Laura Appel - MHA | Michigan Health & Hospital Association

MHA Monday Report March 27, 2023

March 27, 2023March 24, 2023 Monday Report

MHA-supported Bills See Action Before Break

The Michigan House of Representatives acted on a pair of MHA-supported bills during the week of March 20. In the House Health Policy Committee, members voted to report legislation to strengthen Michigan’s Healthy Michigan statute. …

MHA Celebrates ACA Anniversary with Congresswoman Slotkin

MHA Executive Vice President Laura Appel joined U.S. Rep. Elissa Slotkin and other healthcare advocates March 23 as part of a virtual press conference organized by Protect Our Care to celebrate the 13th anniversary of …

MHA, Industry Leaders Gather at Trinity Health to Discuss Food Insecurity

As individuals and families across the state and country continue to face food insecurity, Michigan’s hospitals, health systems and community leaders are engaged in creating collaborative solutions. MHA CEO Brian Peters joined fellow food security …

Expanding Advocacy Roots with the Next Generation

The MHA collaborated with Wayne State University for the first-ever student-led advocacy day March 22. Science Policy Network-Detroit is a student organization at Wayne State that aims to advocate for science-related issues in …

March 30 Webinar Outlines Considerations for the End of the Public Health Emergency

The Department of Health and Human Services COVID-19 public health emergency expires May 11, 2023, which may significantly decrease the flexibility providers have become accustomed to. The MHA will host The End of the …

Medicaid Eligibility Redetermination Webinar Recording Available

The Michigan Medicaid program has grown to nearly 3.2 million Michiganders, an increase of more than 700,000 when compared to pre-pandemic levels, due to federal statutory limitations on states’ abilities to remove people from the …

MHA Webinar Explores PACE Program Partnerships

With the closure of nursing homes and long-term care facilities, hospitals and health systems need options to care for seniors. Dually eligible frail seniors are one of the most complex cohorts with multiple co-morbidities, frequent …

Applications Open for Excellence in Governance Fellowship, Prepares Trustees to Lead

The MHA Excellence in Governance Fellowship is now available to healthcare board members looking for innovative, effective ways to lead their organizations as hospitals and health systems navigate financial strain and labor challenges. Applications are …

The Keckley Report

Affordable Care Act 2.0: New Trends and Issues, New Urgency

“Thursday marks the 13th anniversary of the signing of the Affordable Care Act– perhaps the most consequential healthcare legislation since LBJ’s passage of the Medicare Act in 1965. Except in healthcare circles, it will probably go unnoticed. …

Complicating matters, the political environment today is more complicated than in 2010 when the ACA became law. The economic environment is more challenging: the pandemic, inflation and economic downturn have taken their toll. Intramural tensions in key sectors have spiked as each fights for control and autonomy i.e. primary care vs. specialty medicine, investor-owned vs. not-for-profit hospitals, retail medicine & virtual vs. office-based services, carve-outs, direct contracting et al . Consolidation has widened capabilities and resources distancing big organizations from others. Today’s media attention to healthcare is more sophisticated. Employers are more frustrated. And the public’s confidence in the health system is at an all-time low. …“

Paul Keckley, March 19, 2023

News to Know

Registration is now open for the MHA Keystone Center Safe Patient Handling Conference.
The MHA is issuing a request for proposal for a $50 million competitive grant program for Michigan healthcare entities to expand access to pediatric inpatient behavioral health services.
The MHA Health Foundation will host a four-part webinar series MHA Board Governance Education that outlines the trends affecting current and future strategic plans, techniques for effectively communicating with stakeholders on key issues and ways to build trust, drive engagement and develop relationships.
The MHA will host an in-person Human Resources Member Forumat the MHA Headquarters in Okemos from 8:30 a.m. to noon April 26, with a virtual option available as well.
The Root Cause Coalition is accepting requests for proposals to present at the 8th Annual National Summit on the Social Determinants of Health Dec. 3-5 in Kansas City.

MHA Celebrates ACA Anniversary with Congresswoman Slotkin

March 23, 2023March 23, 2023 Issues in Healthcare, Top Issues - Healthcare

Laura Appel speaks during a press conference on the 13th anniversary of the Affordable Care Act.

Appel emphasized the MHA’s long-standing support of the ACA and Michigan’s Medicaid expansion through the Healthy Michigan Plan, which provided millions of Americans with health insurance, provided access to care for millions of residents with preexisting conditions and saved billions of healthcare dollars. More than one million Healthy Michigan Plan beneficiaries are currently covered by Michigan’s Medicaid expansion program allowed by the ACA and more than 320,000 Michiganders receive coverage through the Health Insurance Marketplace created by the ACA. Appel also referenced the $10 billion reduction in Medicare payments that Michigan hospitals committed to experience in order to ensure state residents have access to expanded health insurance coverage under the ACA.

Additional speakers during the press conference included Laura Bonnell, CEO of the Bonnell Foundation, and Sarah Stark, a Type 1 diabetic who benefitted from the original ACA expansion.

Media representatives from The Detroit News, WWJ Newsradio 950, WOOD TV8 and WLNS-TV joined the press conference.

A press release was published following the conclusion of the press conference by Protect Our Care and a recording of the press conference is available on the Protect Our Care Michigan Facebook page.

MHA Monday Report March 20, 2023

March 20, 2023March 17, 2023 Monday Report

State Medicaid Office Addresses Legislative Policy Panel

The MHA Legislative Policy Panel convened March 15 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals. The meeting was highlighted by a presentation on Medicaid redetermination from Brian …

MHA Provides Testimony Supporting State Psychiatric Care and Healthy Michigan Plan

During the week of March 13, the MHA provided testimony to both the Michigan House Appropriations Subcommittee on Health and Human Services and the House Health Policy Committee. Laura Appel, executive vice president of Government …

RFP Available for Pediatric Inpatient Behavioral Health Grant

The MHA is issuing a request for proposal for a $50 million competitive grant program for Michigan healthcare entities to expand access to pediatric inpatient behavioral health services. The funding was appropriated by the …

MHA Keystone Center PSO Annual Meeting May 3

The healthcare workforce is at higher risk of harm due to violence than other professional fields. Recent increases in workplace violence represent a major barrier to both staff and patient safety, prompting the need for …

Registration Open for MHA Human Resources Member Forum

The MHA will host an in-person Human Resources Member Forum at the MHA headquarters in Okemos from 8:30 a.m. to noon April 26, with a virtual option available as well. The forum is structured as …

Changes to Medicaid Dental Coverage Effective April 1

The Michigan Department of Health and Human Services will implement a new service delivery model for adult dental benefits effective April 1, 2023. The following groups will be eligible: Medicaid beneficiaries ages 21 years and …

Changes to Telemedicine Policy Post-COVID-19 Public Health Emergency

The Michigan Department of Health and Human Services will rescind certain COVID-19 telemedicine flexibilities beginning May 12, 2023, with the conclusion of the federal health public health emergency. Policy MMP 23-10 outlines flexibilities that …

Michigan Dispensing Law Changes

Michigan state law will be updated beginning March 29, 2023, to allow pharmacists to dispense a non-controlled prescription written by a prescriber licensed in another state or province of Canada. Public Act 80 of 2022 …

Latest AHA Trustee Insights Covers Board Development and Behavioral Health

One of the strongest predictors of health system performance is the quality of governance that shapes its response in an unstable environment. The March edition of Trustee Insights, the monthly digital package from the American …

The Keckley Report

The Biden Budget: Key Signals to Voters and an Important Implications for the Health Industry

“Last Thursday, the Biden administration released its proposed FY24 federal budget which is certain to spark political posturing by partisans on all sides and long-term speculation by political pundits and economists. At a high level, it includes… …

In total, healthcare spending represents 30% of the total outflow of federal funds in this budget compared to 29% in ’22 (Medicare 12%, Veteran’s Health 2% and Other Line Items 15%)—almost 50% more than Social Security and more than 100% above defense spending. …”

Paul Keckley, March 12, 2023

News to Know

The MHA will host The End of the COVID-19 Public Health Emergency (PHE) and Preparing for the New Regulatory Environment webinar from 4 to 5 p.m. March 30.
Registration is now open for the MHA Keystone Center Safe Patient Handling Conference.

MHA in the News

The MHA received media coverage the week of March 13 regarding conversations around workforce funding and current challenges amid the third anniversary of the COVID-19 pandemic.

MHA Provides Testimony Supporting State Psychiatric Care and Healthy Michigan Plan

March 17, 2023March 17, 2023 Member News

During the week of March 13, the MHA provided testimony to both the Michigan House Appropriations Subcommittee on Health and Human Services and the House Health Policy Committee.

Laura Appel, executive vice president of Government Relations and Policy and Lauren LaPine, senior director of Legislative and Public Policy at the MHA provided testimony Mar. 15 to the House Appropriations Subcommittee.

Laura Appel, executive vice president of Government Relations and Policy at the MHA, provided testimony Mar. 15 to the House Appropriations Subcommittee on Health and Human Services. Appel provided an overview of the impact healthcare workforce challenges are having on state psychiatric care and the need for additional support.

“We share the frustration of families, caregivers and our colleagues at the Michigan Department of Health & Human Services when state psychiatric beds go offline,” said Appel. “We appreciate the Governor’s proposed investments and understand there are many needs in our state – I hope the subcommittee will consider an investment in healthcare for our most vulnerable residents among the highest priorities.”

Adam Carlson, senior vice president of Advocacy at the MHA provided testimony Mar. 16 to the House Health Policy Committee.

Adam Carlson, senior vice president of Advocacy at the MHA, provided testimony Mar. 16 to the House Health Policy Committee in support of House Bill (HB) 4224, introduced by Rep. Julie Rogers (D-Kalamazoo). HB 4224 would repeal the Medicaid work requirement law that was passed in 2018. That legislation would require Michigan’s Medicaid beneficiaries to report employment or evidence of their search for work in order to maintain coverage.

“Ensuring coverage and access for our lower-income community members improves the health and wellness of our state, while having a positive effect on securing and maintaining employment,” said Carlson.

Members with questions about workforce funding or other state legislative action may contact Adam Carlson at the MHA.

Supplemental Signed into Law, MHA Provides Additional Testimony

March 10, 2023March 10, 2023 Member News

Laura Appel, executive vice president of Government Relations and Policy. MHA, provided testimony to the Senate’s Health Policy Committee.

Governor Gretchen Whitmer signed a supplemental appropriation bill on March 8 that includes $75 million for hospital recruitment, retention and training of healthcare workers. The funding was included as a part of House Bill (HB) 4016, now Public Act 5 of 2023.

Laura Appel, executive vice president of Government Relations and Policy at the MHA, provided testimony to the Senate’s Health Policy Committee. Appel provided a general overview of the role hospitals play in the healthcare continuum, the continuing post-pandemic patient transfer issues and potential solutions to address these challenges and the workforce crisis.

“The cost of maintaining standby trauma resources is millions of dollars for each level I and II trauma designated hospital location and those costs are incurred regardless of the number of patients that need those services every day,” said Appel.

Lastly, a new bill introduced in the Michigan House of Representatives would make improvements to Michigan’s Healthy Michigan statute. HB 4224, introduced by Rep. Julie Rogers (D-Kalamazoo), would remove Michigan’s Medicaid work requirements. The work requirement is currently disallowed by the courts. The MHA supports HB 4224 and expects additional legislation to make improvements to the Healthy Michigan statute in the coming weeks.

Members with questions about workforce funding or other state legislative action may contact Adam Carlson at the MHA.

MHA Monday Report Feb. 6, 2023

February 6, 2023February 3, 2023 Monday Report

MHA Testifies During First House Health Policy Committee Hearing

The first hearing of the new legislative session for the House Health Policy Committee was held Feb. 2. Led by Chair Julie Rogers (D-Kalamazoo), new committee members heard testimony from advocacy organizations about the state of public health in Michigan. …

Implicit Bias Trainings Available to Meet LARA Requirement

The Department of Licensing and Regulatory Affairs revised Public Health Code – General Rules to allow asynchronous teleconferences or webinars as acceptable modality of training as part of the implicit bias training standards for all professions licensed or registered under …

MHA Ludwig Community Benefit Award Accepting Nominations

Hospitals taking part in local efforts to enrich the overall welfare of their communities are encouraged to nominate those programs for the 2023 MHA Ludwig Community Benefit Award. First presented in 1990, the annual award honors MHA-member healthcare …

MHA Annual Meeting Sponsorship Opportunities Available

Just as hospitals and health systems have changed their strategies to adapt to the new environment, MHA education programming and sponsorships have changed to deliver more value. The MHA team are designing in-person events tied to the priorities of the …

MHA CEO Report — Medical Liability and Denney Damages

In last month’s CEO Report, we focused on the new political environment in Lansing, with a host of first-time lawmakers taking office, Democrats assuming majority control of both chambers of the legislature and a host of …

The Keckley Report

The Big Tech Advantage in U.S. Healthcare

“This week, 100 of the Fortune 500 will report earnings for 2022 and heightened attention will be on four tech giants–Apple Inc., (AAPL); Amazon (AMZN) Meta Platforms Inc.(META) and Alphabet Inc.(GOOG). Comparatively, reports this week by Pfizer, Merck and Eli Lilly will get industry attention but news about these technology-giants will extend to a much wider audience. Why? …

2023 will be pivotal to U.S. healthcare’s future: it’s the transition year from pandemic adaptation buoyed by emergency-relief funds and opportunistic private equity plays in capital-starved sectors to a normalcy that’s unprecedented. … “

Paul Keckley, Jan. 30, 2023

MHA in The News

The MHA received media coverage the week of Jan. 30 regarding the 340B drug pricing program and the lack of child psychiatrists in northern Michigan. Crain’s Detroit Business published an op-ed Feb. 1 from MHA CEO Brian Peters on …

MHA Testifies During First House Health Policy Committee Hearing

February 3, 2023February 3, 2023 Member News

MHA EVP Laura Appel testified during the first House Health Policy Committee hearing of 2023.

Laura Appel, executive vice president of government relations and public policy, MHA, joined the committee to provide testimony on the intersection between hospitals and health system and Michigan’s public health system. Her presentation focused on the role hospitals played over the first years of the COVID-19 pandemic and the ongoing need for partnership on vaccination, addressing health inequity and improved emergency preparedness. The MHA submitted written testimony in addition to the in-person presentation to the committee.

“Lack of funding in core public health programs slowed the response to the COVID-19 pandemic and exacerbated its impact, particularly in low-income communities, communities of color and for older Americans – populations that experience higher rates of chronic disease and have fewer resources to recover from an emergency,” said Appel.

The testimony at this hearing was informational only and the committee did not discuss specific legislation. The MHA will continue to work closely with committee members to support and strengthen public health in Michigan.

Members with questions can contact Sean Sorenson at the MHA for more information.

Media Recap: 340B & Child Psychiatry Access

February 3, 2023 Issues in Healthcare, MHA In The News, Top Issues - Healthcare

The MHA received media coverage the week of Jan. 30 regarding the 340B drug pricing program and the lack of child psychiatrists in northern Michigan.

Crain’s Detroit Business published an op-ed Feb. 1 from MHA CEO Brian Peters on how the 340B drug pricing program benefits hospitals. The placement of the op-ed follows recent criticism of the program in the media on how the program generates savings for hospitals and health systems.

“Michigan has some of the best state-level 340B protections in our country that prioritize access to care for vulnerable patients,” said Peters. “The program is funded through drug company discounts and not taxpayer dollars. Reducing the availability of 340B simply means even higher profits for drug companies. As the Michigan Legislature begins a new session, it is important to remember that for three decades, the 340B drug pricing program has received bipartisan support and helped hospitals from Detroit to the Upper Peninsula.”

In a separate story, Laura Appel, executive vice president of government relations and public policy, MHA, appeared in a story that looks at the shortage of child psychiatrists in rural and northern Michigan and the challenges it presents to children and families accessing care. The story originally written by Capital News Service was picked up by publications such as the Midland Daily News, Cadillac News, Ludington Daily News and City Pulse.

Members with any questions regarding media requests should contact John Karasinski at the MHA.

Omnibus Spending Bill Includes Major Health Policy Measures

December 21, 2022January 5, 2023 Member News

After the MHA’s recent visits to Capitol Hill to advocate for year-end member priorities, Congress has reached a major deal on a year-end omnibus legislative package. The package includes health policy measures related to Medicare and Medicaid provisions, telehealth and hospital-at-home programs.

Lawmakers are blocking the implementation of the Statutory Pay-As-You-Go (PAYGO) sequester which would have required a 4% cut to Medicare payments. In addition, both the Medicare Dependent Hospital and enhanced low-volume adjustment programs are extended for two years. The Medicare hospital-at-home program and pandemic-era telehealth flexibilities are also extended for two years. There is a one-year delay in lab payment changes stemming from the Protecting Access to Medicare Act of 2014.

Regarding Medicaid, the package separates the enhanced federal medical assistance percentage (FMAP) and the Medicaid eligibility maintenance of effort from the declaration of the Public Health Emergency. Beginning in April, states may remove those who no longer qualify for Medicaid, regardless of when the COVID-19 public health emergency ends. The enhanced FMAP, currently a 6.2% addition to state Medicaid matching rates, is gradually phased out through 2023. These changes help fund a year of continuous coverage provisions for children at risk of losing health insurance and standardizing 12 months of postpartum coverage.

Passage of the final legislation is likely to happen by midnight on Dec. 23, 2022. The bill text is public, giving high likelihood to the healthcare provisions outlined above. However, there is a possibility for last-minute changes.

For more information about the year-end omnibus legislation contact Laura Appel at the MHA.

Appel Discusses REHs with WOOD TV8

December 15, 2022December 16, 2022 MHA In The News

MHA EVP Laura Appel speaks with WOOD TV8.

WOOD TV8 published a story Dec. 12 on the passage of Senate Bill (SB) 183, which includes language allowing rural emergency hospital (REH) licensure in Michigan. The bill passed Dec. 6 with overwhelming support in both the State House and Senate following collaboration between the MHA, the Michigan Department of Health and Human Services, the Michigan Department of Licensing and Regulatory Affairs and the Whitmer administration on making the necessary changes in state statute to allow for the new federal designation.

Laura Appel, executive vice president of government relations and public policy, MHA, spoke with WOOD TV8 on the bill and the challenges rural hospitals face which led to the creation of the federal REH designation. Appel discussed the high fixed costs associated with maintaining inpatient services and the financial reimbursement benefits offered to REHs.

“If your population goes down, your fixed costs don’t go down, but Medicare is going to continue to help you with those,” said Appel. “Regardless of where you are, if you’re a hospital in financial stress or if you’re a hospital that doesn’t want to become financially stressed … you have all of those things working in your favor.”

The MHA also received mentions in stories published Dec. 15, including one from Michigan Radio on the surge of respiratory illnesses being treated by Michigan’s pediatric hospitals and from Bridge on the increase of flu-related hospitalizations in the state.

Members with any questions regarding media requests should contact John Karasinski at the MHA.