Michigan Legislature Protects Healthcare in FY 2021 Budget

The Michigan Legislature approved the fiscal year (FY) 2021 state budget Sept. 23. Gov. Gretchen Whitmer has indicated support for the budget, which takes effect Oct. 1, protects vital funding sources for patient care in Michigan hospitals and expands access to healthcare services. In a time when other states have enacted Medicaid reductions, the MHA successfully advocated for a significant increase in outpatient Medicaid reimbursement rates. This is the first such statewide increase since 2002 and is vital as Michigan hospitals continue to respond to the COVID-19 pandemic. The association published a statement noting its appreciation for the budget’s protection of vital funding sources for patient care in Michigan hospitals.

The approved budget reflects the protection or enhancement of many MHA priorities:

  • Increases hospital Medicaid outpatient reimbursement rates by 21.4% over the rates in effect in FY 2020. When combined with other adjustments, this is projected to provide a net benefit of nearly $250 million for Michigan hospitals over the course of the fiscal year.
  • Maintains the significant increase to hospital Medicaid outpatient reimbursement rates for critical access hospitals that took effect Jan. 1, 2020.
  • Protects funding for the rural access pool and obstetrical stabilization fund.
  • Continues to maintain funding for disproportionate share hospitals and graduate medical education, pursuant to the multiyear budget agreement supported by the MHA board.
  • Fully funds the Healthy Michigan Plan.
  • Directs the Michigan Department of Health and Human Services to account for acuity measures when establishing inpatient behavioral health reimbursement rates.

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

CEO Report – Maternal Health Matters

MHA Rounds Report - Brian Peters, MHA CEO

“I realized when you look at your mother, you are looking at the purest love you will ever know.” ― Mitch Albom

MHA CEO Brian PetersLast week Gov. Gretchen Whitmer presented her State of the State address, establishing her priorities for the upcoming year. A considerable portion included a focus on healthcare, particularly maternal health. In Michigan, 52.5% of maternal deaths caused by cardiomyopathy, infection/sepsis and hemorrhage are determined to be preventable. Whenever we see statistics in healthcare, we can always have a discussion about methodology, but frankly, any preventable death is unacceptable and deserves our full attention. 

In pursuit of our association’s mission to advance the health of individuals and communities, we commend Gov. Whitmer for taking a leadership role on this issue and bringing needed attention to a topic that affects us all. Michigan’s birthing hospitals play a key role in welcoming new life to Michigan’s families and must do everything in their power to protect the health of a mother and baby during their most vulnerable time. It is our sincere belief that the governor’s plan will provide much needed support to the efforts that the MHA Keystone Center and our member hospitals have already undertaken to ensure health equity by addressing disparities and social determinants of health.

Specifically, the governor’s plan will extend postpartum Medicaid benefits for a full year for mothers, increase access to treatment for substance abuse and mental health services for mothers and expand access to home visiting programs. The full care continuum reaches outside the four walls of a hospital, and these initiatives can make a large impact in ensuring all mothers and babies remain healthy.

Training our future physicians, nurses and healthcare professionals in implicit bias will also go a long way in establishing acceptable treatment and practices for our hospital community. I’m excited to see Randolph Rasch, dean of the Michigan State University College of Nursing and Dr. Audrey Gregory, CEO of the Detroit Medical Center, have been identified by Gov. Whitmer to lead this important effort.

The MHA Keystone Center has been actively working to address this issue since 2009, when the MHA Keystone: Obstetrics collaborative was established. Several years ago, the work of the collaborative merged into the Michigan Alliance for Innovation in Maternal Health (MI AIM), with recent data showing encouraging results from our efforts. Between 2014 and 2017 in Michigan:

  • Severe maternal morbidity decreased by 10.5%.
  • Complications from hemorrhage decreased by 19.6%
  • Maternal hypertension complications decreased by 19%

The MHA Keystone Center is also involved in the Obstetrics Initiative (OBI), an interdisciplinary quality initiative funded by Blue Cross Blue Shield of Michigan that engages maternity care providers and hospitals in a collaborative effort to safely reduce the use of primary cesarean deliveries for low-risk pregnancies.

In addition, I’m proud to have 48 of Michigan’s birthing hospitals engaged in providing process and outcome data to the MHA Keystone Center. However, more work can be done. We’d love to see full participation and encourage all of our members offering obstetrical services to submit this data. For those birthing hospitals that are participating, the MHA Keystone Center is debuting a new MI AIM dashboard later this month.

I also encourage our members to join the MHA Keystone Center at this year’s Maternal Infant Health Summit, March 30 and 31 in Lansing. Hosted by the Michigan Department of Health and Human Services, MI AIM and the Maternal Infant Health Strategy Group, professionals from across the healthcare community will come together to support our shared goal of ensuring health equity to all Michigan mothers and babies.

Lastly, the pressing need to improve maternal health is not limited to Michigan, and it has drawn the attention of the U.S. House Education and Labor Committee at the federal level. Two observations from members of our own congressional delegation at a recent hearing of that committee:

  • “The United States has one of the highest maternal mortality rates in the developed countries, and deaths among women of color is fueling that growth.” –  U.S. Rep. Brenda Lawrence (D-Southfield), Black Maternal Mortality Caucus co-chairwoman.
  • “We have an emergency going on in America right now, and I cannot think of a better instance of the sanctity and preciousness of life than this, than the life of the mother.” – U.S. Rep. Haley Stevens (D-Rochester Hills). 

Over the past 100 years, the MHA has been involved in many efforts to improve care and quality. As we embark on a new calendar year, I can think of few causes worthier of our attention and efforts. I hope you will join Gov. Whitmer, the MHA Keystone Center, our member hospitals, and all of our maternal health partners in this critical endeavor.

As always, I welcome your thoughts.

MHA Grateful for State of the State Focus on Maternal Health

MHA CEO Brian Peters

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association.

MHA CEO Brian PetersWe are grateful Gov. Whitmer is bringing attention to maternal health in Michigan. The preventable death of any woman during or following pregnancy is unacceptable. Currently, women of color are affected at a significantly higher rate than non-Hispanic white women. As a healthcare community, removing health disparities is crucial in improving the quality and safety of care in Michigan for every mom and baby. We look forward to working with Gov. Whitmer in ensuring health equity for all.