Tag: Change Healthcare

MHA CEO Report — A Program Year in Review

Issues in Healthcare, Top Issues - Healthcare, MHA Rounds
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.

MHA CEO Report — Cybersecurity Takes Center Stage

Issues in Healthcare, Top Issues - Healthcare, MHA Rounds
MHA Rounds image of Brian Peters

“There are only two types of companies: those that have been hacked, and those that will be.”  – Robert Mueller

“Dear Health Care Leaders,

As you know, last month Change Healthcare was the target of a cyberattack that has had significant impacts on much of the nation’s health care system. The effects of this attack are far-reaching; Change Healthcare, owned by UnitedHealth Group (UHG), processes 15 billion health care transactions annually and is involved in one in every three patient records. The attack has impacted payments to hospitals, physicians, pharmacists, and other health care providers across the country. Many of these providers are concerned about their ability to offer care in the absence of timely payments, but providers persist despite the need for numerous onerous workarounds and cash flow uncertainty.”

So began a letter dated March 10 from Xavier Becerra, the Secretary of the U.S. Department of Health and Human Services (HHS), referencing what is emerging as one of the most extensive and impactful cyberattacks in U.S. history. The scrutiny directed at Change’s parent company UnitedHeath Group – from Congress, HHS, the media and others – is only just beginning, and there is no telling what sort of new regulations, penalties and associated policy change will be the end result. In the meantime, the MHA has stepped up to support our members by sharing as much information and intelligence as possible, and by advocating for flexibility and relief from both private payers and the state Medicaid program.

America’s hospitals are no strangers to external events creating seismic upheaval in our daily operations. Sometimes those events emanate from the world of public policy and politics, sometimes they come in the form of a localized natural disaster or tragic mass casualty event, and no one needs to be reminded of the impact of the global COVID-19 pandemic. But in the wake of the Change Healthcare crisis, there is no doubt cybersecurity now deserves to be on the top of the list of concerns for hospital leaders across the country, and right here in Michigan.

For some time now, the FBI has stated that healthcare organizations are the top target of cybercriminals across the globe, and these attacks have increased significantly in the last two years. Data sharing requirements in healthcare and the connectivity of health information – while well-intended – creates many potential risks for cybercriminals to exploit. Hospitals take these attacks extremely seriously. They are threat-to-life crimes because of the impact they can have on patient safety and access to care, and are formally treated as such by the FBI.

Again, this is not a new issue. A year and a half ago, cybersecurity was the topic for my CEO Report, where we expressed the potential for cybercrimes to cripple an organization. At that time, we saw how multi-national organizations with U.S.-based operations were impacted when Ukrainian government and critical infrastructure organizations were victims of cyberattacks during the Russian invasion of Ukraine. Yet again, we saw how the breach of one organization can cause rippling consequences for an entire industry; one that accounts for 17.3% of our nation’s Gross Domestic Product.

This is why the MHA has been engaged on this topic for many years and goes to great lengths to assist our members. The MHA was closely involved in the creation of the Michigan Healthcare Security Operations Center (HSOC) to help monitor and react to cyber risks with participating member organizations. We also partner with MHA Service Corporation Endorsed Business Partner CyberForceQ, a leader in the field, to assist members who need cybersecurity assistance. For the first time, we also have our very own MHA Vice President and Chief Information Security Officer, Mike Nowak, who works closely with the HSOC, our member CISOs and our external partners in this space. And Jim Lee, our senior vice president, data policy & analytics, continues to lead our MHA Health Information Technology Strategy Council, which is providing meaningful insight on the impact of this latest attack.

It can take months for a third-party review to determine what information was breached and ultimately taken. But from the hospital perspective, it is clear the Change Healthcare cyberattack is yet another example of a breach that initiates with an outside vendor, and those vendors are not always completely transparent and forthcoming with those organizations directly impacted by the breach. One thing we know for sure: our hospitals are victims in these situations and should be treated as such. We want to work with state and federal policymakers and regulatory agencies to prevent cyberattacks, and to root out and punish the criminals who perpetrate these crimes. We will be very concerned about any proposals that unfairly punish hospitals or create new barriers to our ability to provide timely access to quality care.

Our members are going to great lengths to mitigate potential risk. However, more can be done at a federal level to thwart bad actors. Hospitals and health systems are part of critical infrastructure, so our law enforcement agencies need the funding and staff to defend against cybercriminals. The American Hospital Association urged the government to use all diplomatic, financial, law enforcement, intelligence and military cyber capabilities to disrupt these criminal organizations, much like what was done in the global fight against terrorism in the wake of 9/11.

Thankfully, it appears our hospitals and health systems in Michigan have been able to manage this crisis better than counterparts in other states. The work of the MHA and our partners has helped make Michigan a leader in this space and to be prepared to respond to these situations. Our cybersecurity efforts are constantly at work, 24/7 year-round, mirroring the same cadence of our hospitals and their patient care. Yet the human component of healthcare is the most vulnerable. It only takes one individual to not notice a phishing or social engineering attempt for yet another failure that can impact hundreds of organizations, thousands of healthcare workers and tens of thousands of patients. This is why we must remain constantly vigilant as the cyber threat landscape continues to grow.

As always, I welcome your thoughts.