Healthcare Economic Impact Included in 2024 MBN Economic Forecast Breakfast

MHA CEO Brian Peters highlights the economic impact of healthcare in Michigan during the 2024 Economic Forecast Breakfast hosted by MBN.

The Michigan Business Network (MBN) hosted the 2024 Economic Forecast Breakfast Jan.11, which featured the inaugural release of the latest Michigan Future Business Index survey data, 2023 reviews and a look ahead on regional economic, business, healthcare, tourism and international business forecasts.

Given the healthcare sector significant role in Michigan’s economy, MHA CEO Brian Peters joined the Economic Forecast Breakfast as a presenter for the first time, highlighting the economic impact of healthcare in Michigan. Peters spoke about the mission and work of the MHA, including key strategic pillars in the 2023-2024 strategic action plan such as workforce support, hospital viability, behavioral health and health equity. Peters also discussed how working with hospitals and economic partners in the region contributes to growing the economy of Michigan. The MHA is an official partner with the MBN.

Other event presenters included Chris Holman, CEO of MBN; Mike Witt, senior vice president of Asset Management; Van Martin, president & CEO of Martin Commercial Properties; Julie Pingston, president & CEO of Choose Lansing; Steve Japinga, senior vice president of public affairs at the Lansing Regional Chamber of Commerce; Bob Trezise, president and CEO of the Lansing Economic Area Partnership; and Charles Ballard, emeritus faculty of Michigan State University Economic Department.

The MHA’s involvement in the event is an example of the association’s collaboration with economic leaders across the state of Michigan.

Members with questions about future regional economic events may contact Ruthanne Sudderth at the MHA.

MHA Monday Report May 15, 2023

MHA Monday Report

capitol buildingHarmful Nurse Staffing Legislation Introduced in Michigan Legislature

Harmful nurse staffing legislation was introduced May 11 in the Michigan Legislature that would mandate nurse staffing ratios, require public disclosure of the ratios and restrict mandatory overtime for nurses. The bill package is pushed by the Michigan Nurses Association and was ….


Behavioral Health ED Boarding Data Available

Behavioral health emergency department (ED) boarding data the MHA has been collecting on a weekly basis from acute care hospitals across Michigan since March 2023 is now available on the Health Data webpage of the …


Annual Meeting iconMHA Annual Membership Meeting Includes Ways to Support Michigan Hospitals

The MHA membership will convene in person for the MHA Annual Membership Meeting June 28 through 30 at Grand Hotel on Mackinac Island. The annual meeting will feature an outstanding lineup of speakers, the family …


DEA Issues Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

After delaying the final rule for ending COVID-19 telehealth prescribing rules, the Drug Enforcement Agency (DEA) has issued a temporary rule to allow the following: The full set of telemedicine flexibilities regarding prescription of controlled …


Upcoming Webinars on Medicare FFS Quality-based Programs

The MHA is partnering with DataGen to host two free webinars focused on Medicare fee-for-service (FFS) quality-based programs, which can reduce hospital inpatient FFS payments by up to 6%, depending upon hospital performance. The webinars …


Webinar Outlines Practices to Re-engage Patients and Families in Care

Fractured social contracts in today’s world have changed the healthcare landscape and culture. There is a convergence of patient consumerism and digital transformation happening, and those who focus on patient-centered care and person and family …


MHA Keystone Center PSO Safe Table – Health IT & Risk Safety

The MHA Keystone Center PSO is hosting a Health IT & Risk Safety Safe Table from 12:30 to 3 p.m. June 14. The event will be held at Goshen Health, located at 200 High Park …


Direct Care and Behavioral Health Workforce Assessment: Regional Feedback Sessions

Public Sector Consultants and Health Management Associates are partnering with the Michigan Department of Health and Human Services to gather the perspectives of people impacted by the direct care worker and behavioral health workforce …


MHA Webinar Focuses on Building Trust and Relationships for Trustees

When stakeholders gather to discuss community vitality, the health and wellbeing of the community is not only about access to safe, affordable healthcare, but about non-medical health influences that have an impact on the community. …


MDHHS Releases Beginner Guide for Doula Providers

Michigan Medicaid began reimbursing doula services provided to individuals covered by or eligible for Medicaid as of Jan. 1, 2023. Doula providers are required to be on the Michigan Department of Health and Human Services …


The Keckley ReportPaul Keckley

The End of the Pandemic Health Emergency is Ill-timed and Short-sighted: The Impact will further Destabilize the Health Industry

“The national spotlight this week will be on the debt ceiling stand-off in Congress, the end of Title 42 that enables immigrants’ legal access to the U.S., the April CPI report from the Department of Labor and the aftermath of the nation’s 199th mass shooting this year in Allen TX.

The official end of the Pandemic Health Emergency (PHE) Thursday will also be noted but its impact on the health industry will be immediate and under-estimated. …

In the weeks ahead as the debt ceiling is debated, the Federal FY 2024 budget finalized and campaign 2024 launches, the societal value of the entire health system and speculation about its preparedness for the next pandemic will be top of mind. …“

Paul Keckley, May 8, 2023


News to Know

  • Upon the end of the COVID-19 Public Health Emergency, the Health Resources & Services Administration will end a 2020 policy allowing hospitals to use 340B drugs for eligible patients in new hospital locations, even if they have not yet appeared on a filed Medicare cost report.
  • The MHA is hosting the webinar MHA Programs of All-Inclusive Care for the Elderly (PACE): An Alternative to Traditional Nursing Home care from 8:30 to 9:30 a.m. May 23.
  • Completed 2022 occupational mix surveys must be submitted by acute care hospitals paid under the Medicare prospective payment system to the Medicare Administrative Contractor by June 30, 2023.

Brian PetersMHA in the News

The MHA received media coverage the week of May 8 regarding nurse staffing legislation, healthcare worker shortages, the ending of the COVID-19 public health emergency and more. A joint media statement was published May 11 …

MHA Monday Report May 8, 2023

MHA Monday Report

capitol buildingState Legislation Introduced to Address Violence Against Healthcare Workers, Strengthen Healthy Michigan Plan and Expand Organ Donor Registration

Legislation to increase the penalties for assaulting healthcare employees and volunteers was introduced in the state House of Representatives during the week of May 1. Additional legislation was introduced to remove unnecessary provisions of the …


Michigan’s Largest Private-sector Employer Remains Healthcare

The Partnership for Michigan’s Health reports healthcare directly employed nearly 568,000 Michigan residents in 2021, demonstrating that healthcare remains the largest private-sector employer in the state despite continued staffing losses attributed to the COVID-19 pandemic. …


Webinar Reveals New Tool to Improve Person and Family Engagement

The MHA is hosting a webinar from 8:30 to 10 a.m. May 24 to review the newly released MHA Person & Family Engagement Roadmap, which includes recommended policies to re-engage patients and caregivers and …


Final Medicaid Bulletin on Continuous Glucose Monitoring Systems

The Michigan Department of Health and Human Services issued a final Medicaid Policy Bulletin May 1 with revisions to the Continuous Glucose Monitoring Systems Policy. In response to the proposed policy issued April 1, …


speak upE.W. Sparrow Hospital Nurse Receives Q2 MHA Keystone Center Speak-up! Award

The MHA Keystone Center presented Cheryl Kay, RN, at E.W. Sparrow Hospital with the quarterly MHA Keystone Center Speak-up! Award, which celebrates individuals or teams in Michigan hospitals demonstrating a commitment to the prevention of …


DEA Delays Ending COVID-19 Telehealth Prescribing Rules

The Drug Enforcement Agency (DEA) is delaying draft rules that proposed stricter telehealth limits on providers prescribing controlled substances, like buprenorphine for opioid use disorder or Adderall for ADHD. The DEA will temporarily extend …


MHA Webinar Reviews PACE Programs

With the closure of nursing homes and long-term care facilities, hospitals and health systems need options to care for seniors. Dually eligible frail seniors are one of the most complex cohorts with multiple comorbidities, frequent …


MHA Podcast Explores How Michigan Leaders Can Collaborate to Address Gaps in Behavioral Health

The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan on key issues that impact healthcare and the health of communities. On episode 29, State Representative …


2023 Ludwig Nominee: Priority Health, National Fitness Campaign Partner to Offer Free Fitness Courts

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, …


MHA Rounds Report - Brian Peters, MHA CEOMHA CEO Report — Attracting Healthcare Talent

Talent acquisition is always top of mind for all business leaders. Demand for workers now outpaces supply throughout the U.S., but particularly here in Michigan due to our demographic realities, including an aging baby-boom generation entering retirement in significant numbers. …


The Keckley Report

Paul KeckleyThe Tit for Tat Game in Healthcare produces No Winners

“Tit for Tat battles in healthcare are nothing new. Last week, they were on full display. …

Most of the food fights in healthcare like last week’s revolve around each sector’s unique response to the three challenges above. That’s why they exist: to protect the interests of their members and advocate on their behalf. All believe their mission and vision is essential to the greater good and the moral high ground theirs. Some are imperiled more than others: not for profit, rural and safety net hospitals, long-term care operators, direct caregivers and public health programs at the top of this list.

Educating lawmakers is necessary but what’s needed is serious, objective forward-looking definition of the U.S. health system’s future. The tit for tat game will not solve anything. That’s where we are. …“

Paul Keckley, May 1, 2023


News to Know

  • National Hospital Week 2023 is May 7-13.
  • The Michigan Department of Health and Human Services created a series of short videos to help providers and community partners navigate policies impacted by the ending of the federal COVID-19 Public Health Emergency.
  • Registration remains open for the 2023 MHA Annual Membership Meeting, scheduled June 28 through 30 at Grand Hotel on Mackinac Island.
  • Completed 2022 occupational mix surveys must be submitted by acute care hospitals paid under the Medicare prospective payment system to the Medicare Administrative Contractor by June 30, 2023.

MHA CEO Brian Peters speaks with WLNS.MHA in the News

The MHA received media coverage the week of May 1 on the economic impact of healthcare in Michigan and planned state legislation that would require nurse-to-patient staffing ratios in hospitals. Crain’s Grand Rapids Business published …

MHA CEO Report — The Challenges for Rural Hospitals

MHA Rounds Report - Brian Peters, MHA CEO

“The country is lyric, the town dramatic. When mingled, they make the perfect musical drama” Henry Wadsworth Longfellow

MHA Rounds Report - Brian Peters, MHA CEOHaving just returned from the annual American Hospital Association (AHA) Rural Health Care Leadership Conference, where I was joined by a strong contingent of MHA members and staff, the future of our rural hospitals has been top of mind.

When I was in graduate school at the University of Michigan many years ago, I recall clearly our discussions related to rural health. In short, we were taught that rural America was statistically older, poorer and sicker than the rest of the country – and this demographic and socioeconomic reality led to all kinds of challenges for those responsible for the health of rural populations and the viability of rural hospitals.

Fast forward to the most recent (2020) census and this dynamic remains true. In addition, we discovered that between 2010 and 2020, rural America actually lost population for the first time in history. Here in Michigan, the latest projections indicate that while the total state population will grow moderately over the next 20 years, the population in rural Michigan will remain flat or even decrease.

The operating environment has never been more difficult for healthcare organizations, for reasons we have documented at length in prior CEO Reports. This statement is particularly true for rural hospitals – 100 of which from across the country have actually closed since 2005. Many more have had to make the difficult decision to terminate service lines or otherwise scale back their operations to keep their doors open. What is driving these challenges?  A few items come immediately to mind:

  • An older and poorer population translates into a higher percentage of government payors (Medicare and Medicaid), which traditionally do not fully cover the true cost of care.
  • The traditional volume-based reimbursement model that has been one of the cornerstones of American healthcare does not serve rural providers – which often lack sufficient volume – particularly well. The pitfalls of the volume-based model were on full display during the worst days of the COVID-19 pandemic, particularly when non-emergent procedures were suspended.
  • Recruiting physicians today most often involves recruiting a spouse as well; in other words, there must be a good job match for both parties to spur a relocation. Physician recruitment is more difficult in rural communities for the simple fact that there are fewer potential jobs for that spouse. In addition, the on-call coverage demands can be particularly significant in rural areas, because the number of available rotating on-call clinicians is simply fewer. I would be remiss if I didn’t mention the Merritt Hawkins firm, which is one of our original MHA Service Corporation Endorsed Business Partners, and is dedicated to working with our members to create solutions to some of the most vexing challenges of the day.
  • Lastly, it is no secret the country is in the middle of a behavioral health crisis, with a lack of available placements leading to behavioral health patients boarding in emergency departments throughout the state, awaiting placement in a more appropriate setting. Hospitals are experiencing higher costs caring for these patients, increasing security to protect other patients and staff, while receiving little to no reimbursement since these patients have yet to be admitted to an inpatient psychiatric unit. This lack of access is even worse in rural areas. For example, the Upper Peninsula only has one licensed child psychiatrist for the entire region.

The reality is that when we think about rural Michigan and the more densely populated areas of the state, we are all inextricably linked. There is no “us and them.” People from the big city travel every day to rural communities for conferences and events, meetings, sales calls, deliveries, vacations and visits with friends and family (and people from rural communities come to the big city for the same reasons). While we want to ensure the vibrancy of a hospital in a rural community so that the residents have access to quality healthcare, we should all want the same thing, because we never know when we might be on one of those sales calls or vacations and need that same access. This is not just theoretical, as I have countless stories about this phenomenon playing out in real life, and I suspect you do as well.

Moreover, hospitals are one of the largest – if not the largest – employers in many rural Michigan communities, playing a crucial role in the economic vibrancy of the state. Healthcare careers provide stable, good paying jobs and positively impact lives every day. Not only are hospitals important for access to care, but also as economic drivers. 121,000 total workers are associated with the healthcare sector in rural Michigan, including 81,000 direct jobs. These direct healthcare workers received $7.6 billion in total wages, salaries and benefits and contributed $1.4 billion in local, state and federal taxes. In addition, the existence of a hospital nearby is one very important item for businesses of all kinds when considering investment in a new factory, office or headquarters.

So, the vibrancy of our rural hospitals should be a priority. What is the MHA doing about it? As it turns out, we have done a lot. Beyond our advocacy on the traditional Medicaid and Medicare budgets, certificate of need, medical liability, workforce funding and many, many other public policy issues that affect all our members, here are just a few of our rural advocacy highlights:

  • We fought hard to secure passage of the Healthy Michigan Plan (our Medicaid expansion program) and have advocated for full funding in every budget cycle since. For the reasons cited above, this is particularly impactful for our rural hospitals.
  • We worked to pass, implement and protect the Critical Access Hospital program, which has created an important lifeline for 37 Michigan hospitals. And the MHA was successful in changing existing statue at the end of 2022 to make adoption of the new Rural Emergency Hospital designation possible for our members.
  • We have worked very hard to protect the 340B drug pricing program, which is vital to many rural hospitals and their ability to provide access to care to all in their communities. Our work includes advocacy with both the state legislature and Congress, and even in the federal courts, where the MHA has filed amicus curiae briefs related to recent 340B cases.
  • The MHA successfully advocated for two new supplemental Medicaid payment pools that specifically benefit our rural members with implementation of the rural access pool in fiscal year (FY) 2012 and the obstetrical stabilization fund in FY 2015. Our advocacy efforts were also successful in securing Medicaid outpatient rate increases in FY 2020, the first increase in two decades, followed by an additional increase in FY 2021. These increases resulted in a 63% increase for critical access hospitals and a 21% increase for all other hospitals compared to Jan. 1, 2020, rates.
  • We successfully advocated for an extension of both the Medicare-dependent Hospital and Low-volume Adjustment programs during the 2022 Congressional lame-duck session, which provide critical support to many rural hospitals.
  • Finally, we have successfully advocated for passage and implementation of state legislation that modernizes the scope of practice for certified registered nurse anesthetists and allows flexibility for each hospital to choose the anesthesia care model that best fits its location, staffing and resources to offer safe and effective patient care.

Our advocacy is also focused on ensuring our members can tell their story and connect with lawmakers, both at the state and federal levels. The MHA hosted its first ever Rural Advocacy Day last September in Lansing to facilitate conversation between rural hospital leaders and members of the Michigan Legislature. The MHA also accompanied members in February for the National Rural Health Association’s Rural Health Policy Institute event. MHA members met with Michigan’s congressional delegation and staff during the trip to discuss rural health issues facing Michigan hospitals. And if you haven’t yet had the opportunity to listen to the Rural Health Rising podcasts, I encourage you to tune in to our friend JJ Hodshire, the CEO of Hillsdale Hospital and an MHA Board member, as he does a fantastic job shining a light on a wide range of rural health issues – with an impressive set of special guests – in real time.

Successful advocacy and storytelling require teamwork. As mentioned above, for years we have partnered closely with the AHA and the National Rural Health Association. We have also enjoyed a close partnership with the Michigan Center for Rural Health (MCRH), and I am pleased to share Hunter Nostrant, CEO of Helen Newberry Joy Hospital, is a member of both the MHA Board of Trustees as well as the MCRH Board.

The mission of the MHA is to advance the health of individuals and communities, and in that context, we have always strived to represent all our members and communities. Each hospital is vital to the health of our great state. While the path forward may be difficult, I’m encouraged by the many rural hospital leaders – some of the nicest, and most talented people that I have met – that have developed innovative and strategic ways to address these challenges and position themselves to be able to care for their communities for years to come.

As always, I welcome your thoughts.

Michiganders Need Continued Access to High-quality, Timely Healthcare

Michigan’s hospitals are facing a funding crisis, putting communities and families across the state at risk of losing access to high-quality, timely healthcare. Health systems, business and university leaders are urging policymakers to address the crisis to avoid further reduction of available beds and access to care and healthcare services.

Michigan has lost a high of 1,700 staffed hospital beds since 2020 due to lack of staffing. This creates a cascade of problems, from longer wait times in the emergency department, reduced services, particularly in rural areas, and more difficulty transferring patients to the appropriate care setting. Respiratory illnesses are also surging, making problems worse.

T. Anthony Denton

“Recently, we have seen a surge in cases of respiratory syncytial virus (RSV), flu and COVID. This puts an additional pressure on emergency departments and our already-strained inpatient bed capacity across Michigan, impacting care statewide. Without funding to address staffing shortages, we run the risk of compromising our ability to provide the same level of exceptional care that we’re accustomed to across the state,” said T. Anthony Denton, senior vice president and chief operating officer, University of Michigan Health System and Michigan Health & Hospital Association board chair.

A 2021 Washington Post-Kaiser Family Foundation survey found that nearly 30% of healthcare workers are considering leaving their profession altogether. The U.S. Bureau of Labor Statistics projects the need for 1.1 million new registered nurses nationwide by 2030, the Association of American Medical Colleges estimates two out of every five active physicians nationwide will be 65 or older within the next 10 years, and the nation faces a projected shortage of more than 3.2 million lower-wage healthcare workers such as medical assistants, home health aides and nursing assistants, according to a Mercer report.

“The overall health and prosperity of Michigan is inextricably tied to the state’s investment in its healthcare and higher education enterprises,” said Daniel Hurley, CEO of the Michigan Association of State Universities. “Michigan’s public universities, together with our hospital and other healthcare partners, look forward to working with state leaders to ensure a future healthcare workforce that is capable of providing the highest levels of quality care for all Michiganders.”

The healthcare workforce shortage — combined with an aging population, a rise in chronic diseases and behavioral health conditions and advancements in medical care delivery — all contribute to an immediate need for resources that will allow hospitals to continue to provide the care residents need and deserve.

Despite staffing losses attributed to the COVID-19 pandemic, healthcare directly employed nearly 572,000 Michigan residents in 2020, continuing to make it the largest private-sector employer in the state. The 2022 Economic Impact of Healthcare in Michigan report found that direct healthcare workers in Michigan earned $44.2 billion in wages, salaries and benefits, with indirect, healthcare-supported workers earning about $28 billion wages, salaries and benefits.

“With healthcare being the largest private-sector employer, a healthy Michigan economy is directly linked to a properly funded healthcare system,” said Susan Smith, executive director, Economic Development Partnership of Hillsdale County. “Without access to healthcare services to support our communities, ranging from obstetrical units to trauma centers, we cannot remain economically competitive, attract or retain talent, or support placemaking for young families and care for everyone at all stages of life.”

Michigan officials have made recent short-term investments to address the hospital staffing crisis, but additional funding remains unappropriated that if used as intended, can improve hospital capacity and service lines. Michigan also needs a long-term funding solution to address stagnant reimbursement that has yet to respond to inflationary pressures to improve the retention of existing healthcare workers and recruit future workers to ensure that residents continue to have access to healthcare services.

Learn how you can help your local hospital or health system by visiting MiCareMatters.org.

Additional quotes:

JJ Hodshire

“Hospitals have an immediate need for resources to continue to provide the services residents need and deserve – like ambulances available for lifesaving care,” said JJ Hodshire, president and chief executive officer, Hillsdale Hospital. “As a rural hospital, we excel at being innovative to make the best use of our resources, particularly staff. However, we can only stretch resources for so long. Everyone can agree that access to lifesaving emergency medical care is a basic need for Michiganders and residents should be able to receive specialized care no matter where they live.”

“My colleagues in pediatric units across the state have spent the past month responding to one of the worst respiratory illness surges I can remember as a physician and the biggest challenge to our ability to care for more children was our lack of available staff,” said Dr. Rudolph P. Valentini, chief medical officer, Children’s Hospital of Michigan and group chief medical offer at Detroit Medical Center. “We can’t afford to have another surge of sick, hospitalized children before something is done to improve the health of our hospitals and health systems.”

Brian Peters

“Michigan residents deserve quality, accessible healthcare services and without hospital resources to adequately provide that care, Michigan hospitals have and will continue to face difficult decisions about what services they can offer,” said Brian Peters, chief executive officer, Michigan Health & Hospital Association.

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