MHA Monday Report May 9, 2022

MHA Monday Report

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Budget Bills Advance in House and Senate


Workforce Challenges Focus of GME Advocacy Day


MDHHS Addresses Medicaid Attending Physician Claim Edit

The Michigan Department of Health and Human Services recently issued an L-letter regarding attending physician claim edits that were implemented Jan. 1, 2022. The letter addresses concerns raised by the MHA and hospitals regarding the claim edit that has resulted in denied claims. …


The Keckley Report

Paul Keckley

Why May 2022 is Pivotal to U.S. Healthcare: Four Reasons

“Since March 2020, America’s focus has been on the pandemic. … Since January 2022, the U.S. economy has eclipsed its 41-year record inflation rate … Since February 24, 2022, America’s attention has been drawn to the Ukrainian invasion by Russia and NATO’s response. …

“And starting yesterday, May begins in what is likely the most consequential for healthcare in years due to the cumulative impact …”

Paul Keckley, May 2, 2022


News to Know

  • The Spring 2022 Michigan Health Policy Forum will take place virtually from 1 to 3:30 p.m. May 23.
  • Applications for the 2023 Foster G. McGaw Prize will be accepted through July 30.

MHA in the News

MHA EVP Laura Appel appears in a State of Reform article on bills that would create specialty integrated plans to cover specialty behavioral health benefits.

Workforce Challenges Focus of GME Advocacy Day

Rep. Luke Meerman (R-Coopersville) meets with Trinity Health Saint Mary’s residents during their GME Advocacy Day visits.

The MHA Graduate Medical Education (GME) Advocacy Day welcomed 32 physician residents from more than a dozen member hospitals to the MHA Capitol Advocacy Center offices May 5 for a day of meetings with members of the Michigan Legislature and their staffs. Each group of residents met with a combination of lawmakers and legislative staff throughout the day, with conversations focusing on the importance of GME funding and the role it plays in Michigan’s healthcare workforce talent pipeline.

Meetings were held in the Michigan Capitol, the Anderson House Office Building and the Senate Binsfeld Office Building. Most of the meetings involved current members of both the House and Senate health policy committees, which is where the majority of healthcare legislation originates. Participating lawmaker offices included those of Senate Health Policy Minority Vice Chair Winnie Brinks (D-Grand Rapids), Senate Health Policy member Sen. Kim LaSata (R-Niles), House Health Policy Majority Vice Chair Luke Meerman (R-Coopersville) and House Health Policy Minority Vice Chair Angela Witwer (D-Delta Township).

Residents used and shared with lawmakers an infographic that provides facts regarding GME and the healthcare workforce shortage. With the nation experiencing a shortage of healthcare workers, residents reinforced the value of GME investment and physician residency training to help address physician shortages.

Members with questions on GME and state legislation related to the healthcare workforce should contact Elizabeth Kutter at the MHA.

MHA CEO Report — GME’s Role in the Healthcare Talent Pipeline

MHA Rounds Report - Brian Peters, MHA CEO

“Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.” ― Rudolf Virchow

MHA Rounds Report - Brian Peters, MHA CEOAs we enter the final two months of the MHA program year, our “all-hands-on-deck” prioritization of the healthcare workforce continues, and I am pleased to share that we have made significant strides in this regard. Included in that progress is work with our partners in higher education, other Michigan healthcare associations, hospital clinical leaders and the Michigan Legislature.

One aspect of our workforce efforts is not new. For many years, the MHA has led a special Graduate Medical Education (GME) Advocacy Day, hosted at our MHA Capitol Advocacy Center (CAC) in downtown Lansing. At this event, medical students, residents from teaching hospitals and academic medical centers, and other key leaders converge on the Capitol and meet with legislators to discuss the vital importance of GME funding in the state budget process.

After a brief hiatus due to the pandemic, we are excited to play host once again for this important in-person event, as we will welcome our colleagues to the CAC on May 5.

When this event began, the primary focus was to express the importance of GME and the national prominence that Michigan has earned in medical education. We have more than 7,200 physician residents currently working in the state, which ranks fourth in the nation. In addition, Michigan is third in the country for student enrollment in public medical schools. The investment Michigan makes in GME is very valuable, as every $1 in GME generates $2.53 in federal funding in fiscal year 2022. While the current rate is enhanced due to the existing public health emergency, there is no question that GME funding for Michigan’s beginning physicians is a wise investment for the future healthcare workforce in our state. GME also improves access to care, as it allows physicians to further their medical education while delivering much-needed care to patients throughout Michigan in teaching hospitals, community clinics and laboratories.

The vital role of GME in filling the talent pipeline is more important today than ever, as Michigan hospitals (and the healthcare delivery system in general) struggle with workforce shortages that have been exacerbated by the COVID-19 pandemic. Those shortages across the state have caused Michigan to lose approximately 1,300 staffed hospital beds over the past 18 months. Nationally, the physician shortage is estimated to be between 37,800 and 124,000 by 2034, including primary care and nonprimary care specialties, as the Association of American Medical Colleges estimates two out of every five active physicians will be 65 or older within the next 10 years.

The participants in our GME Advocacy Day have experienced many of the challenges that we’ve shared with elected officials: stress, burnout, workplace violence, vaccine hesitancy and significant loss of life due to COVID-19 and a host of other medical issues. Their perspective is extremely valuable as we make the case for funding and public policy that ensures the viability of our healthcare infrastructure for years to come. In addition to full funding of the traditional GME pool, there are several related items on the radar screen here in Lansing, including:

  • Included in the state’s Higher Education budget proposal is House Bill 5785, which would provide funding to create a healthcare workforce collaborative between the MHA and Michigan’s public and private post-secondary educational institutions. This partnership would not only provide employers with a better understanding of statewide graduates in health professions, but further improve the knowledge of employment opportunities in healthcare for post-secondary education institutions throughout the state. Included in the collaborative would be the creation of a searchable and accessible repository that allows healthcare employers to understand current educational trends and provides prospective employees easy access to healthcare positions throughout the state.
  • The MHA also supports legislation designed to incentivize more medical school and advanced practice nursing program preceptors by providing new tax credits. Senate Bills 998 and 999 would create a new tax credit for individuals who agree to work as a preceptor for required clinical rotations. We believe this legislation could help increase the capacity for clinical rotations at hospitals across the state, which would also improve the talent pipeline.

As we advocate in support of GME and related issues, we of course greatly appreciate the collaboration of our friends from the Michigan State Medical Society (MSMS) and Michigan Osteopathic Association (MOA). Together, our three associations make up The Partnership for Michigan’s Health, which has a long history of working together on healthcare issues of common interest, including the achievement of major medical liability reforms in the early 1990s, which established the foundation for much of our advocacy work in the Legislature and the courts ever since.

Most recently, the collective voice of our three associations, along with associations representing various other areas of healthcare, led to successfully securing $300 million in state funding for the recruitment, retention and training of healthcare workers. Collectively, the Healthcare Workforce Sustainability Coalition was created to focus on workers already within the healthcare workforce. Gov. Whitmer also recently signed Senate Bill 247 that would decrease wait times for commercial insurance prior authorization requests, a priority for all three associations. We are also united in our opposition to Senate Bill 990 that would create a serious public health risk by licensing naturopathic practitioners and classifying them as physicians. As healthcare associations, the professional careers of our members are dedicated to serving their patients and protecting the health and safety of the public. This opposition is an example of our need to protect the public from a practice that lacks scientifically proven treatment methods and clinical training.

In addition, we have long collaborated with MSMS and MOA to produce The Economic Impact of Healthcare in Michigan Report, which provides a detailed look at the extensive roles hospitals and health systems play in their local economies. Work is underway on the next issue of the report. The MHA Keystone Center Board of Directors has also designated one seat each for the MSMS and the MOA since its inception to ensure physician representation as we strategize on safety and quality improvement issues. And finally, the MHA and the MOA literally got closer last year when the MOA relocated its offices to the MHA headquarters building in Okemos – an arrangement that is unique anywhere in the country.

I’d also be remiss if I didn’t mention the MHA’s new focus on engaging with our physician leaders. For the first time ever, the MHA will be hosting activities dedicated to our physician leaders during our MHA Annual Meeting, including several sessions that will include CME credits. MHA Chief Medical Officer Dr. Gary Roth is leading these efforts, which complement his work throughout the pandemic engaging with our health system chief medical officers to facilitate consistent and reliable dialogue that allowed the MHA to efficiently provide policy updates to our clinicians as well as real-time feedback to policymakers. We’re extremely fortunate to have Dr. Roth, as the MHA is one of just a few state hospital associations with a full-time CMO on its leadership team.

Lastly, in an effort to fully support our physician colleagues (and other caregivers), the MHA Keystone Center is offering the Well-being Essentials for Learning Life-Balance (WELL-B) webinar series to prevent healthcare burnout by delivering weekly webinars on evidence-based well-being topics, including prevalence and severity of burnout, relationship resilience and being present. It is encouraging to see that over 4,000 individuals have already signed up for this innovative program.

As you can see, there is no magic pill that can solve the healthcare staffing crisis overnight. It will take many years and a multitude of public and private solutions to protect access for all of Michigan’s communities. GME is one of those key solutions, and we call on our elected officials – and all Michiganders – to give it the support it deserves.

As always, I welcome your thoughts.

MHA Monday Report March 7, 2022

MHA Monday Report

MHA Covid-19 update

Combating the Novel Coronavirus (COVID-19): Week of Feb. 28

The state of Michigan reported that 1,842 new cases of COVID-19 were confirmed statewide March 3 and 4, with an average of 921 cases per day. Out of 68 recorded COVID-19-related deaths for the two days, 54 were identified during a Vital Records review. Adults in the hospital March 4 with  …


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Behavioral Health Funding, Essential Health Provider Program Expansion is Advanced

The Michigan Legislature acted on several pieces of legislation impacting hospitals during the week of Feb. 28. Some of the covered topics included behavioral health funding, streamlining prior authorization requests, increased penalties for …


Apply by March 31 for New Graduate Medical Education Residency Openings

Applications are due March 31 for hospitals to apply for new graduate medical education residency slots provided under Section 126 of the Consolidated Appropriations Act. Hospitals will be required to complete their applications and submit them through the Medicare Electronic Application …


Federal 100% Cost Share for COVID-19 Expenses Extended

The Federal Emergency Management Agency in February 2021 increased federal funding for COVID-19 pandemic expenses from 75% to 100%, retroactive to the beginning of the pandemic in January 2020. The agency has now extended the COVID-19 federal 100% cost share for an …


mha advancing safe care awardNominations Being Accepted for 2022 Advancing Safe Care Award

In hospitals across the state, healthcare personnel work together to ensure patients receive safe, high-quality care. To recognize Michigan hospitals that are tackling issues daily to make care safer and more dependable, the MHA …


Virtual Nurse Training Programs Available

The MHA and the Michigan Health Council are partnering on two offerings designed to strengthen the nursing workforce. The Clinical Faculty Academy is a virtual training program preparing nurses for the role of clinical instructors. The interactive training materials, based on adult learning …


MHA CEO Report — Auto No-fault: Our Work ContinuesMHA Rounds Report - Brian Peters, MHA CEO

MHA CEO Brian Peters reviews efforts from the MHA to address and reform Michigan’s auto no-fault insurance law.


Webinar Reviews CMS CoPs on Telemedicine Standards

Significant changes were recently made to the Centers for Medicare & Medicaid Services Conditions of Participation regarding regulatory standards of telemedicine because of the COVID-19 pandemic. These standards, along with 1135 telemedicine waivers and new tag numbers assigned for …


Donations Sought to Aid Ukrainian Refugees

Ukrainians affected by the ongoing crisis in their country are in desperate need of help. The U.S.-Ukraine Foundation has established a fund to provide food, medical care and emergency supplies to refugee families. The U.S.-Ukraine Foundation is a strategic organization aimed at supporting …


Laura AppelMHA Announces Senior Staff Promotions, Additions

The Michigan Health & Hospital Association is promoting Laura Appel to executive vice president of government relations and public policy from her prior role as senior vice president, health policy & innovation. In this role, which takes effect …


The Keckley Report

Paul Keckley

Telehealth at a Crossroad: Atrophy or Accelerate?

“Two explanations for the downward trend in telehealth utilization are widely offered: 1-the increased risks associated with inaccurate or incomplete information exchanged between a patient and physician virtually and/or compromised personal health information, and 2-lack of adequate reimbursement by payers. Each is valid.”

Paul Keckley, Feb. 28, 2022


MHA in the News

MiBiz interviewed Adam Carlson, senior vice president, advocacy, for a story published Feb. 27 on the $300 million funding appropriation for healthcare recruitment, retention and training recently signed by Gov. Gretchen Whitmer.

Legislature Passes State Budget That Protects Healthcare Funding

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Michigan CapitolThe Michigan Legislature approved Sept. 22 the fiscal year (FY) 2022 state budget. The governor has indicated support for the budget that goes into effect Oct. 1, and the agreement protects vital funding sources for patient care in Michigan hospitals and expands access to healthcare services. The MHA published a statement on the passage of the budget Sept. 22.

Specifically, the budget reflects the protection or enhancement of many MHA priorities:

  • Continues enhanced outpatient Medicaid rates. For FY 2022, the increase in rates is projected to result in the continuation of funding that translates to $270 million in net revenue for hospitals.
  • Protects funding for the rural access pool and obstetrical stabilization fund.
  • Continues to maintain funding for disproportionate share hospitals (DSH) and graduate medical education (GME), pursuant to the MHA board-supported multiyear budget agreement.
  • Fully funds the Healthy Michigan Plan.
  • Continues the additional $2.35 hourly wage increase for direct care workers at skilled nursing facilities and enhanced reimbursement for ground ambulance services to reimburse at 100% of the Medicare rate.
  • Continues expanded Medicaid coverage for women up to 12 months postpartum.
  • Adds $3 million in new funding to set up a statewide system of care for stroke and ST-elevated myocardial infarction (STEMI) emergencies within the existing statewide trauma system.

In addition, nearly $10 billion in state and federal funding is still available that will be allocated through a supplemental budget process. The MHA will advocate the state use portions of the funding to address the association’s behavioral health priorities and workforce issues.

Members with questions on the state budget may contact Adam Carlson at the MHA.