Media Recap: Implicit Bias Training & Medicaid Maternal Health Coverage

Brian Peters

The MHA received media coverage the week of May 9 on the upcoming Public Health Code Rules requiring implicit bias training for all professions licensed or registered under the Public Health Code and the recently approved extension by The Centers for Medicare & Medicaid Services of Michigan Medicaid and Children’s Health Insurance Program coverage for 12 months after pregnancy.

Bridge published May 11 a story on the healthcare industry’s reaction to the June 1 implementation date of the implicit bias training requirement. MHA CEO Brian Peters is quoted in the article expressing the positive reaction from hospitals on the requirement and their commitment to eliminate health disparities.

“There’s been no push back,” said Peters. “Everyone realizes this is the right thing to do.”

State of Reform also published May 10 an article on the increase in coverage for postpartum mothers from 60 days after birth to a full year in Michigan. Laura Appel, executive vice president of government relations and public policy, MHA, spoke with State of Reform on the importance of this coverage extension towards addressing maternal mortality and racial disparities.

“It feels counterintuitive to why healthcare coverage for women would end 60 days after they gave birth,” said Appel. “You would in no way expect coverage to end so quickly.”

CEO Report — Our Commitment to Safety and Quality

MHA Rounds Report - Brian Peters, MHA CEO

If you can’t describe what you are doing as a process, you don’t know what you’re doing.” — W. Edwards Deming

MHA Rounds Report - Brian Peters, MHA CEOThe last week has been an eventful and successful one for the MHA. The Michigan Legislature and Gov. Gretchen Whitmer came to an agreement on the state budget for the new fiscal year, which fully preserves all our hospital and healthcare funding priorities — needed more than ever as our hospitals continue to combat COVID-19 and deal with extraordinary staffing challenges. We were officially honored by Modern Healthcare with the Best Places to Work in Healthcare distinction. And finally, we received great news when Blue Cross Blue Shield of Michigan (BCBSM) announced a $5 million commitment through 2024 to support the MHA Keystone Center’s expanded quality and safety improvement programs. I would like to personally thank BCBSM CEO Dan Loepp for his support of this continued partnership, which is the right thing to do for all Michiganders.

Since its inception in 2003, the MHA Keystone Center has provided leadership and facilitation that has directly resulted in improved patient care and quality outcomes — in other words, we have demonstrably saved lives and saved healthcare dollars. No wonder that the MHA Keystone Center has earned both national and international acclaim.

Our first flagship initiative involved central line associated bloodstream infections (CLABSI). Through that work, Michigan hospitals saw a 22% improvement in CLABSI rates. Initial BCBSM funding also supported work that saw a 31% improvement in catheter-associated urinary tract infections (CAUTI) and a 5.9% improvement in venous thromboembolism.

Following our initial successes, the Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN) was created, allowing us to collaborate with our colleagues in Illinois and Wisconsin. Our HIIN efforts from Sept. 2016 to March 2020 produced a total cost savings of nearly $293 million, saved 3,350 lives and avoided 25,204 incidents of harm among hospitalized patients.

The MHA is now one of eight organizations participating in the Superior Health Quality Alliance, a Centers for Medicare & Medicaid Services (CMS)-contracted organization that seeks to improve the quality of health and healthcare through innovation, effectiveness and efficiency in designing and implementing CMS Network of Quality Improvement and Innovation Contractors initiatives that are person-centered and integrated across the continuum of care and services. This important work with federal contracts is yet another way we can improve quality in the acute care setting.

High reliability work has been a focal point for the MHA for several years, which was initiated with our members in 2015. This work ensures exceptional quality of care is consistently delivered for every patient, every time. In 2018, the MHA Keystone Center launched a Reliability Culture Implementation Guide in partnership with our fellow state hospital associations from Illinois, Minnesota and Wisconsin. This guide provides resources available for front-line staff, executive leaders and board members to help identify areas of opportunity.

Over the past year, CEOs representing all our community hospitals have signed the MHA Pledge to Address Racism and Health Inequities, demonstrating our members’ unified commitment to address disparities, dismantle institutional racism and achieve health equity. Recent examples of tangible steps taken to accomplish those goals include the publishing of the Eliminating Disparities to Advance Health Equity and Improve Quality guide and offering a virtual series to address four diversity, equity and inclusion concepts: equitable conversations, equitable messaging, partnership building and diversity pipeline development. The Health Equity guide is geared to assist organizations in addressing health disparities to achieve equitable care by providing key strategies, recommendations for action, implementation levels, and resources to support progress.

Thanks to funding from the Michigan Health Endowment Fund, the MHA Keystone Center recently launched its second Age-Friendly Health Systems Action Community free of charge to MHA members. The Action Community builds on existing practices of participating organizations and combines them to reliably implement the evidence-based framework of high-quality care with all older adults in the system. With Michigan’s aging population, this work is exceptionally important and timely.

One way to help instill a safety culture within a healthcare organization is empowering all members of a care team to speak up if they think something may be wrong. Our patient safety organization created the quarterly Speak-up! Award program five years ago to honor healthcare staff who spoke up to prevent harm, which has prevented nearly $12 million in avoidable costs.

We have also done our part to address the tragedy of opioid overdoses, which lead to more deaths in Michigan than automobile accidents. The GLPP HIIN recently created the Midwest Alternatives to Opioids (ALTO) program; participating hospitals collectively have seen an 11.32% decrease in opioid administration and a 13.38% increase in ALTO administration. Because the COVID-19 pandemic has only worsened the opioid epidemic, we are committed to expanding this important work.

The MHA advocacy and policy departments also assisted in the creation of Project Baby Deer, a rapid Whole Genome Sequencing project to improve pediatric intensive care units and outcomes in Michigan. Genetic disorders are a leading cause of morbidity and mortality in infants. Early diagnosis of genetic disease has the potential to change clinical management in many meaningful ways, including initiating lifesaving treatments, avoiding unnecessary tests and procedures, shortening hospital stays and empowering families with real-time diagnoses to help with their understanding and decision-making. In addition to improving outcomes, Project Baby Deer also can prevent avoidable healthcare costs.

As you can see, we have a rich history that we can be incredibly proud of. And without question, BCBSM has been an instrumental partner with us on this journey, providing some $16 million in direct funding support to date. This new BCBSM funding will help to ensure that our critical work in safety and quality continues into the future. Specifically, it will allow the MHA Keystone Center to increase hospital participation in the Michigan Alliance for Innovation on Maternal Health (MI AIM), increasing implementation of pre- and post-partum Obstetric Hemorrhagic Risk Assessment, increasing implementation of Quantitative Blood Loss Assessment, and increasing the percentage of women who receive timely treatment of severe hypertension. It will accelerate our work on the opioid epidemic by maximizing the use of medication-assisted therapy, and it will allow us to expand our efforts to address healthcare workplace injuries — thereby ensuring that hospitals are as safe as possible for our front-line caregivers.

In each example noted above, we have helped to establish a clear process that people can understand, trust and execute.

Lastly, I want to stress that all Michigan hospitals and their team members voluntarily participate in MHA Keystone Center initiatives to advance safety for patients and workers and quality of care. There is no mandate in place to require hospitals to participate in this work, but they each choose to do so because of their missions to care for the sick and vulnerable. The pandemic has shined a bright light on the unselfishness of our healthcare heroes and their participation in these efforts is another terrific example of the lengths they go to improve care for their patients. I want to thank both BCBSM and our member hospitals for believing in this vital work and taking the steps necessary to ensure evidence-based best practices are implemented to the point that they make a difference in patients’ lives. This is mission-driven work that all Michiganders can be proud of

As always, I welcome your thoughts.

Video Series Highlights Health Equity, Dashboard Available to Measure Progress

Advancing Health Equity logo

Advancing Health EquityThe MHA and MHA Keystone Center are committed to assisting members in advancing health equity, eliminating disparities and addressing institutional racism to improve care for all Michiganders. The third and final video in the MHA Keystone Center’s video series, Eliminating Disparities to Advance Health Equity, is now available and highlights the Health Equity Organizational Assessment (HEOA) dashboard.

The video series was developed to provide guidance on completing the HEOA accurately. The HEOA identifies key priorities within nationally recognized components of an organization’s ability to identify and address disparities. The first video served as a call to action to sign the pledge and the second video detailed how to complete the HEOA.

The final video discusses how to use the HEOA dashboard, which provides a detailed report containing custom feedback and recommendations to help organizations identify key actions and next steps. Members may access the HEOA in KeyMetrics.

In conjunction with the video series, the MHA Keystone Center released the second edition of the guide, Eliminating Disparities to Advance Health Equity and Improve Quality. This version is updated to better align with the HEOA, specifically the letters of implementation and star ratings in section 5.  

Members with questions may contact the MHA Keystone Center.

Registration Open for Diversity, Equity and Inclusion Virtual Series

Chief executive officers from more than 130 hospitals and health systems signed the MHA Pledge to Address Racism and Health Inequities, indicating a unified commitment to addressing disparities, dismantling institutional racism and achieving health equity. As part of their commitment to addressing health disparities, the MHA and the MHA Keystone Center are offering a virtual series to address four diversity, equity and inclusion concepts: equitable conversations, equitable messaging, partnership building and diversity pipeline development. The webinar series will address targeted topics in engaging ways by involving the audience in practices like role playing and mapping exercises. Hospital and health system executives, including chief executive officers; medical, nursing and human resources executives; governing board members; and key diversity, equity and inclusion leaders are encouraged to participate to advance their health equity efforts.

An important orientation webinar will take place from 11 a.m. to noon June 30, followed by four webinars held from 11 a.m. through 12:15 p.m. on specific dates through Aug. 31. The series will be presented and facilitated by speaker and coach Kevin Ahmaad Jenkins, PhD. Pricing includes the entire series and is available for teams of five members and larger. To register, contact the MHA Field Engagement division indicating the intention to register for the DEI series and providing an email address and phone number. Registrants will be contacted for additional information to complete the process. Questions about the series should be directed to Erin Steward at the MHA.

Celebrating Member Commitment to Addressing Racism and Health Inequities

Take the Pledge

Pledge to Address Racism and Health InequitiesNearly 100 hospitals and health systems have signed the MHA Pledge to Address Racism and Health Inequities since it was released in November 2020. The MHA acknowledges the importance of this unified commitment and honors the organizations that have signed the pledge on its Health Disparities webpage.

The COVID-19 pandemic has magnified the longstanding health disparities our communities face. While efforts to advance health equity are not new for most health systems, the pledge acts as a deliberate approach to delivering equitable care for all Michiganders. By asking chief executive officers of MHA-member hospitals and health systems to sign the pledge, members are ensuring that addressing systemic racism and health disparities is a leadership-driven priority.

The organizations that sign the pledge recognize the impact of racism on health, and that healthcare systems have a moral obligation to equalize care – first by identifying and addressing any racism that may exist within their organization. The MHA and MHA Keystone Center are equipped to assist with these efforts. The MHA Keystone Center’s guide, Eliminating Disparities to Advance Health Equity and Improve Quality, provides practical information on assessing each organization’s level of implementation within key categories to reduce disparities, and delivers recommendations for action.

An online video further explains the pledge and the association’s health equity efforts. A copy of the pledge is available on the MHA Health Disparities webpage. To officially sign the pledge, contact the MHA Keystone Center.

MHA Keystone Center Hosts Twitter Chat on Health Equity

HE Twitter Chat

Health Equity Twitter Chat RecapThe MHA Keystone Center hosted a one-hour Twitter chat Nov. 19 to discuss the role of organizations in addressing health disparities to achieve equitable care. The chat allowed participants to engage with their peers on identifying key components of achieving equitable care, as well as organizational success in reducing health disparities.

The MHA Keystone Center served as moderator for the Twitter chat and asked questions from @MHAKeystoneCtr as participants shared their answers using the hashtag #KeystoneHealthEquity. The chat gathered more than 21,000 impressions (the number of times the conversation was seen) to reach approximately 7,200 users.

At the end of the chat, a short video was shared as a call to action, asking organizations to sign the MHA Pledge to Address Racism and Health Inequities, committing to addressing systemic racism and health disparities that affect people of color and all marginalized populations in Michigan communities. The pledge was formally adopted at the Nov. 4 MHA Board of Trustees meeting and aligns with the overarching commitment to achieving health equity in the 2020-2021 MHA strategic action plan.

The Twitter chat complements the MHA Keystone Center’s recently released guide Eliminating Disparities to Achieve Health Equity and Improve Quality, a resource available to assist organizations in addressing health disparities to achieve equitable care by providing key strategies, recommendations for action, implementation levels and resources to support progress. Visit the MHA Health Disparities webpage to learn more about the MHA Keystone Center’s current initiatives on health equity. Members with questions may contact the MHA Keystone Center.

Register Now for MHA Virtual Breakthrough Event

Virtual Breakthrough

Large segments of the population lack medical care and cannot afford insurance coverage. An unprecedented decline in life expectancy exists due to suicide and drug-related disease. Minorities, low-income individuals and the elderly are disproportionately dying of disease and neglect. Atul Gwande, MD, has said that repairing healthcare is not an elective procedure, it’s a lifesaving procedure.

To address these circumstances, MHA Breakthrough will explore actions to build health within communities and make true differences in healthcare. Offered in a virtual format for 2021, Breakthrough focuses on two areas: the future of medicine and healthcare post-COVID-19 crisis, and how to address health disparities exposed during the pandemic. These topics will be explored during two half-day sessions offered on the Zoom platform.

Leading the discussion on COVID-19 is Marty Makary, MD, MPH, who is a New York Times bestselling author and professor of surgery at the Johns Hopkins. His April 2020 article in the New York Times was the first major media article calling for universal masking to partially re-open American businesses. He has been a frequent medical commentator on CNBC and Fox News.

Renée Branch Canady, PhD, CEO of the Michigan Public Health Institute and a recognized national thought leader in the areas of health inequities and disparities, will engage participants in conversation about understanding and supporting health equity and how to measure evidence that policies are working.

Breakthrough virtual sessions will be offered from 2:30 to 4:30 p.m. Feb. 25 and from 9 to 11 a.m. March 18. Details on the event and registration are available online. Questions about Breakthrough may be directed to Erin Steward at the MHA; contact Erica Leyko at the MHA for assistance with registration or discuss sponsorship opportunities for the event.

MHA Members Pledge to Address Racism and Health Inequities

Take the Pledge

The MHA Pledge to Address Racism and Health Inequities MHA released its Pledge to Address Racism and Health Inequities Nov. 19. The pledge was endorsed by the MHA Board of Trustees at its Nov. 4 meeting and is intended for chief executive officers at MHA-member organizations to sign, indicating a unified commitment to addressing disparities, dismantling institutional racism and achieving health equity.

While efforts to deliver equitable care are not new for most health systems, increasing evidence suggests that racial and ethnic minority groups are being disproportionately affected by the COVID-19 pandemic. The pledge highlights the moral obligation of healthcare systems to equalize care, starting by identifying and addressing any racism that may exist within their organization. Further, the pledge recognizes the unique position of hospitals and health systems to address this issue and advance diversity, inclusion and equity efforts.

“The MHA’s mission is to advance the health of all individuals and communities, and that mission has never been more critical than it is today,” said MHA CEO Brian Peters. “By signing the pledge, members are ensuring that achieving health equity is a leadership-driven approach.”

An online video further explains the pledge and the health equity efforts of the association and the MHA Keystone Center.

The MHA and its members have long been committed to addressing health disparities to achieve equity for all populations. The association has hosted many events, including educational webinars on diversity, inclusion and cultural competency; a regional health equity learning session; a Twitter chat to spread awareness; and case example webinars for obtaining race, ethnicity and language data to drive improvement. Recordings and slides of these webinars are available on the MHA Community site.

In an additional effort to support hospitals on their journey to achieving health equity, the MHA Keystone Center recently released the new guide Eliminating Disparities to Advance Health Equity and Improve Quality. The document provides practical guidance for organizations seeking to assess and act on identified gaps so that deliberate action is taken to ensure that the outcomes are equitable across all patient populations.

The association has also been a longtime advocate of legislation to enhance these efforts with state and federal legislators to ensure a safe environment for both patients and healthcare professionals.

Together, these efforts aim to support, inform and inspire healthcare organizations as they work to eliminate disparities and institutional racism, ultimately improving patient care for all populations.

For a copy of the pledge, visit the MHA Health Disparities webpage. To officially sign the pledge, contact the MHA Keystone Center.

MHA Joins Roundtable Discussion on Community Health

Dr Roth

Dr. Gary Roth, MHA Chief Medical Officer, discusses how businesses can make a big impact on community health.While the COVID-19 pandemic has been a challenging time for leaders, it has allowed businesses to participate in innovative conversations. MHA Chief Medical Officer Gary Roth, DO, joined leaders from around the state Oct. 26 in a virtual roundtable to discuss how businesses can make a big impact on community health during this pandemic. Dorrie Dils, CEO of Gift of Life Michigan, and Sandy Baruah, president and CEO of the Detroit Regional Chamber, also participated in the roundtable.

The business roundtable is part of Let’s Talk, Gift of Life’s multicultural outreach campaign to educate African American, Latinx and Arab American communities about the need for organ donors and break down misconceptions about the organ donation process. Since its inception in 2019, the campaign continues to encourage conversation about these issues and bring diverse donor stories to the forefront. A recording of the discussion is available on YouTube.

“Every year, Michigan hospitals participate in an annual competition to see who can register the most organ donors. Efforts such as these can lead to a dramatic increase in the Michigan Organ Donor Registry, which now contains more than 66% of Michigan adults, almost three times the percentage of 10 years earlier,” Roth said when asked what business leaders can do to support community health and organ and tissue donation.

Gift of Life Michigan is the state’s only federally designated organ and tissue recovery program, providing all services necessary for organ donation to occur in Michigan. To learn moreabout organ and tissue donation efforts, visit the Gift of Life Michigan website. Members may also contact Gary Roth at the MHA for more information.