MHA Monday Report Feb. 13, 2023

MHA Monday Report

MHA Board of Trustees Reviews State and Federal Advocacy Options to Further Strategic Priorities

The MHA Board of Trustees began its Feb. 8 meeting with a federal advocacy briefing from federal lobbyist Carlos Jackson with Cornerstone Government Affairs. Jackson highlighted the policy and funding threats and opportunities healthcare providers …

capitol buildingFiscal Year 2024 Executive Budget Recommendation Released

Gov. Whitmer released her executive budget recommendation Feb. 8 for fiscal year 2024. The proposed budget fully protects traditional hospital line items for Medicaid and the Healthy Michigan program, continues targeted rate increases from recent budget cycles and includes …

MHA and Rural Members Advocate on Capitol Hill

The MHA and rural hospital leaders visited Capitol Hill in Washington D.C. Feb. 7-9 to advocate for specific rural healthcare policies as part of the National Rural Health Association’s Rural Health Policy Institute event. …

Registration Available for MHA Keystone Center Safe Patient Handling Conference

Registration is now open for the MHA Keystone Center Safe Patient Handling Conference. The all-day event will take place April 13 at the Ann Arbor Marriott Ypsilanti at Eagle Crest. In partnership with the MHA Keystone Center, …

January MA Enrollment Increases by 33,000 Beneficiaries

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.25 million in January, an increase of 33,000 beneficiaries since October. The January enrollment is spread across 48 MA plans that are currently operating in the state, …

The Keckley Report

Paul KeckleyWave Two Value-Based Care: The Five Market Shifts that Will Reset the Payment Environment for Providers

“Wave One of the Value Based Care environment was marginally effective: CMS’ alternative payment models showed promise but savings to Medicare fell short of expectations per MedPAC. Medicare Advantage enrollment grew but plan sponsors were overpaid by Medicare. Hospital avoidable readmissions and complications efforts have been successful but the pandemic economy decapitated hospital resources necessary to compete in the value-based environment. Wave One is a mixed bag. …

The Wave Two Value Agenda in U.S. healthcare will impact every player and be messy. The backdrop of the 2024 Campaign cycle and post-pandemic economy mean impetus will shift from resource-constrained Medicare to the private sector as both offer significant but distinct opportunities for lower spending. And the revolution of generative AI assures shortcomings of the system—diagnostic error, administrative waste, fraud—will be widely exposed. …”

Paul Keckley, Feb. 6, 2023

News to Know – Feb. 13, 2023

  • Prospective payment system hospitals are reminded that any requests for corrections to the January public use file data being used by the Centers for Medicare and Medicaid Services to develop the fiscal year 2024 Medicare wage index must be received, along with supporting documentation, by the Medicare Administrative Contractor by Feb. 15, 2023.
  • The MHA is offering its popular Healthcare Leadership Academy program on March 13-15 and May 15-16.
  • MHA Endorsed Business Partner Demand Workforce/Qodex will host a free 30-minute webinar on Mission Impossible: Let’s Talk About How to Heal Your Staffing Crisis at noon ET Feb. 22 to discuss healthcare trends in staffing including creative approaches to deliberately using your nursing workforce.

MHA in the NewsMHA CEO Brian Peters

The MHA received media coverage the week of Feb. 6 regarding a variety of topics, including the fiscal year 2024 executive budget recommendation, the role food insecurity has as a social determinant of health, the new state House Behavioral …

MHA Board of Trustees Reviews State and Federal Advocacy Options to Further Strategic Priorities

The MHA Board of Trustees began its Feb. 8 meeting with a federal advocacy briefing from federal lobbyist Carlos Jackson with Cornerstone Government Affairs. Jackson highlighted the policy and funding threats and opportunities healthcare providers face under the new divided Congress and Biden administration, including possible provider cuts to address deficit reduction, programs affected by the expiration of the federal public health emergency declaration and ongoing pharmaceutical industry challenges to 340B drug pricing policies.

The board also examined several state advocacy initiatives to further the board’s strategic priorities focusing on financial viability, workforce wellbeing and restoration and the furtherance of efforts aimed at improving health equity and behavioral healthcare. The board supported pursing additional state funding for workforce security and pediatric psychiatric care, as well as an effort to maximize federal Medicaid matching funds. The board also directed the MHA to work with the MHA Health Equity Taskforce and the MHA Safety and Quality Committee to address health disparities through the development of tools for the transparent reporting of health equity performance measures.

In addition to advocacy efforts aimed at state and federal policymakers, the board continued to support the association’s ongoing partnerships with hospitals throughout the state to “tell our story” publicly about the challenges and opportunities healthcare organizations face and how hospitals can work together to advance the health of individuals and communities.

The board also received a report from the MHA Service Corporation, which included a spotlight of Endorsed Business Partner Merritt Hawkins, as well as a discussion of staff succession in light of the upcoming retirement of longtime Chief Operating Officer Peter Schonfeld at the MHA.

The board concluded with regional hospital council reports and an update from MHA CEO Brian Peters.

For more information about actions of the MHA Board of Trustees, contact Amy Barkholz at the MHA.

MHA Board of Trustees Advances Strategic Action Plan, Affirms Policy Panel Legislative Recommendations

The MHA Board of Trustees began their Nov. 2 meeting with a review of key communication strategies to assist hospitals and health systems to “tell their stories” about the unprecedented financial and workforce challenges they currently face and how they are adapting to meet the critical healthcare and economic development needs of their communities. The board had previously identified financial viability and workforce restoration and wellbeing, along with behavioral health and health equity, as the four key pillars in its annual strategic action plan. The board also affirmed recommendations by the MHA Legislative Policy Panel regarding Certificate of Need and potential measures to improve access to care and patient experience, and potential legislative options to assist hospitals with challenges associated with placing patients in post-acute care settings.

Guest presenter, Bryan Sexton, director, Duke University Center for Healthcare Safety and Quality, provided an update on the success and effectiveness of his ground-breaking work with the MHA Keystone Center on the “Well-B” project to improve caregiver well-being and mitigate burnout through a series of cost free, one-hour sessions accessed at the participant’s convenience through their mobile phone. Nearly 5,000 registrants have participated in the no-cost sessions, which qualify for continuing medical education credits, and the results have been proven using evidence-based methodologies to reduce stress and improve feelings of gratitude and well-being. A new series of sessions will be available starting in January and previous sessions continue to be accessible to Michigan-based healthcare workers at no cost.

The board concluded with regional hospital council reports and an update from MHA CEO Brian Peters.

For more information about actions of the MHA Board of Trustees, contact Amy Barkholz at the MHA.

Recording Available for MHA Strategic Action Plan Review

The MHA hosted a virtual forum Oct. 18 reviewing the Strategic Action Plan that was approved by the MHA Board of Trustees in August. The forum discussed pressing challenges and opportunities facing healthcare, including workforce development and wellbeing, health equity, behavioral health and financial stability. The forum also discussed the tactics to accomplish these goals and how the membership can support these initiatives. The forum was recorded and is available to members.

Members with questions should contact Erica Leyko at the MHA.

Michigan Hospitals Invested $4.2 Billion in Community Programming Mid-pandemic to Improve Health, Well-being of Residents

New report outlines hospital community health efforts in FY 2020

The Michigan Health & Hospital Association (MHA) released today the Healthy Futures, Healthy Communities report that demonstrates a nearly $4.2 billion investment in community-based partnerships and programming in fiscal year (FY) 2020. Overall, hospitals invested more than $869 million in community and voluntary-based activities, from education and prevention services to community outreach, research and workforce development.

Data in the report shows investments made throughout the first year of the COVID-19 pandemic, demonstrating Michigan’s hospitals and health systems continued offering a wide range of services and resources to their communities inside and outside of the traditional healthcare setting that improved the overall health, wellness and quality of life of residents.

“Even through some of the most challenging times in healthcare, hospitals and health systems haven’t wavered in their commitment to helping improve the overall health and wellness of the communities they serve,” said MHA CEO Brian Peters. “This report gives a clear and simple message: The impact of our healthcare workforce reaches far beyond the walls of patient rooms.”

In addition to community benefit services and programs, the report also highlights the contributions of hospitals when it comes to uncompensated care. In FY 2020, the unpaid costs of patient care at Michigan hospitals totaled more than $3.4 billion, which includes both financial assistance and bad debt at cost, as well as Medicaid and Medicare payment shortfalls, other means-tested government programs and subsidized health services.

“The programs​ and services that ​hospitals and health systems provide ​have ​a long-term and positive impact on community health,” said T. Anthony Denton, J.D., MHSA, senior vice president and chief operating officer of University of Michigan Hospitals, Health Centers and Medical Group and 2022-2023 Chair of the MHA Board of Trustees. “Patients and communities bec​ame more intertwined ​than ever as ​healthcare teams worked to provide care, compassion, financial and in-kind resources and knowledge throughout the COVID-19 pandemic and continue to do so. Our role as anchor institutions ​is and has always been vital, providing an important uplift to those in need by way of various contributions which demonstrate our value as a major community asset. Through our many efforts, we are privileged to build bridges and connect communities to inform, elevate and empower individuals and families to mitigate social determinants and advance health, inspire hope and foster meaningful presence.”

Included in the report are examples of programs implemented by hospitals throughout Michigan that expand access to care and improve the health of vulnerable populations within their communities.

“McLaren, as a large health system, serves large urban settings and smaller rural communities, and the critical charge of being a community-integrated provider is having a sound, community-based system of care in place,” said Dr. Justin Klamerus, McLaren Health Care chief medical officer. “Increasingly, health care is moving toward care that existed outside of the hospital, both in treatment and preventive practices. It’s part of our responsibility to attune ourselves to the needs of our communities, especially in critical access areas, and doubly so during a time when many may still be hesitant to seek care in a hospital setting. Our facilities in Bay, Caro and the Thumb Region are true in the commitment to their communities and are really working to meet their needs.”

The full report and stories from hospitals across the state that exhibiting community benefit can be accessed online here.

Board of Trustees Meets at MHA Capitol Advocacy Center

The MHA Board of Trustees met at the MHA’s downtown Lansing offices April 13 and were joined by Michigan House of Representatives Appropriations Committee Chair Thomas Albert (R-Lowell). Albert provided an update on the progress of the fiscal year 2023 state budget, which includes funding for the state’s Medicaid and other health-related programs, indicating he expected the budgets to progress in a timely manner and be presented to the governor by the statutory July 1 deadline. The board also heard from State Attorney General Dana Nessel via a recorded video in which she described how the state would be allocating a $776 million legal settlement from opioid drug manufacturers. Nessel indicated the funds would be divided evenly between the state and local county and municipal units of government. The board called on members to share best practices to help hospitals reach out to their local community health departments and seek collaborative ways to use the funds most effectively.

The board also engaged in a strategic discussion on workforce sustainability and behavioral health funding and delivery, noting that both are key priorities in the association’s multiyear action plan. A discussion surrounding the recent Tennessee case involving a criminal conviction of a nurse reinforced the board’s priorities surrounding building a culture of safety and supporting the ongoing work of the MHA Keystone Center. Other action included approval of an amendment to the MHA bylaws to extend Type 2-B membership to Michigan-based ambulatory care organizations. The amendment will also go to the MHA House of Delegates for approval at the association’s annual meeting in June. Finally, the board approved the recommendations of the Task Force on Dues and Governance to provide a 2% annual dues increase over the next three years based on a value-driven performance assessment and approved Type 3 association memberships for Enviah, PC; Joint Venture Hospital Laboratories, LLC; and Lilly USA. For more information, contact Amy Barkholz at the MHA.

MHA Board Meeting Focused on Workforce, Other Healthcare Challenges

At its Feb. 9 meeting, the MHA Board of Trustees had robust conversations about key priorities for healthcare and the MHA. Among them were the MHA’s role as healthcare and public policy continue to evolve; workforce development and shortages (including $300 million appropriated by the Michigan Legislature; see related article); auto no-fault insurance; staffing agency challenges; COVID-19 data trends; Medicaid payment and policy; and much more. The MHA will use much of the board’s discussion to address strategic priorities this program year and beyond.

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

Member Forum to Examine MHA Strategic Action Plan

The MHA will host a virtual member forum from 2 to 3 p.m. Feb. 24 to outline the MHA 2021-2022 program year’s strategic action plan, which the MHA Board of Trustees approved in August. The forum will review the priorities set for the year, progress to date, and the tactics the association will use to accomplish goals during the remainder of the program year. In addition, it will discuss ways members can support those initiatives.

The forum will also review the pillars of the strategic action plan, the ramifications of COVID-19, state advocacy priorities and initiatives, the commitment to address racism and health inequities, and tools to assist members in that commitment.

The forum is offered free of charge, but members are asked to register by Feb. 21. Members with questions should contact Erica Leyko at the MHA.

Register Now for Member Forum Reviewing MHA Strategic Action Plan

An MHA virtual member forum will outline the association’s 2021-2022 strategic action plan approved by the MHA Board of Trustees in August. The forum will be held from 10 to 11 a.m. Oct. 15 to review the plan’s priorities, potential tactics to accomplish them and how members can support the initiatives. MHA CEO Brian Peters will review the pillars of the strategic action plan, and other key MHA leaders will provide an update on state advocacy priorities and initiatives.

The forum is free of charge, but members are asked to register by Oct. 13. Questions may be directed to Erica Leyko at the MHA.

MHA Hospital Priorities Fully Funded in Legislative Budget Proposals

capitol building

The state House of Representatives and Senate advanced budget proposals May 13 for both the current year and the upcoming fiscal year that fully fund hospital priorities, including new MHA Board of Trustees’ priorities from its April meeting.

During that meeting, board members discussed several possible funding items that could be used to address the ongoing and worsening behavioral health crisis in Michigan and its significant impact on hospitals and patients. The board directed the MHA to focus on funding to address these issues and work toward better patient care. The House budget proposal approved May 13 includes $125 million to add pediatric psychiatric patient beds at hospitals, improve care of behavioral health patients in the emergency department and add additional settings of care for behavioral health cases.

In addition, the House and Senate included a separate MHA priority of $160 million in COVID-19 relief funding for hospitals as they continue to respond to the pandemic. The payments are allocated proportionate to statewide Medicaid inpatient volume over the previous 12 months and will assist hospitals in maintaining the resources they need to improve the health of Michigan citizens.

The Michigan House and Senate also advanced their respective budget proposals for state fiscal year 2022, beginning Oct. 1, 2021. Both the House and Senate proposals protect key hospital priorities, including full funding for:

  • 21% increase in hospital Medicaid outpatient rates that took effect Oct. 1, 2020.
  • Critical access hospital-specific Medicaid outpatient rate increase that took effect Jan. 1, 2020.
  • Graduate medical education.
  • Disproportionate share hospital payments.
  • Healthy Michigan Plan.
  • Rural access pool.
  • Obstetrical stabilization fund.

On the legislative side, a proposal from the House includes new provisions that would streamline the prior authorization process for Medicaid managed care and reduce the timeframes for prior authorization approvals. In addition, language was added in the House proposal that would prohibit the use of any Michigan Department of Health and Human Services funds for vaccinations under a mandatory vaccination program. The MHA is concerned that this provision could hinder state vaccination efforts and will work closely with legislators to understand the impact of this language and address potential issues.

The proposals are now likely to be negotiated between the House and Senate before advancing to the governor’s desk for approval or veto. The negotiations are likely to last several more weeks. Members with questions may contact Adam Carlson at the MHA.