MHA CEO Report — Benefits of the State Budget

“We must find time to stop and thank the people who make a difference in our lives.” ― John F. Kennedy

We have rightfully spent a lot of time in the past two years thanking the heroes who work in our hospitals and other healthcare settings for the incredible work they have done in the face of extreme challenge.

I want to take a moment now to thank another group of people who have recently helped our cause through their bipartisan actions; our elected officials in Lansing were extremely busy the last week of June passing the fiscal year 2023 state budget, which has since been signed by Gov. Whitmer. Our MHA mission is to advance the health of individuals and communities — and this budget absolutely provides significant help in that regard. While some elements of the new budget represent long-standing MHA priorities, others are new funding items that have the potential to reshape access to care and help our members and the patients and communities they serve.

Our MHA team does a tremendous job advocating for the importance of items such as the Healthy Michigan Plan, graduate medical education of physician residents, disproportionate share hospital funding, maximization of our robust provider tax program and Medicaid payment rates, the rural access pool and obstetrical stabilization fund, and critical access hospital reimbursement rates. Every election cycle, new legislators are welcomed to Lansing and the MHA’s efforts never stop to ensure these decisionmakers are aware of the impact these budget items play in their communities. The bottom line is the financial viability of hospitals is increasingly reliant on these important programs, and the MHA is dedicated to protecting them.

Hospital closures continue to happen across the country. However, they have occurred at a much higher rate in states that have not participated in Medicaid expansion through the Affordable Care Act. Maintaining funding for our expansion program — the Healthy Michigan Plan — has been one of our top priorities, and the pandemic has made the importance of insurance coverage more important than ever. In short, when the pandemic hit and thousands of Michiganders lost their jobs, the Healthy Michigan Plan was there to ensure access to good healthcare.

Our hospitals that treat the highest numbers of uninsured and underinsured patients also qualify for disproportionate share hospital funding, which provides enhanced reimbursement to account for the higher costs of care. This pool is funded through hospital provider taxes that reduce the state’s general fund contribution to the overall Medicaid program.

Small, rural and independent hospitals can often experience financial challenges in a particularly acute way, thus items such as the rural access pool, obstetrical stabilization fund and critical access hospital reimbursement rates also support access to healthcare services in rural areas. Labor and delivery units typically do not contribute to positive margins, but they are extremely important for families and communities. The obstetrical stabilization fund provides additional means for hospitals in rural areas to maintain these services so expectant mothers can avoid driving exorbitant distances for these services. Lastly, the state also included $56 million in new funding to increase Medicaid reimbursement rates for primary care services, which will help individuals on Medicaid receive the necessary primary and preventative care that can help prevent hospitalizations and reduce overall healthcare costs.

The top concern of hospital leaders remains workforce sustainability, and the continued funding for graduate medical education is one tool we must continue to use to maintain the physician talent pipeline that is sorely needed. At the same time, we are extremely happy to see inclusion of state funds to expand access to Bachelor of Science in Nursing degree programs at the state’s community colleges to help address the nurse talent pipeline, a $56 million line item. This proposal was supported by the MHA when it was formally introduced, and we look forward to seeing our post-secondary partners implement it to grow the healthcare workforce.

Lastly, behavioral health investments have been at the forefront of our advocacy efforts for some time and we were very pleased to see new funding to improve and enhance state behavioral health facility capacity. Michigan lacks adequate capacity to treat patients with behavioral and mental illness and this new funding is an important and necessary step to address the shortage. Included is $50 million to expand pediatric inpatient behavioral health capacity, $30 million to establish crisis stabilization units and $10 million to fund the essential health provider loan repayment program to cover behavioral health professionals.

In total, the budget includes $625 million in new investments for behavioral health funding and investments in workforce. While this will not solve all the issues impacting hospitals, it provides needed resources and demonstrates the commitment of lawmakers to a healthy Michigan. This budget also signifies that our work must continue to advocate for the resources necessary for hospitals and health systems to care for all Michiganders. Once again, on behalf of the entire MHA family, I want to acknowledge and thank both Governor Whitmer, as well as lawmakers in the state House and Senate, for their support of this latest state budget. And I would also encourage anyone who cares about access to quality, affordable healthcare to engage in the process, share your stories and input with those who can make a difference going forward. But also remember to say thank you when they support our cause.

As always, I welcome your thoughts.

Crain’s Coverage on Healthcare Funding in State Budget

Brian Peters

Brian PetersThe MHA received media coverage since July 15 from Crain’s Detroit Business on new investments for behavioral health funding and the healthcare workforce in the fiscal year 2023 state budget.

Crain’s first published an article July 15 on the state’s higher education budget, which includes $56 million to fund the Michigan Associate Degree in Nursing to Bachelor of Science in Nursing program at community colleges across the state. Included was a quote from MHA CEO Brian Peters in support of the funding.

“Staffing shortages are impacting Michigan hospitals throughout the state, particularly in the areas of nursing,” said Peters. “This plan will help us get more highly-skilled professionals into the field quickly and increase access to nursing education in more communities across the state.”

Crain’s also published an editorial July 22 focusing on the investments being made to improve mental health treatment, particularly among children and teens. The editorial also included a quote from Peters from an op-ed Crain’s published in February from Peters.

“While we do have a small number of outstanding facilities dedicated entirely to mental health care services, and acute-care hospitals have dedicated resources and units to these services, it is simply not enough,” said Peters.

Media Recap: SCOTUS Dobbs Decision, State Budget and Rural Hospital Challenges

Brian Peters

The MHA received media coverage on a variety of topics during the weeks of June 27 and July 4. Areas of focus included the Supreme Court of the United States (SCOTUS) decision in Dobbs v. Jackson Women’s Health, the passage of the fiscal year 2023 state budget and challenges facing small and rural hospitals.

The MHA shared a statement with media following the SCOTUS decision that repealed Roe v. Wade. Outlets that included comment from the MHA in their stories included the Detroit Free Press, Bridge and Gongwer.

The passage of the state budget the morning of July 1 by the Michigan Legislature was celebrated by MHA CEO Brian Peters in a media statement that outlined the existing MHA budget priorities that continue to be protected as well as significant new funding to support behavioral health capacity and the healthcare workforce. MLive, MiBiz, The Center Square and Gongwer carried portions of the statement.

Renewed attention was brought to financial challenges faced by small and rural, particularly independent, hospitals due to a legislative request for funding from Sturgis Hospital as the organization pursues the possibility of converting to the new rural emergency hospital designation through the Centers for Medicaid and Medicare Services. MiBiz and Bridge published articles that include reaction from the MHA following assistance the association made in the legislative ask that secured $11 million for Sturgis Hospital.

Members with any questions regarding media requests should be directed to John Karasinski at the MHA.