MHA Monday Report Sept. 12, 2022

MHA Monday Report

Healthcare Remains Michigan’s Largest Private-sector Employer Despite Pandemic Losses

The Partnership for Michigan’s Health reports healthcare directly employed nearly 572,000 Michigan residents in 2020, demonstrating that healthcare continues to be the largest private-sector employer in the state despite staffing losses attributed to the COVID-19 pandemic. The 2022 release …


Lt. Gov. Hosted at Capitol Advocacy Center


MHA Drafts Comments on 340B Provisions and REH Payment Policies


MHA Offering Basics of Case Management Boot Camp


Implicit Bias Trainings Available to Meet LARA Requirement


Webinar Explores Guidelines for Strategic Planning


Virtual Nurse Preceptor Academy Supports New Employee Training and Retention


MHA CEO Report – Time to Focus on Cybersecurity


AHA Trustee Insights Outlines Financial Turnaround and Succession Planning


Paul KeckleyThe Keckley Report

In Campaign 2022, Healthcare Voters Will Matter More

“Today begins the countdown to election day November 8: in 63 days, voters will elect 36 Governors, 30 State Attorneys General, 27 Secretaries of State, 35 US Senators, 435 US House of Representatives and State Legislators in 46 states. It’s a consequential election for the country and for its healthcare industry…

Campaigns will avoid healthcare issues other than abortion. Conceding that healthcare is expensive and access uneven, most midterm campaigns will default to partisan themes…”

Paul Keckley, Sept. 6, 2022


News to Know

  • The deadline to provide contact information in preparation for the state’s anticipated grant program to implement an Emergency Department Medication for Opioid Use Disorder program has been extended to Sept. 23.

MHA in the News

MHA CEO Brian Peters

MHA CEO Report — Time to Focus on Cybersecurity

MHA Rounds Report - Brian Peters, MHA CEO

MHA Rounds Report - Brian Peters, MHA CEOThe world-altering powers that technology has delivered into our hands now require a degree of consideration and foresight that has never before been asked of us.” ― Carl Sagan

A long-held practice utilized by businesses of all stripes is the ubiquitous SWOT (strengths, weaknesses, opportunities and threats) analysis. For a hospital or health system in 2022, there is no shortage of candidates to fully stock the “threat” category. In this column, I want to draw attention to one that deserves increased attention because of its potential to cripple an organization in an instant: cybersecurity.

The wonders of technology have dramatically improved healthcare in Michigan and beyond. Advancements include imaging technology that identifies serious disease at a much earlier stage, robotic devices that permit surgical interventions that were previously considered too risky to attempt, remote patient monitoring and telehealth, and electronic medical records that facilitate better tracking and coordination for patients across various sites of care — the list is impressively long.  And amid our current workforce shortage crisis, we often describe technology in healthcare as a “force multiplier” that can supplement and extend our limited staffing resources to help ensure adequate access to care.

Make no mistake, healthcare still has one foot on the proverbial dock and one foot in the proverbial boat. That is, many of our communications and services remain in the “analog” world, while a growing share have become electronic, digitized and inter-connected. This phenomenon — coupled with the fact that the personal health information we collect and store has more value on the black market than any other data — has painted a neon target on our back for a growing cadre of cybercriminals and adversarial nation states. It is no accident the FBI has identified healthcare as the number one target of these bad actors. And simply put, a cyberattack on a hospital is a “threat to life” crime. We must act accordingly.

The statistics on healthcare attacks are enough to keep any executive up at night. An attack on a midsize hospital creates an average shutdown time of 10 hours and costs on average $45,700 per hour, according to an Ipsos report. In the same report, 49% of the respondents said their annual compliance budget for cybersecurity wasn’t enough. According to IBM, a data breach at a healthcare organization costs more than any other sector at $10.1 million. And the threat continues to grow, as healthcare cyberattacks have increased by 84% from 2018 to 2021, according to Critical Insight. Michigan hospitals, health insurance companies, physician offices and others have been the victims of ransomware attacks and related cybercrime in recent years.

If this wasn’t bad enough, a spotlight was shone on cybersecurity this past spring during Russia’s invasion of Ukraine, when cyberattacks on the Ukrainian government and critical infrastructure organizations had the potential to ripple across multi-national organizations and infect U.S.-based operations, including healthcare. Experts believe this scenario will be part of every future global conflict. And unfortunately, for many hospitals and health systems who welcome patients from multiple foreign countries, and who have business partners outside the United States, the practice of “geo-fencing,” or blocking all incoming email traffic from outside the country, is not always a viable approach.

So where can hospitals and health systems turn for help? At the national level, the American Hospital Association anticipated this trend several years ago and employs John Riggi as the national advisor for cybersecurity and risk. John has been a resource for the MHA in the past and as a former leader within the FBI’s cybercrime division, he maintains close ties with all the relevant government agencies.

And here at the MHA, we are also very committed to strengthening our own cyber defenses, while doing the same for our members. We have appointed Mike Nowak to serve as our own Chief Information Security Officer. Several years ago, Mike and his team helped to launch, and have subsequently helped to operate, the Michigan Health Security Operations Center (Mi|HSOC) for hospitals and health systems. Created for healthcare providers by healthcare providers, this first of its kind entity has the proven ability to prevent, detect, analyze and respond to cybersecurity events. Operating 24/7/365, the Mi|HSOC has developed strong relationships and communication with law enforcement at various levels, including the Michigan State Police Cyber Division, FBI and Secret Service.

An organization that helped form the Mi|HSOC is CyberForce|Q, which is now an MHA Service Corporation Endorsed Business Partner. In addition to sharing tactical information on emerging threats with the members of the security operations center, CyberForce|Q offers a variety of additional cybersecurity services to our members and other healthcare clients.

The bottom line — the MHA and our partners have helped Michigan become a leader in this space. By mitigating potential risk, physicians, nurses and staff of our member hospitals have the best opportunity to provide exceptional patient care without any external interruptions. While the advocacy, policy and safety and quality areas of the association often receive public attention, our cybersecurity efforts are constantly at work, often without much notice, to protect healthcare in Michigan.

But we need your help. I am the farthest thing from an expert in this field, but one thing I have learned is that the “human factor” is the most critical element of our defenses — and therefore the most vulnerable. Think twice before opening a suspicious email or text message, safeguard your electronic devices and passwords and take the time to educate yourself on all of the best practices to follow in the midst of this new, online world. The health of your patients and communities may depend on it.

As always, I welcome your thoughts.

Peters Focuses on Rural Hospital Challenges in Rural Innovation eXchange Story

MHA CEO Brian Peters

MHA CEO Brian Peters

Rural Innovation eXchange interviewed MHA CEO Brian Peters for a story published April 28 that examines the challenges facing rural hospitals in Michigan.

Peters discussed staffing shortages and efforts to improve workforce sustainability, the impact of COVID-19 on hospital finances and cybersecurity threats.

“The [workforce] pipeline is going to be so important,” said Peters. “The pipeline as it exists today is not adequate, particularly in rural areas, which are significantly older than non-rural areas and have older and sicker patients. This also means that the phenomenon of folks leaving the field is felt more acutely in rural communities.”

Other healthcare executives appearing in the story include John T. Foss, vice president of operations, Mercy Health Lakeshore Campus; Steve Barnett, president and CEO, McKenzie Health; and JJ Hodshire, president and CEO, Hillsdale Hospital.

The MHA also provided comment to Michigan Radio for a story published April 27 on increasing COVID hospitalizations due to the omicron BA.2 variant.

“…[B]ut there are clear indications that the severity of illness is down and so we hope there will not be a surge of COVID hospitalizations like the state has experienced previously,” said John Karasinski, director, communications, MHA.

MHA Monday Report April 25, 2022

MHA Monday Report

capitol building

Senate Moves Appropriations Subcommittee Budgets and Advances Opioid Settlement Legislation

The Michigan Senate Appropriations Subcommittee on Health and Human Services reported out April 20 their budget recommendation for the fiscal year 2023 budget beginning Oct. 1. Senate Bill 828 protects hospital priorities including maintaining funding for the Healthy Michigan Plan …


DIFS Utilization Review Decisions Favor Hospitals

The Michigan Department of Insurance and Financial Services (DIFS) issued in early April two important utilization review decisions in favor of hospitals related to auto no-fault insurance reimbursement. Under the new system enacted as part of Public Act 21 of 2019, hospitals …


LARA Rules Requiring Implicit Bias Training Take Effect June 1

The Department of Licensing and Regulatory Affairs (LARA) revised Public Health Code Rules requiring implicit bias training for all professions licensed or registered under the Public Health Code, except for Veterinary Medicine, effective June 1. …


CMS Releases FY 2023 Proposed Rule to Update Hospital IPPS

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service hospital inpatient prospective payment system for fiscal year 2023. When all proposed changes are considered, the rule is expected to result in a net decrease …


Cybersecurity Member Forum Scheduled for June 2

The MHA will host a cybersecurity member forum from 9 a.m. to 3 p.m. June 2 at the Henry Center for Executive Development. Increasing cybersecurity threats support the need for leaders to identify vulnerabilities of medical devices and supply chains, to select staff who can lead threat mitigation …


Long-term Acute-care Hospital Payment System Proposed Rule Released

The Centers for Medicare & Medicaid Services recently released a proposed rule to update the Medicare fee-for-service long-term care hospital prospective payment system for fiscal year 2023. …


Webinar Focused on Long-Term Goal Planning and Accountability

Successful stewardship of an organization is central to the role of governance. In many boardrooms, an inward, short-term operational focus robs governing boards of their attention to external forces and long-term strategic imperatives. It takes discipline and a symbiotic relationship between the board …


Nurse Preceptor and Clinical Faculty Academy Available Online

New nurses can be overwhelmed with responsibilities, which is why nurse preceptors make a difference. Nurse preceptors help new nurses develop their professional identity, access appropriate clinical research and learn from mistakes. …


The Keckley Report

Paul Keckley

Why Not-for-profit Hospitals Are Soft Targets

“Last week, the Lown Institute issued its latest report card on not-for-profit hospitals finding most undeserving of their tax breaks. …

“In response, the American Hospital Association (AHA) released a statement criticizing the Lown Institute’s ‘faulty methodology’ and defending hospitals’ use of financial resources.”

Paul Keckley, April 18, 2022

Cybersecurity Member Forum Scheduled for June 2

The MHA will host a cybersecurity member forum from 9 a.m. to 3 p.m. June 2 at the Henry Center for Executive Development. Increasing cybersecurity threats support the need for leaders to identify vulnerabilities of medical devices and supply chains, to select staff who can lead threat mitigation while workforce shortages remain high, as well as a host of other responsibilities.

Representatives from a midsize hospital and a health system will share the steps the leadership teams took to recover from cyberattacks and the processes amplified to identify vulnerabilities and reduce breaches of data systems and cloud-based security services. Cybersecurity experts from the American Hospital Association (AHA) and the Federal Bureau of Investigation (FBI) will also discuss cyber threats investigated and how the AHA is helping the field mitigate threats and exchange information with the FBI and other government agencies. They will also share ways to facilitate cyber resource requests between technical and nontechnical leadership, including chief information, financial and medical officers.

Attendees will also participate in a table-top exercise to test their organizations’ incident response plans. The Michigan Health Information Network Shared Services is generously sponsoring this event.

To create a safe meeting for everyone, the MHA has developed a code of conduct, including COVID-19 vaccination verification. The vaccination verification process and other safety measures are detailed on the Member Forum webpage under the Code of Conduct policy. The forum is open to MHA-member organizations only, who can register for $150 per person. For more information, contact Brenda Carr at the MHA.

MHA Monday Report April 4, 2022

MHA Monday Report

capitol buildingGovernor Signs Broadband Funding Bill

Gov. Gretchen Whitmer signed a $4.7 billion supplemental appropriations bill into law March 30. Senate Bill 565, introduced by Sen. Jon Bumstead (R-Newaygo), will provide supplemental appropriations to implement a statewide broadband program. …


New Website to Help Providers Boost Childhood Vaccination

Healthcare providers have unique opportunities to increase the number of children who are up to date with childhood vaccinations to keep them safe from a multitude of diseases. Motivated by that fact, the I Vaccinate initiative has launched a new provider toolkit website to …


Cybersecurity Cannot Be Overlooked

During a time of major workforce shortages and operational challenges, staff who have the expertise to oversee cybersecurity are mostly reacting to threats instead of proactively managing risks from employees, technology, processes and third-party vendors. …


Strengthening Nursing Workforce Using Virtual Tools

Nursing leaders are continuously thinking about the nursing workforce. Once a nursing student lands on the unit floor, nurse educators must mentor them to handle such patient care challenges as why a patient might be frustrated or barriers he or she will encounter as they are caring for patients. …


MHA Rounds Report - Brian Peters, MHA CEOMHA CEO Report — Change to Our Behavioral Health System Can’t Wait

MHA CEO Brian Peters focuses on Michigan’s behavioral health system and shares MHA-recommended solutions.


Paul KeckleyThe Keckley Report

President Biden’s FY2022 Budget: The Numbers Don’t Add Up

“Amidst media attention to Russia’s month-long invasion of the Ukraine, the emergence of the new BA-2 Omicron variant and inflation which has sent consumer sentiment to an 11-year low, attention shifts to the 74-page White House Fiscal Year 2022 Budget …

“What’s also notable about this budget is the importance of healthcare in the federal budget: federal funding for Medicare and Medicaid are forecast to grow faster than overall Federal receipts.”

Paul Keckley, March 28, 2022


MHA in the News

The MHA received media coverage since March 25 on hospital and nursing workforce challenges and legislation that assists independent hospitals.

Cybersecurity Cannot Be Overlooked

During a time of major workforce shortages and operational challenges, staff who have the expertise to oversee cybersecurity are mostly reacting to threats instead of proactively managing risks from employees, technology, processes and third-party vendors.

The MHA will host a cybersecurity member forum from 9 a.m. to 3 p.m. June 2 at the Henry Center for Executive Development. Cybersecurity experts from the American Hospital Association (AHA) and the Federal Bureau of Investigation (FBI) will review criminal and national security cyber threats investigated and how the AHA is helping the field mitigate threats and exchange information with the FBI and other government agencies. They will also discuss ways to create an organizational culture of cybersecurity and facilitate cyber resource requests between technical and nontechnical leadership.

Representatives from a midsize hospital and a health system will share about their cyber or supply chain attack incidents and experiences with cloud-based security services. Attendees will also participate in a table-top exercise to test their organizations’ incident response plans. The Michigan Health Information Network Shared Services (MiHIN) is generously sponsoring this event.

The forum is designed for chief executive, information, financial, operating and medical officers. The forum is open to MHA-member organizations only. Members can register for $150 per person. For more information, contact Brenda Carr at the MHA.

MHA Monday Report March 28, 2022

MHA Monday Report

MHA Covid-19 updateCombating the Novel Coronavirus (COVID-19): Week of March 21

With the number of new cases trending downward, Michigan hospitals continued to have patients with severe cases of COVID-19 in their intensive care units (ICUs). As of March 25, 100 Michiganders with confirmed or suspected …


capitol buildingPrior Authorization, Statewide Broadband Efforts Advance to Governor

During the week of March 21, the Michigan Legislature advanced several bills related to MHA priorities, including legislation to change the prior authorization process for commercial insurers, expand the Essential Health Provider Loan Repayment Program, …


State Senators Address Legislative Policy Panel

The MHA Legislative Policy Panel convened virtually March 23 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals. The meeting was highlighted by separate presentations from Sen. Aric Nesbitt …


Governance and Leadership Dynamics Important to Community Health

Successful stewardship of an organization is central to the role of governance. Accomplishing goals requires action planning and execution, frequent accountability check-ins, and communication and transparency about plans and goal metrics. The webinar You and Your …


Twitter Chat to Discuss Emergency Department Medication for Opioid Use Disorder

To help raise awareness around Emergency Department Medication for Opioid Use Disorder, the MHA will host a Twitter chat from noon to 1 p.m. April 4. During the event, the MHA will post questions from @MIHospitalAssoc, with commentary from the MHA Keystone Center, the Community Foundation of Southeast Michigan and other members of the Michigan Opioid Partnership. …


Survey Results Will Support Rural Workforce Solutions

The National Rural Health Association and The Chartis Center for Rural Health are partnering on a new rural health safety net survey exploring staffing shortages at rural hospitals. Hospital input will provide a better understanding …


Links Fore Health Sponsorships Available

Participants will gather from June 29 through July 1 for the MHA Annual Membership Meeting on Mackinac Island. This meeting is the most important association event of the year and is attended by more than …


The Keckley Report

“Self-care is the bridge to healthcare value, but crossing it will be challenging for the U.S. health industry. It’s key to reducing the progression of chronic conditions, avoiding unnecessary hospitalization, improving workforce performance and lowering healthcare costs. But it’s not taken seriously as a solution by policymakers, physicians and others who discount its potential. Is that likely to change? The jury’s out but It’s getting fresh attention.”


News to Know

Nominations for the MHA Healthcare Leadership Award will be accepted through April 1. 

MHA Monday Report March 21, 2022

MHA Monday Report

MHA Covid-19 updateCombating the Novel Coronavirus (COVID-19): Week of March 14

As Michigan begins the third year of living with COVID-19, new cases, hospitalizations and deaths are trending downward and hopes are high that a new variant will not emerge to cause another surge of disease. The state reported …


capitol buildingLegislature Advances Prior Authorization, Workplace Safety Bills

During the week of March 14, the Michigan Legislature acted on a bill to make changes to the prior authorization process for commercial insurers and a bill to increase penalties for assaulting healthcare employees and volunteers. …


Cybersecurity Member Forum Scheduled for June 2

Cyberattacks are a clear and present danger to patient care and safety and are becoming a more frequent reality. Most recently, ransomware criminals issued a public statement indicating they stand ready to retaliate against the West in defense of Russia. Reinforcing cybersecurity as part of the organization’s …


$35 Million in Grants Available for Mental Health Support

The Department of Health and Human Services announced March 9 that nearly $35 million in funding is available nationally to strengthen and expand community mental health services and suicide prevention programs for children and young adults. Grants are available through the …


The Keckley Report

Paul Keckley

Drug Manufacturers are Fighting their Holy War on Three Fronts

“The conundrum facing the drugmakers is this: insurers, clinicians, regulators and consumers believe prescription drugs work reasonably well—they trust the safety, efficacy and effectiveness of prescription drugs. But voters (83%) think drug prices are inexplicably too high, suspecting manufacturers of systemic price gauging and greed. And policy proposals tying US prices to international comparisons are gaining momentum … Pricing is opaque and under increased pressure.

“In response, drug manufacturers have escalated their war against price constraints on three fronts as they adjudicate their defense to Congress and state legislatures.”

Paul Keckley, March 14, 2022


News to Know

  • Nominations for the 2022 MHA Advancing Safe Care Award are due March 25.

MHA Monday Report Feb. 14, 2022

MHA Monday Report

MHA Board Meeting Focused on Workforce, Other Healthcare Challenges

At its Feb. 9 meeting, the MHA Board of Trustees had robust conversations about key priorities for healthcare and the MHA. Among them were the MHA’s role as healthcare and public policy continue to evolve; workforce development and shortages (including $300 million appropriated by the Michigan …


capitol buildingVital Healthcare Workforce Funding Passed by Michigan Legislature

The Michigan Legislature passed Feb. 9 House Bill 5523, a supplemental spending bill that includes $300 million for healthcare facilities for recruitment and retention of healthcare workers. While this funding will not solve the long-term …


Governor’s Budget Recommendation Supports Healthcare Workers, Protects Hospitals

The fiscal year 2023 executive budget recommendation was presented to the Legislature Feb. 9 by State Budget Director Chris Harkins. The governor’s budget for the upcoming fiscal year protects key hospital priorities and includes …


Michigan Legislature Addresses Multiple Healthcare Bills

The Michigan Legislature took up several bills impacting hospitals during the week Feb. 7. Some of the covered topics included legislation to expand the essential health provider loan repayment program, make changes to nonopioid directive forms, new regulation for pharmacy benefit managers …


Virtual Breakthrough

Register by Feb. 14 for Virtual MHA Breakthrough

The MHA Breakthrough event will be held virtually from 1 to 3 p.m. Feb. 17, and registration is encouraged by close of business Feb. 14. For many months, leaders have had limited opportunities to study challenges and learn from each …


Virtual Training Offered Feb. 15 for FY 2019 Medicaid DSH Audit

Myers and Stauffer LC, Michigan’s contractor for the federally mandated Medicaid disproportionate share hospitals audits, encourages hospital staff to participate in the upcoming virtual training at 10:30 a.m. Feb. 15. Hospital staff will also benefit from viewing …


Housing as Healthcare Webinar to Explore Population Health Improvement

Homelessness can take many forms, with people living on the streets, in encampments or shelters, or with family and friends. While the federal government reports 1.5 million people a year experience homelessness, other estimates find up to twice this number of people are without …


Responses to Cybersecurity Attacks, Mitigation Strategies Focus of Member Forum

The healthcare sector remains a target-rich environment for cyberattacks due to a large amount of sensitive data related to patient care and operations. The MHA will host a cybersecurity member forum from 9 a.m. to 3 p.m. March 24 at the Henry Center for Executive Development. The forum is …


PPSOSO Annual Meeting to Focus on Well-being and Workplace Violence

The MHA Keystone Center Patient Safety Organization (PSO) Annual Meeting brings together national safety and clinical experts each year to discuss hot topics in healthcare. It will be held virtually from 9 a.m. to 3:10 p.m. March 9. …


Headline Roundup: Workforce Funding, Executive Budget and More

The MHA responded to several media requests the week of Feb. 7 on topics including passage Feb. 9 of House Bill 5523 that provides $300 million in healthcare workforce funding, Gov. Gretchen Whitmer’s Feb. 10 executive state budget recommendation and COVID-19 hospitalizations. …


The Keckley Report

Paul Keckley

Two Events this Week Will Shape U.S. Healthcare for 2022

“On the foreign policy front, the potential Russian invasion of the Ukraine has forced talks this week among heads of state …

“And on the domestic front, the Consumer Price Index for January will be released Thursday by the Bureau of Labor Statistics and all eyes will be on the inflation rate …

“The U.S. health system is directly impacted by both sets of events though the immediate impact might not be readily obvious.”

Paul Keckley, Feb. 7, 2022


News to Know

  • Nominations for the 2022 Ludwig Community Benefit Award are due Feb. 18.