emergency preparedness. The HHS Centers for Medicare & Medicaid Services set payment policy for Medicare and Medicaid services.

Daschle spent 26 years in the U.S. Congress and has a record of support for public health. His interest in health care is evident through his efforts to help coordinate congressional approval of the Clinton health plan in 1994. After losing his Senate seat in 2004, Daschle continued to concentrate on health policy, especially reform of health care coverage in America. In February 2008, Daschle published Critical: What We can Do About the Health-Care Crisis, which proposes a federal health board to "create a public framework for a largely private health-care delivery system." He advised Obama on health care during the presidential campaign and is expected to be the point person for the president-elect's health care reform agenda. For more information, contact Laura Appel at the MHA.

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During the most recent meeting of the MHA Board of Trustees, board members endorsed the recommendations of the MHA Patient Safety Organization that all hospitals using patient alert wristbands should adopt the use of three standardized colors.

Immediately following the endorsement, a wristband standardization survey was e-mailed to MHA-member hospital chief executive officers, chief operating officers, directors of patient safety and quality, and chief nursing officers to be completed by Dec. 1. Thus far, the MHA has received a tremendous response to both the survey and the pledge. However, responses from all Michigan hospitals are necessary to complete this survey effort and to ensure the success of the initiative. The survey and pledge can be accessed and completed online. Members with questions regarding the patient alert wristband standardization initiative should contact Morgan Martin at the MHA.

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The MHA Health Foundation Winter Leadership Conference will be held Feb. 18 and 19 at the Grand Traverse Resort & Spa. Many opportunities to sponsor events are still available. However, the deadline to be listed as a sponsor in the conference brochure is Dec. 5.

The MHA Health Foundation Winter Leadership Conference is the most popular education and networking event for Michigan small and rural hospital CEOs and senior leaders, and sponsorship offers a variety of ways for organizations to receive recognition and visibility among this group of executives.

Details of sponsorship opportunities and Intent-to-Sponsor forms are available in the MHA Corporate Sponsorship and Advertising Program brochure. For more information, contact Erin Steward at the MHA.

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The Centers for Medicare & Medicaid Services (CMS) will use data reported on hospitals' Medicare cost reports for fiscal years ending between Sept. 1, 2006, and Aug. 31, 2007, to develop the Medicare wage index for fiscal year (FY) 2010. Under the Medicare prospective payment system (PPS), the Medicare wage index is developed annually and used to adjust Medicare payments for geographic wage differences. Since nearly all Medicare services have transitioned to a prospective payment system, it is crucial that hospitals ensure their data is accurately reported each year based on the latest CMS regulations and interpretations.

In early October, the CMS released a public use file containing data that hospitals reported on their cost reports for periods ending during this timeframe. To assist hospitals with the annual data review process, the MHA provided hospitals with a four-year comparative analysis of this data. During the annual review period, hospitals can also request changes to their data submitted on the latest occupational mix survey for the 12-month period July 1, 2007, through June 30, 2008, which will be used to adjust the Medicare wage index in FYs 2010, 2011 and 2012. Hospitals have until Dec. 8 to review their data and submit requests for changes, along with supporting documentation to National Government Services (NGS). Questions about the wage index should be directed to Larisa Knorr at NGS or Vickie Seal at the MHA.

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Keeping up with the critical changes occurring within the outpatient prospective payment system and the Healthcare Common Procedure Coding System (HCPCS) code sets is imperative for revenue cycle managers and reimbursement specialists - fair reimbursement depends on it, and coding errors are what representatives from the Centers for Medicare & Medicaid Services Recovery Audit Contractor program will be looking for.

The MHA Health Foundation Webinar Secure Outpatient Prospective Payment System Revenue Integrity: 2009 Updates for your Outpatient Data Cycle will be held from 10 a.m. to 3 p.m. Dec. 18. The Webinar will examine the addition of 27 allowable procedures for ambulatory payment classifications, eight procedures as office-based procedures, and updates to the list of device-intensive procedures, as well as the transitional pass-through payments; payments for drugs, biologicals and radiopharmaceuticals; and status indicator Q. Participants will also learn how to examine payment, coding and operational challenges for hospital evaluation and management services. Andrea Clark, RHIA, CCS, CPCH, is the featured speaker.

A $275 connection fee per MHA-member organization must be received by Dec. 12. Online registration and additional details are available on the MHA Web site. For more information, contact Sara Miller at the MHA.

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Critical access hospitals (CAHs) and others will soon be able to voluntarily submit quality-of-care data under the Medicare hospital outpatient quality data reporting program. The Centers for Medicare & Medicaid Services (CMS) recently announced this change, effective with patient encounters in first-quarter 2009. During the period Nov. 15 through Jan. 31, 2009, these hospitals can register to participate in the program by completing and submitting a Notice of Participation. Earlier this year, the CMS granted a request by the American Hospital Association to allow CAHs to participate in outpatient quality reporting because of their commitment to public transparency and quality improvement. Members with questions should contact Sam R. Watson at the MHA.

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The fiscal year (FY) 2009 Urban Areas Security Initiative (UASI) Nonprofit Security Grant Program (NSGP) that provides funding support for homeland security improvements has announced a grant opportunity that applies to hospitals in Macomb, Monroe, Oakland, St. Clair, Washtenaw and Wayne Counties. This grant money is available to southeast Michigan hospitals that could allocate it toward the "acquisition and installation of security equipment, specifically in prevention of and/or protection against the risk of a terrorist attack."

A guidance and application kit from the U.S. Department of Homeland Security is available online, as is the application. All eligible grantees must submit their grant application by Jan. 15, 2009 for consideration. Members with questions should contact Mary Gager Anderson at the Michigan State Police.

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Michigan hospitals have once again demonstrated they are among the best of the best, this time for cardiovascular care. In the 10th edition of Thomson Reuters 100 Top Hospitals®: Cardiovascular Benchmarks for Success, 11 Michigan hospitals rank in the nation's top 100 for cardiac services.

The global information company examined the performance of nearly 1,000 U.S. hospitals and determined those that performed significantly better on risk-adjusted measures of mortality and complications. The top 100 were divided among teaching hospitals with cardiac residency programs, teaching hospitals without cardiac residency programs, and community hospitals.

Listed in the group of 30 hospitals with cardiac residency programs are Henry Ford Hospital, Detroit; St. John Hospital and Medical Center, Detroit; Providence Hospital and Medical Centers, Southfield; and Beaumont Hospital, Royal Oak.

Michigan teaching hospitals without cardiac residencies that are among a group of 40 such benchmark hospitals are Mercy Health Partners, Muskegon; Bronson Methodist Hospital, Kalamazoo; St. Joseph Mercy Hospital, Ann Arbor; Munson Medical Center, Traverse City; St. Joseph Mercy Oakland, Pontiac; Henry Ford Macomb Hospitals, Clinton Township; and Marquette General Hospital. No Michigan hospitals appear on the list of 30 community hospitals.

Thomson Reuters concluded that, if all hospitals performed at the level of the 100 benchmark facilities, nearly 6,000 lives would be saved per year, nonfatal complications would be prevented in an additional 720 patients, and about $1,500 in health care costs would be saved per case.

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Last week, the Centers for Medicare & Medicaid Services (CMS) proposed covering bariatric surgery for Medicare beneficiaries with type 2 diabetes who have a body-mass index (BMI) of 35 or more. Currently, Medicare covers four types of bariatric surgery for patients with a BMI of 35 or more and at least one serious health condition. In its proposal, the agency would include diabetes as one of the qualifying health conditions. The CMS will accept comments on the proposed decision for 30 days and issue a final decision within 90 days of the Nov. 12 posting. It indicated it did not find convincing medical evidence that bariatric surgery improved health outcomes for diabetes patients with a BMI under 35. Members with questions should contact Vickie Seal at the MHA.

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This summer, the Centers for Medicare & Medicaid Services published new hospice conditions of participation (CoPs). All Medicare hospices must comply with the new regulations by Dec. 2, with the exception of the Quality Assessment and Performance Improvement regulation, which has been extended to Jan. 31.

The changes to the CoPs include heightened expectations of governance requirements for hospital-based hospice programs. Subpart D, §418.100 of the CoPs states that "A governing body (or designated persons so functioning) assumes full legal authority and responsibility for the management of the hospice, the provision of all hospice services, its fiscal operations, and continuous quality assessment and performance improvement. A qualified administrator appointed by and reporting to the governing body is responsible for the day-to-day operation of the hospice. The administrator must be a hospice employee and possess education and experience required by the hospice's governing body."

The interpretive guidelines, a revised State Hospice Operations Manual, the revision of the State of Michigan Hospice Medicaid Regulations, and surveyor training are expected by January. For more information, contact Jeff Towns at the Michigan Hospice and Palliative Care Organization at (517) 886-6667 or Sam R. Watson at the MHA.

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The Joint Commission has developed a Rapid Process Improvement Team to work on the challenges presented by hospitals and the accrediting body interpreting its standards differently. As a component of this initiative, the Joint Commission is requesting input from accredited hospitals.

The commission is developing a survey tool to measure the degree of inconsistency by gathering customer feedback. The Joint Commission is seeking assessments and suggested additions or revisions to the proposed survey, as well as suggested implementation strategies, such as post-survey calls or online follow-up tools. Members with questions should contact Siew Lee Cheng at The Joint Commission or Sam R. Watson at the MHA.

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Last week, the Medical Services Administration (MSA) hosted a meeting for ambulatory surgical centers (ASCs) to obtain input on the establishment of a new Medicaid reimbursement system for these facilities. Medicaid participation with ASCs was legislated in the fiscal year 2008 Michigan Department of Community Health appropriations, with a budget neutrality requirement. However, the MSA will not implement the ASC payment system until the conversion of the current Medicaid claims processing system to the new Community Hospital Automated Medicaid Processing System (CHAMPS) is complete, which is expected to occur in late spring or early summer 2009. The MSA indicated that it must obtain certification of CHAMPS by the Centers for Medicare & Medicaid Services before adding ASCs or other new provider types. Future meetings will be held to develop ASC payment rates and resolve various technical issues. Members with questions should contact Vickie Seal at the MHA.

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The MHA Quality, Compliance and Patient Safety Committee, chaired by Cheryl Knapp, vice president of quality and patient safety, Bronson Healthcare Group, Kalamazoo, met earlier this month. At the meeting, the committee received reports regarding new accreditation options from Houston-based Det Norsek Veritas (DNV) that use the International Standards Organization's ISO 9000 method for monitoring processes.

The committee also heard reports regarding the MHA Patient Safety Organization and updates to the MiHospitalInform.org transparency and accountability Web site. The committee received a presentation on patient education for medications used to prevent deep vein thrombosis, and a second presentation focused on the cardiovascular quality improvement program.

Acting as the data privacy committee for the MHA, the committee approved a request from the Agency for Healthcare Research and Quality to release de-identified hospital demographic data from the American Hospital Association's annual survey. The next meeting of the committee will be held Jan. 9 at MHA headquarters in Lansing. Members with questions should contact Sam R. Watson at the MHA.

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The Centers for Medicare & Medicaid Services (CMS) recently announced that, beginning in 2010, only Medicare beneficiaries with certain chronic medical conditions will be eligible for Medicare Advantage (MA) special needs plans (SNPs). SNPs are Medicare Advantage plans that serve only beneficiaries living in institutions, those eligible for both Medicare and Medicaid, or those living with severe or disabling chronic conditions. The Medicare Improvements for Patients and Providers Act (MIPPA) directed the CMS to convene a clinical advisory panel to determine the specific conditions that met the MIPPA statutory definition of a severe or disabling chronic condition in regard to SNPs. The panel has now identified the following conditions:

• chronic alcohol and other drug dependence
• certain autoimmune disorders
• cancer (excluding pre-cancer conditions)
• certain cardiovascular disorders
• chronic heart failure
• dementia
• diabetes mellitus
• end-stage liver disease
• end-stage renal disease requiring dialysis (all modes of dialysis)
• certain severe hematologic disorders
• HIV/AIDS
• certain chronic lung disorders
• certain chronic and disabling mental health conditions
• certain neurologic disorders
• stroke

The panel identified these 15 conditions as being medically complex, substantially disabling or life threatening, having a high risk of hospitalization or other adverse outcomes, and requiring a specialized delivery system across domains of care. Members with questions should contact Vickie Seal at the MHA.

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• MHA members are invited to attend the second annual meeting of the Michigan Health Insurance Access Advisory Council (MHIAC), from noon to 1:30 p.m. today at the Kellogg Hotel and Conference Center in East Lansing. The meeting will feature a brief recap of the MHIAC's accomplishments to date, followed by a presentation by John Ferman from Health Policy Alternatives, a Washington, DC-based health policy think tank, on how this year's election results will affect health policy in Michigan and the nation. For more information, contact Carolyn Wiener at MHIAC at (248) 448-5056.

• The MHA Hospitals for a Healthy Environment Committee will meet from 10 a.m. to noon Thursday, Dec. 4, at MHA headquarters in Lansing. The group will continue to develop initiatives to help hospitals reduce their ecological footprint. For more information, contact Paige Hathaway at the MHA.

• All MHA offices will be closed Thursday and Friday, Nov. 27-28, in observance of the Thanksgiving holiday. Therefore, the next issue of the MHA Monday Report will be published Dec. 8. Have a safe and healthy holiday!