Media Recap: Michigan Healthcare Careers, Digital Health Trends

Laura Appel

Laura AppelThe MHA received media coverage the week of Sept. 16 regarding Michigan healthcare careers and what’s next for digital health.

Second Wave Michigan published a story Sept. 17 on healthcare careers and the existing healthcare workforce shortage. The story includes quotes from Laura Appel, executive vice president and government relations and public policy, MHA, about how shortages impact hospitals, the impact of state funding and the results of the MHA’s annual hospital workforce survey.

“We’re bouncing back. We’re on the rebound for sure,” said Appel. “But it’s going to require a lot of work and staying on top of things. It’s not a one-and-done situation where you work at it for one year and then it will all be fixed. Workforce shortage is a long-term situation, and it’s going to require long-term commitment.”

The story is part of the Yours, Mine, and Ours — Public Health series from Second Wave Media that highlights how Michigan’s public health agencies keep individuals healthy, safe and informed about issues impacting physical and mental health in communities, homes, workplaces and schools.

Becker’s Hospital Review published a story Sept. 20 featuring insight from hospital and health system executives across the U.S. on the future of new technology in healthcare.

“Advancements in artificial intelligence (AI) present many opportunities to improve the delivery of healthcare and reduce administrative burden,” said MHA CEO Brian Peters. “Our association created a member-wide task force to develop a framework for Michigan hospitals focused on the safe, ethical and equitable application of AI within healthcare. This framework includes clear guidance and model policies to help hospital policy makers manage the evolving impact of AI. While hospitals will vary in the implementation of AI and the resources they have available, this framework should help to ensure consistent application across the state so patients can continue to receive quality, accessible healthcare.”

Members with any questions regarding media requests should contact John Karasinski at the MHA.

Appel Discusses Radiology Workforce Shortage

Laura Appel

Laura AppelWWMT-TV Newschannel 3 aired a story Sept. 9 on the radiology workforce shortage in hospitals, including a shortage of radiologists and radiology technicians.

MHA Executive Vice President Laura Appel was interviewed for the story, explaining how the shortage impacts hospital operations and what hospitals are doing to address workforce shortages.

“People that have a trauma, an emergency, an urgency, that is all going to be the first thing that hospitals are doing,” said Appel. “Finding someone to read those images and get those results.”

Members with any questions regarding media requests should contact John Karasinski at the MHA.

MHA CEO Report — Site-Neutral Payment Policies: The Latest Threat to Patient Access

MHA Rounds graphic of Brian Peters

“The worst form of inequality is to try to make unequal things equal.” — Aristotle

MHA Rounds graphic of Brian PetersOperating a hospital has never been more challenging than it is today. At the most fundamental level, hospitals are small towns that operate 24/7, year-round, built around expert clinicians, as well as a wide variety of highly skilled employees in multiple disciplines. Collectively, they are tasked with the awesome responsibility of delivering a broad spectrum of high-quality healthcare services to everyone in their respective communities, regardless of their health or socio-economic status.

Our MHA Chief Medical Officer, Gary Roth, DO, often says “healthcare is everyone’s destiny.” He’s right: at some point, all of us – or our loved ones – will require the assistance of our healthcare system. And when that day comes, we as patients can and should expect that we have ready access to care. Michigan hospitals take that expectation very seriously, whether that comes in the form of physician recruitment, retention and call coverage, drug acquisition, facilities maintenance and expansion, or ensuring that the latest diagnostic and treatment technology is on-site.

Here is an economic reality: being prepared to care for anyone, for any diagnosis, at any time, creates high fixed costs. In classic business terminology, hospitals are “price takers” when it comes to government payers, because Medicaid and Medicare effectively tell hospitals what they will receive in reimbursement.

Against this backdrop, our field is currently facing a strong push at the federal level to prevent hospitals from receiving Medicare reimbursement at a level that appropriately recognizes the higher fixed and operational costs referenced above. Referred to as “site-neutral payments,” this policy would force hospitals to accept the same rates as those paid at other sites of care. This ignores the fact that the cost structures between the two settings are very different because hospitals go to great lengths to have the infrastructure in place to save lives every day. Non-hospital settings serve a very valuable but different role, and the reimbursement they receive today reflects those differences. In addition to being open 24/7/365 to all patients – including those with multiple comorbidities, and little or no health insurance coverage, hospitals must have redundant systems for energy and water so surgeries and other patient care can continue uninterrupted when the power goes out or other systems are compromised. Physician offices have no such requirements and don’t bear these costs.

Hospital outpatient departments also provide convenient access to care for the most vulnerable and medically complex patients. These settings are more likely to treat Medicare patients who have more chronic and severe conditions, have been recently hospitalized or in an emergency department and are dually eligible for Medicare and Medicaid. These patients are more expensive to care for and rely on hospital outpatient departments for their increased healthcare needs.

Implementing site-neutral payment policies would be detrimental to access to care for patients across Michigan and the country. If reimbursement is slashed across the board, hospitals will be forced to reduce their costs, which will come in the form of reduced hospital beds, service lines or even potentially hospital closures. This plan for inadequate payment can be particularly harmful for hospitals serving a high percentage of vulnerable patients, including rural hospitals. When a hospital closes services due to site-neutral payment policy, they will close to everyone, not just people covered under Medicare.

I was recently honored to be appointed to the American Hospital Association Board of Trustees and this issue is clearly a key focus of their advocacy work on Capitol Hill. The MHA is joining that effort by advocating with Michigan’s members of Congress, and our message is unambiguous: comparing hospitals with other sites of care is not comparing apples and oranges – it’s comparing apples and space shuttles. More importantly, reducing healthcare costs can’t come at the expense of reduced access to care.

As always, I welcome your thoughts.

Congresswoman Slotkin Introduces American Made Pharmaceuticals Act

MHA CEO Brian Peters

U.S. Representative Elissa Slotkin (D-MI) issued a press release Aug. 8 highlighting her introduction of the American Made Pharmaceuticals Acts that included a quote of support from MHA CEO Brian Peters. The bipartisan bill, introduced with U.S. Rep. Don Bacon (R-NE), would incentivize domestic production of critical medicines and help prevent drug shortages by securing the pharmaceutical supply chain. Its Senate companion is led by Sens. Tina Smith (D-MN) and Tom Cotton (R-AR).

“Drug shortages severely hamper a hospital’s ability to provide every patient with the best treatment,” said Peters. “We applaud Rep. Slotkin for leading on this important issue and introducing legislation that should increase domestic pharmaceutical manufacturing, strengthen our pharmaceutical supply chain and prevent future drug shortages.”

Members with any questions regarding media requests should contact John Karasinski at the MHA.

MHA CEO Report — A Program Year in Review

MHA Rounds graphic of Brian Peters

“Winning is not a sometime thing, it is an all the time thing. You don’t do things right once in a while…you do them right all the time.”  — Vince Lombardi

MHA Rounds image of Brian PetersI am pleased to share we just completed a successful MHA Annual Meeting, continuing a long-standing June tradition whereby we celebrate the conclusion of one MHA program year, and prepare for the next. Each program year is unique with the different challenges it presents. At this point five years ago, no one could have predicted how the emergence of COVID-19 would flip healthcare on its head and drastically alter the tactical objectives of our association. However, there is a constant: the MHA continues to rise to any challenge presented to us and we deliver results for our membership to improve the health and wellness of individuals and communities.

The 2023-2024 program year focused intensely on workforce, viability and behavioral health, while addressing the various “wildcard” issues that always come up. We were led with great wisdom and compassion by Shannon Striebich, president and CEO, Trinity Health Michigan, as our board chair. Due to Shannon’s commitment and leadership, the MHA accomplished numerous highly successful and impactful outcomes on behalf of our members.

One of the most significant challenges in this past year was the threat posed by government-mandated nurse staffing ratio legislation. This proposed policy had the potential to dramatically reduce access to care for individuals throughout the state. Our advocacy on the issue lasted throughout the entire year but was highlighted by an Advocacy Day we hosted in September that featured more than 150 hospital representatives, primarily consisting of nurse leaders, who came to the Capitol and conducted 118 meetings with lawmakers that day. Later in the year, the MHA successfully advocated our position at a committee hearing, where more than 60 supporters attended on very short notice to push back on false narratives and to support alternative nurse staffing solutions. As a result of our efforts, no committee votes have been scheduled, and momentum on this harmful legislation has been effectively stalled.

While we had to play defense against this harmful proposed legislation, the MHA spent the program year actively engaged in workforce development and efforts to grow the healthcare talent pipeline. The MHA worked with stakeholders to implement new funding designed to expand access to Bachelor of Science in Nursing degrees through partnerships between community colleges and four-year universities, while also engaged in partnerships with other organizations to promote healthcare careers, increase clinical faculty and nurse preceptors, address high turnover rates in rural areas and promote healthcare career options. We continued our award-winning healthcare career marketing campaign designed to attract future workers and also redeployed our annual hospital workforce survey that shows the efforts of Michigan hospitals to recruit, retain and train healthcare workers is making a real difference. Finally, we hired our first-ever chief nursing officer at the MHA, which is already strengthening our ties to the nursing community throughout the state.

The viability of hospitals was another key focus and was largely supported through our legislative advocacy work. MHA funding priorities continued to be protected in the state budget, which includes $163 million for graduate medical education, $45 million for traditional disproportionate share hospitals, $15 million through the rural access pool and an additional $8 million for the obstetrical stabilization fund. The fiscal year 2024 budget also included $60 million annually to support hospitals with Level I and II trauma centers and $34 million annually to support hospitals that provide inpatient psychiatric care. Besides state funding, the MHA protected Medicaid funding, medical liability, the 340B drug pricing program and certificate of need.

The MHA is also intricately involved in in addressing the behavioral health crisis plaguing our state and country. Expanding access to care is a key focus, which included the MHA administrating a $50 million grant program to expand access to pediatric inpatient behavioral health services. The Michigan Department of Health and Human Services (MDHHS) is a close partner in this work and the MHA participated in the MDHHS Advisory Committee on the creation of a psychiatric bed registry. The MHA launched a new member ED boarding survey to quantify the number of patients struggling with behavioral health access in the emergency department and the MHA is using this data when engaging with lawmakers, stakeholders and the public to explain the scope of the program. These learnings informed the creation of a four-bill package of legislation to address board-identified issues in the behavioral and mental health system, such as coverage parity and community mental health shortcomings.

Much of the work in the past year has focused on maternal and infant health and improving maternal health and birth outcomes. And I am pleased to share that our MHA Board of Trustees just approved the full slate of recommendations emanating from the MHA Community Access to Health Task Force, giving us the support to continue this important journey together.

And as usual, we effectively dealt with a long list of “wildcard” issues that emerged during the program year, including drug shortages, guardianship, infection control, patient transport, population growth and safety and quality. We also continued to strengthen our efforts related to the growing cybersecurity threat. Indeed, the Change Healthcare cyberattack was one of the largest and most impactful attacks ever seen and served as a clear reminder of the importance of our work in this space.

At our Annual Meeting, I spoke to our attendees about “the power of zero.” In the 2023-2024 program year, the following were true:

  • The number of Michigan acute care community hospitals and health systems that are not members of our association is zero. We have everyone at the table, which allows us to speak with one powerful, united voice.
  • We passed 39 MHA-supported bills through the state legislature that were enacted into law, with five more on their way to the governor for her signature. The number of MHA-opposed bills that made their way to the finish line was zero.
  • The MHA now has a full-time chief medical officer and a full-time chief nursing officer (as noted above). How many other state hospital associations can say this? Zero.
  • And most importantly, how many other associations – in any sector – are as relevant, as impactful, as mission-driven and successful as the MHA? I believe that number is zero.

I would like to recognize and thank our outstanding MHA Board of Trustees, our members, sponsors and business partners, but most of all, our incredible MHA staff for coming together to achieve such tremendous results for the patients and communities we collectively serve. I hope you will take the opportunity to celebrate these results with us.

As always, I welcome your thoughts.

Michigan Legislature Champions Healthcare Funding

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association.

MHA CEO Brian PetersThe Michigan Legislature passed a state budget that champions crucial healthcare funding and protects access to vital healthcare services across Michigan communities.

The fiscal year 2025 state budget and fiscal year 2024 supplemental proposals continue funding pools that support rural and critical access hospitals, obstetrical services, the Healthy Michigan Plan and Michigan’s Medicaid populations. Each of these pools help maintain access to care for underserved populations throughout the state.

The budget also includes new funding to support peer recovery coaches in hospitals to enhance substance use disorder services. These individuals are specifically trained to provide advanced peer recovery support services and are proven to help patients overcome obstacles in their substance use disorder recovery. Michigan joins the more than 38 other states in supporting this model of providing needed care.

We look forward to Gov. Whitmer signing this budget, which protects access to care and ensures hospitals can continue to advance the health of individuals and communities.

Update: Rural Cybersecurity Program

The White House held a briefing on June 14 with representatives from Google and Microsoft to elaborate on the cybersecurity program being offered to rural communities. These initiatives are designed to improve cybersecurity measures for rural hospitals across the United States.

Microsoft is extending its nonprofit program to provide rural hospitals with up to a 75% discount on productivity and security solutions, including Microsoft Office 365. Larger hospitals already using Microsoft Office 365 will receive a year of advanced security solutions at no extra cost. Additionally, Microsoft is offering free security assessments for rural hospitals to identify vulnerabilities and strategic guidance for addressing them. They are also providing training and skill-building opportunities for IT and compliance employees. Microsoft is committed to collaborating closely with rural hospitals and has initiated an innovation lab to explore technology solutions for streamlining processes like revenue recapture. Hospitals interested in participating can register through the Microsoft Cybersecurity Program for Rural Hospitals intake form, which is available online.

Google is launching several initiatives to enhance cybersecurity for rural hospitals. They will provide endpoint security advice free of charge and offer funding to support software migration. Google will initiate a pilot program with rural hospitals to develop customized security capabilities tailored to their unique needs. Furthermore, Google is investing in cybersecurity clinics, educational institutions to assist small and underserved rural health systems. These clinics will educate students and provide direct support to rural hospitals. They will offer Chrome Enterprise Premium and Chrome OS Flex to rural health systems in the United States, as well as consulting services and financial assistance. Google Workspace, their collaboration and productivity suite, will be provided to rural health systems with AI security add-ons, facilitating zero trust implementation and ensuring all threats coming through email are detonated in the cloud. Additionally, Google is partnering with Mandiant to offer on-demand training courses and mentorship programs through the health ISAC to enhance threat intelligence skills and information sharing within the healthcare sector. Finally, Google plans to pilot a consulting program for five rural health systems, focusing on developing refined security technologies and services tailored to their needs. Interested parties can contact rural-health@google.com for more information or to participate in these programs.

The federal government is taking action to support healthcare cybersecurity through initiatives like the Department of Health and Human Services’ cybersecurity gateway website, which offers guidance and best practices. Additionally, the Advanced Research Projects Agency for Health is investing over $50 million to develop tools for patching software vulnerabilities in healthcare systems.

Members with questions may contact Lauren LaPine at the MHA.

340B and Mackinac Policy Conference Media Coverage

The MHA received media coverage the week of June 3 that includes coverage on the 340B drug pricing program and from the Mackinac Policy Conference on the healthcare workforce.

Michigan Advance published an article June 6 recapping the Michigan House Insurance and Financial Services Committee meeting June 5 on House Bill 5350, which would protect access to affordable prescription drugs and healthcare services through the 340B Prescription Drug Pricing Program. The article specifically references an infographic submitted to the committee by the MHA, which describes the value of the 340B program and how it supports vulnerable patients and the providers that care for them.

“[MHA] says the program allows hospitals flexibility to invest savings back into local healthcare needs through programs such as mobile health clinics, financial assistance programs for low-income patients, supporting high-cost lines of service needed within a community, or providing access to low-cost drugs.”

In addition, the article references the additional MHA-members who testified in support of the bill. MIRS and Gongwer also published stories on the testimony.

Ruthanne Sudderth, senior vice president and chief strategy officer, MHA.
Ruthanne Sudderth, senior vice president and chief strategy officer, MHA.

Ruthanne Sudderth, senior vice president and chief strategy officer, MHA, also appeared in two podcast episodes published the week of June 3 that were recorded at the Detroit Regional Chamber’s Mackinac Policy Conference.

Sudderth joined Blue Cross Blue Shield of Michigan’s A Healthier Michigan podcast to speak about the long-standing partnership between BCBSM and the MHA on a variety of issues, including the history of the MHA Keystone Center and addressing healthcare workforce needs.

Sudderth appeared on The Michigan Opportunity as well, a podcast produced by the Michigan Economic Development Corporation, to discuss the healthcare workforce. Also appearing in the episode is Gov. Whitmer.

Members with any questions regarding media requests should contact John Karasinski at the MHA.