MHA Monday Report May 29, 2023

MHA Monday Report

Michigan Society of Anesthesiologists Address Legislative Policy Panel

The MHA Legislative Policy Panel convened May 24 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals. The meeting was highlighted by a presentation on potential state licensure of …

Bcapitol buildingills on Healthy Michigan Plan Improvements and Tax Credit for Clinical Preceptors See Action

Action was taken the week of May 22 on a variety of bills that would make improvements to the Healthy Michigan Plan, require adult changing tables be included in future construction or renovation projects and …

capitol building

Governor Signs Red Flag Laws

Legislation to create Extreme Risk Protection Orders (ERPOs) was signed by Gov. Whitmer May 22. These new public acts allow for certain individuals, including healthcare providers, to file an ERPO if a person is a …

MHA Continues Work Towards Chemotherapy Drug Shortage

The MHA has been in frequent contact with members of the Michigan Congressional delegation since the association was made aware of shortages of the chemotherapy drugs carboplatin and cisplatin. Representatives Debbie Dingell (D-Ann Arbor) and …

Licensing and Regulatory Updates

The Michigan Department of Licensing and Regulatory Affairs recently published updated rules related to hospitals. Those updates include the following: Final EMS Life Support Agencies and Medical Control Rule The final rule, effective May …

CMS Releases Medicare Wage Index Information

The Centers for Medicare & Medicaid Services (CMS) recently released the timetable and preliminary hospital data that will be used to develop the Medicare wage index for fiscal year 2025, which begins Oct. 1, …

MHA Enrollment Data Analysis Expansion

The MHA recently expanded its analysis of enrollment data to reflect Medicare and Medicaid enrollment as a percentage of each county’s total population and the split for Medicare and Medicaid between fee-for-service and managed care …

MHA Keystone Center Cohosting Caregiver Navigation Roundtable

The MHA Keystone Center is partnering with the Michigan Health Endowment Fund and RUSH University Medical Center to host a virtual roundtable from 10 to 11:15 a.m. June 21 on implementing caregiver navigation programs in …

Person and Family Engagement Leaders Explore PFE Roadmap

Approximately 80 leaders responsible for quality, safety and patient experience and patient care participated in an MHA webinar to review the newly released MHA Person & Family Engagement (PFE) Roadmap, which includes recommended policies to re-engage …

2023 Ludwig Nominee: Hurley Patient Advocate Seeks to Address Barriers to Care

Since 1990, the MHA has honored member healthcare organizations working to enrich the overall welfare of their local communities through the Ludwig Community Benefit Award. This year, the MHA is excited to showcase all award nominees, …

The Keckley Report

Paul KeckleySocial Determinants of Health: Lots of Talk, Modest Results

“For healthcare, this divergence of views is problematic the proposed debt ceiling compromise includes reducing SNAP benefits (Supplemental Nutrition Assistance Program), imposing work requirements for “able-bodied” Medicaid recipients and cutting community health centers budgets—all hit low-income and underserved populations hardest. In these populations, social determinants of health (SDOH) i.e., food insecurity, unsafe/unhealthy housing, inadequate transportation et al play a central role in their health and its costs, but not much is done. …

Abundant health services research points to one conclusion: the inadequacy of solutions to the nation’s burgeoning social issues aka ‘social determinants of health’ results in poorer health status and higher health costs. Disparities persist. Structural flaws and divergent views about public health have calcified its neglect. It’s’ a disconnect the health system is prompted to fix. …”

Paul Keckley, May 22, 2023

MHA CEO Brian Peters appears on the Michigan Business Beat.

MHA in the News

The MHA received media coverage the week of May 21 regarding the continued shortage of cancer drugs carboplatin and cisplatin and hospital workforce shortages. MHA representatives appearing in published stories include CEO Brian Peters, Executive …

MHA Continues Work Towards Chemotherapy Drug Shortage

The MHA has been in frequent contact with members of the Michigan Congressional delegation since the association was made aware of shortages of the chemotherapy drugs carboplatin and cisplatin. Representatives Debbie Dingell (D-Ann Arbor) and Tim Walberg (R-Tipton) led the Michigan delegation in sending a bipartisan letter May 24 to Food and Drug Administration (FDA) Commissioner Dr. Robert Califf to urge the FDA to take immediate action to mitigate the effects of the nationwide shortage of chemotherapy medications. Every member of the Michigan delegation signed on to the letter.

U.S. Senators Gary Peters (D-Bloomfield Twp.) and Debbie Stabenow (D-Lansing), along with U.S. Representative Elissa Slotkin (D-Lansing), wrote a separate letter to Dr. Califf asking that the FDA do everything in its power to mitigate the dire shortage of cancer drugs that has reached crisis levels in recent months.

The office of Sen. Peters also provided the following information to the MHA during the week of May 22 regarding the shortages.

  • The shortages for each drug are caused by the manufacturer Accord deciding to place production on hold, pending further assessments. Four other manufacturers of the drugs have not been able to fill the supply gap left by Accord.
  • The FDA has continued to work with Accord on prioritization of their assessments for product release and cisplatin and carboplatin are prioritized for release. Cisplatin is now being released following the assessment and supplies are making their way to hospitals and cancer centers. Meanwhile, carboplatin is planned to be released soon.
  • The FDA is also working with the other four manufacturers to increase supply and are offering expedited review of anything needed to increase supply, such as additional manufacturing lines, facilities and suppliers.
  • The FDA is requesting the manufacturers provide data to extend expiration dating for lots on the market that remain in distribution but are nearing expiration. Once received, the FDA will post the drug, old lot number and new lot number on the Extended Use database on the Drug Shortage website.
  • In addition, the FDA is exploring temporary importation to meet patient needs during the shortage. During temporary import, the FDA evaluates the overseas product attributes, as well as the manufacturing facilities, to ensure no risks exist for US patients.

Updates for both cisplatin and carboplatin are being provided by the FDA on the drug’s FDA Drug Shortage webpages.

Members with questions may contact Renee Smiddy with the MHA.

Headline Roundup: Chemotherapy Drug Shortages & Hospital Workforce

Laura Appel

The MHA received media coverage the week of May 15 regarding a shortage of two critical chemotherapy medications, hospital nurse staffing legislation and the well-being of hospital workers. A press release was published May 17 by the MHA regarding the shortage of cisplatin and carboplatin and the strategies hospitals and health systems are implementing to continue chemotherapy treatments for patients.

MHA representatives appearing in published stories include CEO Brian Peters and Executive Vice President Laura Appel. MONL President Kim Meeker, RN, BSN, MBA, also appears in a story on the nurse staffing legislation, while MHA Keystone Center WELL-B partner Bryan Sexton, PhD, from the Duke Center for Healthcare Safety and Quality, appears in a story about how hospitals assist healthcare workers with feelings of grief and loss.

Below is a collection of headlines from around the state.

Friday, May 19

Thursday, May 18

Wednesday, May 17

Tuesday, May 16

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

Patient Treatment Impacted by Shortage of Cancer Drugs

Manufacturing delays at several pharmaceutical companies are causing nationwide shortages of two critical chemotherapy medications – forcing Michigan hospitals and health systems to find alternative treatments for patients, some of which may be less effective. The two drugs are cisplatin and carboplatin and are used to treat several types of cancer, including bladder, lung, ovarian and testicular cancers. The shortage of these chemotherapy drugs is widespread across the country, impacting hospitals throughout all regions of Michigan.

Both drugs are provided by healthcare providers as injections to oncology patients. The shortage of cisplatin was originally reported to the U.S. Food & Drug Administration (FDA) Feb. 10, 2023, while carboplatin was reported April 28, 2023. Both shortage durations are expected to last at least into June 2023.

To reduce the impact of shortages on patients, hospitals are trying many different solutions, including managing existing supply, seeking alternative sources for drugs in short supply, adjusting chemotherapy regimens for impacted patients and working with healthcare systems, as well as state and federal officials, to mitigate these challenges.

“The priority of hospitals is delivering the right care to every patient, every time,” said MHA CEO Brian Peters. “Drug shortages severely hamper a hospital’s ability to provide patients with the best treatment, while forcing hospitals to implement strategies that may increase the cost of care and sometimes do not offer the same effectiveness in treatment.”

This current shortage follows a national trend of drug shortages impacting healthcare providers for years. A survey of medical oncologists published in the New England Journal of Medicine found 83% were unable to prescribe their preferred chemotherapy agent due to shortages.

The MHA supports the following strategies that will address the issue:

  • Relaxing prior authorization requirements from health insurers for alternative therapies so they can be widely used, as appropriate.
  • Establishing an early warning system to help avoid or minimize drug shortages.
  • Removing regulatory obstacles faced by manufacturers and the FDA as a way of averting or mitigating drug shortages and allowing drug imports.
  • Improving communication with healthcare providers, including extent and timeliness of information. There often is no transparency on the cause of a drug shortage and many shortages occur with generic drugs.
  • Exploring incentives to encourage drug manufacturers to stay in, re-enter or initially enter the market.

Patients concerned about the impact of this drug shortage should contact their healthcare provider.