The state Legislature remains deadlocked on spending levels for corrections, community health, general government, education and human services for fiscal year 2010. To avoid a government shutdown of nonessential state services this week, the Senate passed two "continuation budgets" for the School Aid Fund and all other departments on Friday. It is important to note that the Senate did not pass true continuation budgets, which would have carried forward current spending levels. Instead, the Senate's plan includes reductions in spending based on the recent target agreement reached between Speaker of the House Andy Dillon (D-Redford Twp.) and Senate Majority Leader Mike Bishop (R-Rochester). If the state House concurs with Friday's Senate action and Gov. Granholm signs the continuation budgets, state government will remain fully operational until Oct. 31 or until a budget agreement is reached.

The Medicaid program remains one of the most controversially unresolved budgets, with proposals to cut 8 to 12 percent from Medicaid provider rates still being debated. Under a 12 percent cut, hospitals would suffer $203 million in lost funding ($54 million in general fund and $149 million in federal matching dollars). The state Legislature was scheduled to work throughout the weekend in an effort to reach a budget agreement.

In response to this devastating threat, the MHA immediately implemented an aggressive paid media campaign last week that included targeted radio and newspaper advertisements. In addition, traditional advocacy efforts via Hospitals-ACT action alerts, earned-media interviews and billboards in front of the Capitol have been intensified. Public efforts culminated Thursday when the MHA led a coalition of health care advocates in holding a news conference in downtown Lansing. A contingent of journalists, including reporters from WILX-TV 10 (NBC) Lansing (LINK if possible), WLAJ-TV 3 (ABC) Lansing, FOX-TV 17 Grand Rapids (LINK if possible) and Capitol area legislative newsletters heard from physicians and executives representing hospitals, nursing homes and statewide physician associations, who articulated the impact of the proposed cuts.

Over the past few weeks, the hospital community has successfully raised the visibility of the implications of massive Medicaid cuts. However, the need to continue to press lawmakers to protect health care funding remains critical in these final few days of negotiation. Hospital advocates must reinforce to lawmakers that these cuts are being considered at a time when more than 1,000 families are losing their health insurance every week, the state's unemployment number is skyrocketing and Michigan's Medicaid caseload is at a record high of nearly 1.7 million patients. Lawmakers must be urged to reject any proposal that contains significant health care funding reductions. Members with questions should contact David Finkbeiner at the MHA.

MHA President Spencer Johnson launched the news conference Thursday, supported by members of the statewide health care community.

Back To Top

Last week, the Senate Finance Committee (SFC) began consideration of more than 500 amendments to Chairman Max Baucus' (D-MT) version of health care reform, called the America's Healthy Future Act. To date, the committee has focused on changes to the Medicare Advantage program, including reductions in payments to health plans and calculating the cost of reform. The SFC will continue to vet the amendments, as well as other concerns, over the course of the next week.

The America's Healthy Future Act is currently estimated to cost approximately $800 billion; however, this estimate could change during the committee process. To pay for reform, hospital Medicare and Medicaid marketbasket updates and disproportionate share hospital payments would be reduced. Payment reductions are linked to increases in coverage enrollment.

The American Hospital Association (AHA) reached an agreement in June with the SFC that would expand health coverage to 95 percent of Americans, while capping hospital spending cuts at $155 billion over 10 years to help finance health care reform. However, the America's Healthy Future Act is currently estimated to cover only 91 percent of Americans. The MHA will continue to work with the AHA to accomplish the original coverage target of 95 percent or seek to reduce the proposed hospital funding cuts accordingly.

On a related note, Speaker of the House Nancy Pelosi (D-CA) announced the U.S. House will complete this week its work on merging into a single bill the reports from the Energy and Commerce, Education and Labor, and Ways and Means committees. The House will not advance a bill to the floor for formal action until the cost of reform is calculated and the SFC completes its work.

An updated background paper and MHA talking points are available on the MHA's National Health Reform Update Web page. For more information, contact Laura Appel at the MHA.

Back To Top

Last week, the MHA Legislative Policy Panel convened its first meeting of the 2009-2010 program year and developed recommendations for the MHA Board of Trustees on major legislative initiatives impacting Michigan hospitals. This year, the panel is led by chair Barbara Rossmann, president & chief executive officer (CEO), Henry Ford Macomb Hospitals, Clinton Township, and vice-chair Robert Casalou, president & CEO, St. Joseph Mercy Hospital, Ann Arbor.

A significant portion of the meeting was spent discussing national health care reform (see related article) and the fiscal year (FY) 2010 Michigan Department of Community Health budget (see related article). The meeting was highlighted by a special presentation on the State Employee Consolidated Health Insurance Plan (House Bill 5345) by Rep. Tim Melton (D-Auburn Hills), who provided the committee with a political and policy overview of the legislation that would consolidate health care benefits for all public employees and retirees. The panel recommended that the MHA support the approved principles on access to care set forth by the MHA Board of Trustees and continue to work diligently with stakeholders and lawmakers to ensure that these reform principles are addressed during the legislative process.

The panel also recommended that the MHA support the concept outlined in Senate Bill 722, sponsored by Sen. Roger Kahn, MD (R-Saginaw Twp.), which would require that each hospital in Michigan must establish a seasonal influenza immunization policy consistent with the guidelines or recommendations issued by the U.S. Centers for Disease Control and Prevention.

In final action, the panel received an update regarding the association's social media advocacy, as well as earned and paid media efforts surrounding the FY 2010 budget. Members with questions should contact Chris Mitchell at the MHA.

Back To Top

The MHA Keystone Center for Patient Safety & Quality is among the winners of the 2009 John M. Eisenberg Patient Safety and Quality Award that were announced Sept. 21 by the National Quality Forum (NQF) and The Joint Commission. The MHA Keystone Center won the award for domestic system innovation in patient safety and/or health care quality at the national level for its work in the MHA Keystone: Intensive Care Unit (ICU) collaborative. This collaborative focuses on interventions to improve patient safety and prevent harm in ICUs and has achieved significant, measurable patient safety improvements while saving lives and reducing health care costs. From March 2004 to March 2009, MHA Keystone: ICU resulted in 1,830 lives saved, more than 140,700 excess hospital days avoided, and more than $271 million in health care dollars saved.

The Eisenberg Awards were established in 2002 by the NQF and The Joint Commission in memory of John M. Eisenberg MD, director of the Agency for Healthcare Research and Quality, a member of the founding board of directors of the NQF and an impassioned advocate for health care quality improvement. These annual awards recognize individuals and organizations that, through a specific initiative or project, have made an important contribution to patient safety and health care quality in the areas of research or system innovation, as well as the achievements of individuals who have made significant and lasting contributions to improving patient safety and health care quality. Members with questions should contact Sam R. Watson at the MHA.

Back To Top

For several years, Michigan hospitals and health systems have demonstrated increased quality through the collaboratives of the MHA Keystone Center for Patient Safety & Quality and other voluntary projects. Hospitals are introducing new initiatives each year to improve accountability and demonstrate value to their patients and the communities they serve. The 2009 MHA Health Foundation Governance Leadership Forum will help hospitals to continue and strengthen these voluntary efforts.

The Governance Leadership Forum is the absolute, must-attend health care governance conference because it focuses on putting tools in the hands of those who lead improvement and change. This year's conference, titled Sustainable Growth Through Leadership, will provide methods and ideas to:

• demonstrate the highest level of quality accountability and continuous improvement
• negotiate partnerships with physicians and nonacute-care providers that are necessary for integration of care
• do things differently in the midst of complex health reform
• get people excited about their potential to help develop a valuable, sustainable health care model that nurtures the community

Registrations for this important conference should be received no later than Oct. 5. Registration questions and requests for more information should be directed to Leigh Anne Jewison at the MHA.

Back To Top

Raghu Sarvepalli, MD, was recently appointed vice president for medical affairs at St. Mary's of Michigan, Saginaw. He has held the position on an interim basis since Mark Lester, MD, left the hospital to relocate to Texas. Sarvepalli will continue his family medical practice at Heritage Family Physicians on a part-time basis and will continue to serve as medical director of the St. Mary's of Michigan Physician Hospital Organization. He completed graduate studies in the United Kingdom, where he also was trained in orthopedic surgery and family medicine. He served a residency through Saginaw Cooperative Hospitals and is board certified in family medicine. He has served as president of the Saginaw County Academy of Family Physicians and has been a member of the medical executive committee for 10 years.

Back To Top

Wednesday is the registration deadline for the MHA Health Foundation webinar EMTALA Guidelines for On-Call Physicians. Compliance officers, risk management and emergency department directors are encouraged to participate to learn more about the recent 6th Circuit Court of Appeals decision that significantly broadens the duties imposed on hospitals by the Emergency Medical Treatment and Active Labor Act (EMTALA). Scheduled for Oct. 6 from 10 to 11:30 a.m., the webinar will also outline how to develop a shared, community emergency department on-call plan.

A second offering is designed for leaders at hospitals and health systems who are trying to capture market share in narrow, procedure-based service lines that are high quality and tailored to the community. The MHA Health Foundation webinar Using Marketing Research to Drive Physician Outreach Strategies, scheduled for Oct. 20 from 11 a.m. to 12:30 p.m., examines the importance of marketing to physicians as a means for growing market share, as well as strategies for driving referral behavior. A case study will review how one medical center used research findings to understand when and why physicians referred patients to the hospital and to competitors and how to effectively engage physicians in service line development.

To participate, a flat-rate registration fee of $195 per webinar for each MHA-member organization must be received four or more business days before the webinar date. Registration is available online for each of these offerings. Contact Leigh Anne Jewison at the MHA with registration questions.

Back To Top

In partnership with the Michigan Department of Community Health and in conjunction with the Michigan Smoke-free Hospitals Grant, the MHA will host a smoke-free webinar called Tobacco Treatment and the Inpatient from 11 a.m. to noon Oct. 29. This webinar is part of a series of free sessions planned throughout 2009 to provide support for the MHA Campaign for Smoke-Free Hospitals. The final webinar, titled Disparate Populations and the 5 A's will be held from 11 a.m. to noon Dec. 17. Registration for the Oct. 29 session is now open, and those wishing to participate in the Dec. 17 session may register one month prior to the webinar date. For additional information, contact Paige Hathaway at the MHA.
 

Back To Top

• The Hospital Affiliated Legislative Officers group will meet from 8:30 to 9:30 a.m. at the MHA Capitol Advocacy Center, Lansing. The agenda includes an update on the state budget and federal health care reform. For more information, contact David Finkbeiner at the MHA.

• The MHA Small or Rural Hospital Council will meet from 12:30 to 2:30 p.m. Tuesday at MHA headquarters, Lansing. The council will receive an update on the status of federal health care reform and state budget negotiations and will discuss association advocacy strategies. For more information, contact Amy Barkholz at the MHA.

• The MHA Business Advisory Council will meet from noon to 2:30 p.m. Wednesday at MHA headquarters, Lansing. The council will discuss the issue of health care reform. For more information, contact Brian Peters at the MHA.