MHA Monday Report Nov. 20, 2023

MHA Monday Report

capitol building2023 Legislative Session Recap

The Michigan Legislature officially adjourned sine die for the calendar year Nov. 14. The top priority for the association this fall was opposing harmful, one-size fits all nurse staffing ratio legislation (House Bills 4550-4552 and …


MHA Board of Trustees Advances Strategic Action Plan, Focus on Workforce Support and Medicaid Maximization

The MHA Board of Trustees focused most of their Nov. 8 meeting on targeted actions in advancement of their 2023-2024 Strategic Action Plan, which outlines the association’s priorities for the year ahead and identifies those …


MHA Policy Experts Join Mental Health Association Panel Event

The Mental Health Association in Michigan hosted the annual Michigan Partners in Crisis event Nov. 3, bringing together industry experts to explore the theme Bridging the Gap in Mental Health Care. Elizabeth Kutter, senior director …


MHA Issues Statement on National Rural Health Day

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association. “As we celebrate National Rural Health Day, we want to express our gratitude to all our rural hospitals …


MHA Podcast Uplifts National Rural Health Day feat. Munson Healthcare

The MHA released a new episode of the MiCare Champion Cast, which features interviews each month with experts in Michigan discussing key issues that impact healthcare and the health of communities. The November 2023 episode, …


MHA Virtual DEI Certificate Program Approved for CME and Nursing Credits

Registration is open for the Diversity, Equity and Inclusion in Healthcare certificate program Dec. 7 and Dec. 8 from 11 a.m. to 3 p.m. EST. The event, hosted by the Michigan Health & Hospital Association …


The Keckley Report

Paul Keckley2024 is a Make-or-Break Year for Physicians

At the interim meeting of the American Medical Association House of Delegates Saturday in National Harbor, MD, President Jesse Ehrenfeld, MD, MPH, urged physicians to take action: “Medicine is not just at a crossroads…it’s at a crisis.” He’s right: 2024 is a make-or-break year for the profession. …

The issues for the medical profession go well-beyond burnout and finances. Though pushback against the Final Rule is understandable, it must be considered in a broader context. Medicare funding is in the cross hairs of budget hawks in Congress and rating agencies (Moody’s November 13, 2023) have downgraded the nation’s debt citing deficits, spending (including Medicare) and political polarization as root causes. And 2024 is an election year in which the economy is the key issue topping the domestic agenda and healthcare affordability a key focus along with access to abortion services. …

Paul Keckley, Nov. 13, 2023


News to Know

TELUS Health CBT (formerly known as AbilitiCBT by LifeWorks) is now offered by TELUS Health, a global leader in total wellbeing.


MHA in the News

The MHA received media coverage the weeks of Nov. 6 and Nov. 13 regarding a committee hearing on proposed nurse staffing ratio legislation. Additional topics covered include hospital market activity, behavioral health, the state’s STEMI …

MHA Board of Trustees Advances Strategic Action Plan, Focus on Workforce Support and Medicaid Maximization

The MHA Board of Trustees focused most of their Nov. 8 meeting on targeted actions in advancement of their 2023-2024 Strategic Action Plan, which outlines the association’s priorities for the year ahead and identifies those areas of work that need long-term attention from the MHA and the hospital community. Once again, the plan is organized into four key pillars: Workforce Support and Innovation, Viability, Improved Behavioral Health and Health Equity.

Opposition to mandated staffing ratios remains a top priority for the association within the Workforce pillar, as it has been shown to be a misguided and potentially harmful approach to addressing workforce shortages. Instead, the association supports specific measures to address educational barriers, innovation and growth within the talent pipeline. Within the Viability pillar, the board discussed ongoing work in partnership with the Michigan Department of Health and Human Services (MDHHS) to maximize Medicaid funding, a review of MDHHS’s process for rebidding Medicaid health plan contracts and a status report on Medicaid eligibility following the expiration of COVID-era waivers. The board also discussed strategic priorities to advance the association’s Behavioral Health and Health Equity pillars. This included continued work on bed access and capacity (especially for children), crisis prevention and education, Community Mental Health system reform and behavioral health data support, as well as continued work on the health equity front to reduce maternal morbidity disparities and partnerships with public health departments to address local disparities.

Board member Douglas Apple, MD, chief clinical officer, Ascension Michigan, and interim president & CEO, Ascension Genesys Hospital, provided a patient story that emulated the use of high reliability principles that resulted in reduction of patient harm. In this case, during a routine preoperative assessment, a nurse appropriately used the Suicide Risk Screening tool and discovered that a patient very recently attempted suicide. The use of the tool and subsequent intervention led to the patient getting critical care for a health risk that would otherwise not have been identified.

The board concluded with board task force reports, an MHA Keystone Center and MHA Service Corporation report, regional hospital council reports, an AHA report and an update from MHA CEO Brian Peters.

Members with questions about the MHA Board of Trustees meetings should contact Amy Barkholz at the MHA.

MHA Virtual DEI Certificate Program Approved for CME and Nursing Credits

Registration is open for the Diversity, Equity and Inclusion in Healthcare certificate program Dec. 7 and Dec. 8 from 11 a.m. to 3 p.m. EST. The event, hosted by the Michigan Health & Hospital Association (MHA) and other state hospital associations in partnership with the Healthcare Experience Foundation, is approved for CME, nursing and patient experience credit.*

The certificate program is designed to equip leaders, staff and clinicians with knowledge and strategies to interpersonally grow and develop the ability to be a more inclusive leader and caregiver. The unique features of this program include participation in a peer development environment with scenario-based learnings and summary evaluations. Industry perspectives from leading healthcare organizations and access to a customized learning portal to support the continued application of knowledge.

Health equity has been lifted up as a pillar of the MHA Strategic Action Plan with the support of the MHA Board of Trustees, driving towards improved equity of access, outcomes and experience. This Virtual DEI Certificate Program is just one of many efforts to help member hospitals’ leaders expand their education and training in the health equity space. Other areas of health equity focus for the association include equity in behavioral health, maternal and infant health, data collection to drive better outcomes and processes, emergency preparedness and more. Members with questions about the health equity pillar of our Strategic Action Plan may contact Jim Lee or Sarah Scranton.

Members with questions about the program should contact Erin Steward at the MHA.

*This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of MyMichigan Health and Michigan Health & Hospital Association. MyMichigan Health is accredited by the Michigan State Medical Society (MSMS) to provide continuing medical education for physicians. MyMichigan Health designates this live activity for a maximum of 8 AMA PRA Category Credit(s)TM .  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AXIS Medical Education designates this continuing nursing education activity for a maximum of 6.0 contact hours.
Learners are advised that accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with an activity. In support of improving patient care, this activity has been planned and implemented by AXIS Medical Education and The Michigan Health & Hospital Association (MHA). AXIS Medical Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

The program is accredited by the Patient Experience Institute for six Patient Experience Education Credits (PXEs).

MHA Monday Report Nov. 13, 2023

MHA Monday Report

MHA board member Beth Charlton provides testimony to the House Health Policy committee.House Committee Hears Testimony on One-Size-Fits-All Nurse Staffing Ratios

The House Health Policy Committee held a testimony-only hearing Nov. 9 on mandated nurse staffing ratio legislation, House Bills 4550-4552. The proposed bills would mandate one-size-fits-all nurse staffing ratios for all Michigan hospitals. The legislation, which does not create more nurses nor solve staffing


CMS Finalizes Physician Fee Schedule for 2024

The Centers for Medicare & Medicaid Services (CMS) released the calendar year 2024 Medicare Physician Fee Schedule final rule Nov. 2, aimed at promoting healthcare equity and expanding access to essential services for Medicare beneficiaries. These policies include several crucial areas, …


2024 Medicare Home Health Final Rule Released

The Centers for Medicare and Medicaid Service recently released a final rule to update the home health (HH) prospective payment system (PPS) for calendar year 2024. The rule includes updates to the Medicare fee-for-service HH PPS payment …


Minimum Staffing Standards for Long-Term Care Facilities

The Centers for Medicare & Medicaid Services released a proposed rule Sept. 1, to establish minimum staffing standards for long-term care facilities, as part of the Biden Administration’s Nursing Home Reform initiative. The MHA supports the goal to ensure safety and …


OPPS 2024 Final Rule Released

The Centers for Medicare and Medicaid Services recently released a final rule to update the Medicare fee-for-service outpatient prospective payment system (OPPS) effective Jan. 1, 2024. The rule: Provides a net 2.1% to the outpatient conversion factor for hospitals that …


Reaching Rural: Advancing Collaborative Solutions Fellowship Program

The U.S. Department of Justice, Bureau of Justice Assistance announced a new cohort for the Reaching Rural: Advancing Collaborative Solutions Fellowship program Nov. 2. This year-long program will help rural leaders find solutions to substance use and misuse within their community through collaboration with …


The Keckley Report

Paul KeckleyThe Conundrum facing Not-for-Profit Hospital Systems

“Does hospital ownership matter? According to a study published last week in Health Affairs Scholar, NOT MUCH. That’s a problem for not-for-profit hospitals who claim otherwise. …

The issues facing not-for-profit hospitals in the U.S. are unique and complex. Per the commentary of the CSOs, their market conditions are daunting and major changes in their structure, funding and regulation unlikely. That means lack of public understanding of their unique role is a conundrum.”

Paul Keckley, Nov. 6, 2023

CMS Finalizes Physician Fee Schedule for 2024

The Centers for Medicare & Medicaid Services (CMS) released the calendar year 2024 Medicare Physician Fee Schedule final rule Nov. 2, aimed at promoting healthcare equity and expanding access to essential services for Medicare beneficiaries. These policies include several crucial areas, such as behavioral health strategies, caregiver support, oral and dental health services linked to cancer treatments, enhancements to the Medicare Diabetes Prevention Program and assessments of social determinants of health.

Building on the agency’s commitment to health equity, CMS is finalizing coding and payment mechanisms for caregiver training services to ensure that healthcare practitioners are compensated for helping Medicare beneficiaries adhere to treatment plans. These are the first Physician Fee Schedule services to include payment for community health workers to address unmet social needs and enable person-centered planning.

The rule also finalizes payments for risk assessments for social determinants of health to ensure seamless integration into healthcare visits.

Lastly, the CMS Behavioral Health Strategy enhances emotional and mental well-being through behavioral health care. This rule creates a mechanism for marriage and family therapists and mental health counselors, including addiction, alcohol or drug counselors, to enroll in Medicare and bill for services beginning January 1, 2024. It also increases payment for crisis care, substance use disorder treatment, psychotherapy and Health Behavior Assessments and Intervention services.

Members with questions may contact Lauren LaPine at the MHA.

MHA Monday Report Nov. 6, 2023

MHA Monday Report

capitol buildingHealthcare Worker Protections Headed to Governor

Legislation increasing penalties for violence committed against healthcare workers was approved by the state House of Representatives in a bipartisan vote during the week of Oct. 30. The MHA-supported bills increase fines for assaulting a healthcare …


Michigan Hospitals Invested $784 Million in Community and Voluntary-based Activities to Improve Health, Well-being of Residents

New report outlines hospital community health efforts in FY 2021  The Michigan Health & Hospital Association released today the Making a Difference in Our Communities report that highlights how hospitals invested more than $784 …


Beyfortus Supply Shortages & CDC Guidelines

Beyfortus (nirsevimab) is a long-acting monoclonal antibody for the prevention of respiratory syncytial virus lower respiratory tract disease in infants approved by the U.S. Food and Drug Administration in July 2023. The MHA has …


speak upC.S. Mott Children’s Hospital MRI Technologist Receives Speak-up! Award

The Michigan Health & Hospital Association Keystone Center a Dragan Spremo at University of Michigan Health C.S. Mott Children’s Hospital with the quarterly MHA Keystone Center Speak-up! Award on Oct 23. The MHA Keystone Center …


Registration Open for Virtual DEI Certificate Program

Registration is open for the Diversity, Equity and Inclusion in Healthcare certificate program offered Dec. 7 and Dec. 8 from 11 a.m. to 3 p.m. ET. The event, hosted by the Michigan Health & Hospital …


HHS Submits Information Blocking Disincentives Proposed Rule

The U.S. Department of Health and Human Services (HHS) recently submitted a proposed rule outlining penalties providers would face if they do not appropriately share patient data as outlined in the 21st Century Cures Act. …


MDHHS Launches Opioid Settlement Spending Webpage

The Michigan Department of Health and Human Services (MDHHS) recently published a webpage to track the allocation of $800 million received for opioid settlement investments. MDHHS Chief Medical Executive Dr. Natasha Baghdasarian indicated the website …


MHA Launches New Governance Affinity Group

Hospitals and health systems face significant adversity, yet Michigan providers continue to provide high quality and accessible healthcare to their communities, in great part because of governing boards, executives and staff leadership. Board and committee …


MHA CEO Report — Registration is Representation

As we have discussed in these monthly reports in the past, I am incredibly proud that the MHA is committed to the health equity journey, which once again has been identified by the MHA Board of Trustees as …


The Keckley Report

Paul KeckleySix Majority Beliefs about the U.S. Health System Compromise its Value Proposition

“As news cycles go, this one was standard fare for healthcare: with the exception of business plan announcements by organizations or as elements of tragedies like Lewiston, Gaza or a pandemic, the business of the health system—how it operates is largely uncovered and often subject to misinformation or disinformation. …

In the next 3 weeks, attention will be on the federal budget: healthcare will be in the background unless temporarily an element of a mass tragedy. Each trade group will tout its accomplishments to regulators and pimp their advocacy punch list. Each company will gin-out news releases and commentary about the future of the system will default to think tanks and focused on a single issue of interest.

That’s the problem. In this era of social media, polarization, and mass transparency, these old ways of communicating no longer work. Left unattended, they undermine the value proposition on which the U.S. system is based.”

Paul Keckley, Oct. 30, 2023


News to Know

  • The MHA will host a virtual member from 2 to 3 p.m. on Nov. 9 to outline the MHA 2023 – 2024 strategic action plan approved by the MHA Board of Trustees.
  • The Centers for Medicare and Medicaid Services recently released an updated 2024 Medicare & You Handbook which provides information for patients regarding traditional Medicare, Medicare prescription drug plans, Medicare Advantage and more.

MHA CEO Report — Registration is Representation

“Thought
Of equality- as if it harm’d me,
giving others the same chances
and rights as myself-
as if it were not indispensable
to my own rights
that others possess the same.”
― Walt Whitman, Leaves of Grass

As we have discussed in these monthly reports in the past, I am incredibly proud that the MHA is committed to the health equity journey, which once again has been identified by the MHA Board of Trustees as one of our association’s strategic pillars for this program year. We have made progress, with much more work on the docket.

It is clear that to achieve health equity, there are multiple complex factors that must be addressed, and by now most of us in the healthcare field recognize how issues like food insecurity, transportation and housing all play a significant role. But there is another important consideration: the ability to participate in elections is one of the foundational elements of our American democracy, and just as our member hospitals are very engaged in removing barriers to healthcare access, Secure Automatic Voter Registration (AVR) removes a barrier for low-income Michiganders in the voter registration process.

In our health equity journey, we have learned that we can’t take certain things for granted. A small but illustrative example: when my physician prescribes for me an important medication that must be refrigerated, neither one of us has traditionally thought twice about it….but what if the patient in question can’t afford their utilities bill, or can’t afford a refrigerator to begin with? In the same manner, most of us don’t think twice about registering to vote, either by driving to the Secretary of State office or logging on to our computer. But what if we don’t have a car and can’t afford a computer or internet access?

At the end of the day, the MHA is an advocacy organization, so we know all too well that elections at both the state and federal levels have major consequences on healthcare funding, and a wide range of public policies that affect health insurance, pharmaceutical access and so much more. It is only logical that the very people who are directly impacted by these healthcare funding and policy decisions should have a voice in the process.

House Bill 4983 currently introduced in the Michigan Legislature would help expand representation in Michigan by using existing government data to register eligible voters. Referred to as Secure Automatic Voter Registration, those receiving Medicaid benefits would be automatically registered to vote, increasing the number of eligible voters by approximately 400,000 to 600,000. Medicaid was picked for several specific reasons. First, the agency already verifies citizenship, which is a requirement for voter registration. Only limited non-health data would be securely and electronically shared with election officials, who would use this information to either register nonregistered Michiganders or update existing registration. New or updated voters would receive a mailer providing an opportunity to decline the registration or correct the information.

Second, registering Medicaid enrollees would address election inequities. People of color, new U.S. citizens, young adults, people with disabilities and low-income individuals are disproportionately excluded from voting in the U.S. and overrepresented among Medicaid enrollees. We know Medicaid beneficiaries, in aggregate, tend to have additional challenges that impede their ability to register to vote, such as working multiple jobs, transportation access, available childcare and other needs.

Lastly, Medicaid provides a secure avenue to update voter registration rolls, as Medicaid offices routinely work with public health information and have experience securely sharing data. The agency routinely shares data securely with other agencies to determine access to additional benefits and with outside organizations that provide healthcare and other services. Such a system streamlines the voter registration process because the state already has the required information on file needed to register to vote. It also allows information to be updated more regularly, improving the accuracy of the voter rolls.

The MHA supports efforts to increase voter participation and we believe that Medicaid Automatic Voter Registration helps to achieve that goal while improving the efficiency of voter registration. The country still only has 69.1% of the voting-age population registered to vote and we can do better. We also see communities with higher voter turnout have better health outcomes, in part due to increased attention and resources from elected officials. In our quest to address inequities across the board, Medicaid AVR is a step in the right direction of improving access to resources within Michigan’s minority and underrepresented populations.

As always, I welcome your thoughts.

Latest AHA Trustee Insights Focuses on Equity for Women and Native Americans

The October edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), focuses on health equity for women and Native Americans.

Trustees should prioritize addressing the distinct needs of women for several reasons. Women represent over half the population, consume more healthcare resources on an individual basis compared to men and are responsible for over 80% of healthcare spending decisions.

According to the US Census Bureau, Michigan is one of 10 states with the largest population of Native Americans. Many Native Americans have incomes significantly below the national average and face challenges with reliable transportation, or lack transportation altogether, which hinders their access to healthcare.

The article highlights strategies for trustees to guide the hospital’s work in reducing healthcare disparities among women and Indigenous Americans. These approaches include advocating for implicit bias training, encouraging open discussions about inequities and creating opportunities to drive collaboration to improve health.

Members with questions about MHA trustee resources or webinars should contact Erin Steward at the MHA.

MHA Monday Report Oct. 16, 2023

MHA Monday Report

First Legislative Policy Panel Meeting New Program Year

The MHA Legislative Policy Panel met Oct. 11 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals. The meeting focused on state legislative updates for the new members of …


Auto No-Fault Hearings Continue, Interstate Compacts Advance

The Michigan Senate Finance, Insurance and Consumer Protection Committee continued to hear testimony during the week of Oct. 9 on Senate Bills 530 and 531. Introduced by Sen. Mary Cavanagh (D-Redford Township) and Sen. Sarah …


ANA-MI Opposes Mandated Nurse Staffing Ratio Legislation

The American Nurses Association – Michigan (ANA-Michigan) publicly announced their opposition Oct. 11 to Senate Bill 334 and House Bill 4550, which require state mandated ratios for hospital nurses. The ANA-MI joins the MHA and …


DEA Plans to Extend Telemedicine Rules for Controlled Substances Through 2024

The Drug Enforcement Administration (DEA) announced pandemic-era rules allowing controlled substances to be prescribed via telemedicine will be extended through Dec. 31, 2024. This extension follows significant opposition to the DEA’s plan to curtail these …


MHA Keystone Center 2022-2023 Annual Report Highlights Quality and Safety Priorities

The MHA Keystone Center recently released its 2022-2023 Annual Report, showcasing its dedication to advancing patient and workforce safety alongside member organizations. The report highlights the healthcare safety and quality improvements made through MHA Keystone Center-led …


MHA to Host Virtual DEI Certificate Program

Save the date for a Diversity, Equity and Inclusion in Healthcare certificate program scheduled for Dec. 7 and Dec. 8 from 11 a.m. to 3 p.m. EST. The event, hosted by the MHA and other …


MiCARE Project Discontinued

The Michigan Care Access Referral Exchange (MiCARE), hosted by Bamboo Health’s OpenBeds solution, will be discontinued effective Oct. 31, 2023. The goal of MiCARE was to create a comprehensive network of behavioral health treatment providers, …


MHA Podcast Covers Program Year Priorities: Behavioral Health, Workforce Restoration, Health Equity and More

The MHA released a new episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan discussing key issues that impact healthcare and the health of communities. The October 2023 episode, …


The Keckley Report

Paul KeckleyAs HLTH 2023 Convenes, Three Themes speak Volumes about Where U.S, Healthcare is Headed

“In Las Vegas this week, 10,000 healthcare entrepreneurs, investors, purchasers and industry onlookers are gathered to celebrate the business of U.S. healthcare. It follows the inaugural Nashville Healthcare Sessions last month that drew a crowd to Music City touting “the premier healthcare conference set in the most relevant, exciting, and welcoming city in the south.“ …

The root causes of the system’s poor performance are understood and considered: they’re daunting. But that does not impede the willingness of private investors to make bets presuming the future of the U.S. healthcare is not a repeat of its past.“

Paul Keckley, Oct. 9, 2023


MHA CEO Brian PetersMHA in the News

The MHA received media coverage the week of Oct. 9 on rural healthcare challenges and legislation proposing state mandated nurse-to-patient staffing ratios. The Detroit Free Press published an article Oct. 12 on the closure of …

MHA Monday Report Oct. 9, 2023

MHA Monday Report

capitol buildingHealthcare Legislative Activity Includes Hearings on Auto No-Fault

Healthcare legislative activity in the Michigan Legislature included hearings on auto no-fault and several other bills during the week of Oct. 2. The Senate Finance, Insurance and Consumer Protection Committee held their first hearing on Senate Bills (SBs) 530 and …


Michigan Reconnect logoMichigan Reconnect Scholarship Eligibility Expands

The temporary expansion of the Michigan Reconnect program to individuals between the ages of 21 and 24 occurred the week of Oct. 2. Funding passed in the fiscal year 2024 state budget allowed for the program to temporarily expand eligibility …


BSC Implements New Electronic Document Sharing Program: Egress

The Bureau of Survey and Certification (BSC) serves as the state survey agency for the Centers for Medicare & Medicaid Services, conducting federal certifications and investigating specific complaints at Michigan healthcare facilities. During surveys, BSC …


The Keckley Report

Paul KeckleyFor Healthcare, the Debt Limit and Possible Shutdown Further a Shift away from its Status Quo

“What’s clear is that every sector in healthcare will be subject to scrutiny through an uncomfortable lens—the consumer. Prices matter. Service matters. Integrity matters. Transparency matters. Ownership matters. Purpose matters. And whether accurate or not, fair or not, comfortable or not, information accessible to consumers is readily accessible.

The shutdown over the debt limit might happen or be diverted. What will not be diverted is growing discontent with the medical system that the majority of consumers believe wasteful, expensive and self-serving. How the status quo is impacted is anyone’s guess, but it’s a good bet its future is not a cut-and-paste version of its past. …”

Paul Keckley, Oct. 2, 2023


News to Know

New MHA associate member VativoRx has been a leader in the rebate management space for over eight years, specializing in providing innovative drug rebate management solutions and uncovering new revenue sources for medications administered within healthcare facilities.


MHA CEO Brian Peters speaks with the Michigan Business Network.

MHA in the News

The MHA received media coverage the week of Oct. 2 regarding auto no-fault legislation introduced in the Michigan Legislature and nurse staffing ratio legislation. The coverage is based on interviews conducted with MHA CEO Brian …