MDHHS Withdraws PIHP Procurement

The Michigan Department of Health and Human Services (MDHHS) has withdrawn its request for proposals (RFP) to competitively procure Prepaid Inpatient Health Plans (PIHPs), ending the planned rebid process.

The decision follows a Jan. 8 ruling that found key elements of the RFP conflicted with provisions of the Michigan Mental Health Code. The court determined that the RFP, as drafted, restricted the ability of Community Mental Health Services Programs to carry out certain statutorily required functions, including entering financial contracts necessary to support managed care responsibilities.

While the court did not issue an injunction directing the state to withdraw the RFP, it identified multiple legal conflicts and left it to MDHHS to determine how to proceed. MDHHS has now opted to rescind the RFP rather than revise or reissue it.

With the withdrawal of the RFP, the existing PIHP structure will remain in place. It is unclear whether MDHHS will pursue a revised procurement approach or other policy changes moving forward.

Members with questions may contact Lauren LaPine-Ray at the MHA.

MHA Reinforces Evidence-Based Vaccination Guidelines

The MHA is strengthening its commitment to evidence-based immunization practices under the guidance of the MHA Healthcare and Public Health Integration Council and chief medical and nursing leaders. Efforts include distributing educational resources, reaffirming alignment with Michigan Department of Health and Human Services recommendations and releasing a public statement.

Gary Roth, DO, MBA, FACOS, FCCM, FACS, chief medical officer, MHA issued a media statement Feb. 4 endorsing the American Academy of Pediatrics immunization schedule. This comes amid concerns that some local health departments have issued guidance that deviates from established standards.

With families receiving vaccine information from various sources, confusion may occur. Healthcare providers continue to serve as trusted voices by offering clear, science-based guidance. Adherence to established immunization schedules remains essential to protecting public health and preventing vaccine-preventable diseases.

Members with questions regarding vaccinations may contact Kelsey Ostergren at the MHA.

New MHA Infographic Provides Overview of RHTP Program in Michigan

The MHA recently released a new infographic that provides an overview of the Rural Health Transformation Program (RHTP) in Michigan. This infographic highlights the scope of the program, Michigan’s rural health landscape and the $173 million awarded to the Michigan Department of Health and Human Services (MDHHS) to support rural health initiatives across the state.  

The infographic also provides demographic and access-related data to help contextualize the need for targeted rural health investment, including information on rural population distribution, Medicaid coverage, distance to care, workforce shortages and the reliance of rural communities on local hospitals as critical access points. 

Timely updates, resources and additional information about the program are available on the MHA RHTP webpage. Members with questions may contact the MHA policy team. 

Michigan Rural Health Transformation Program Application Diminishes Potential Impact

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

We are disappointed the Michigan Rural Health Transformation Program application submitted by the Michigan Department of Health and Human Services does not include explicit support for Michigan’s 73 rural hospitals.

The application lists four initiatives, none of which include recommendations from Michigan’s rural hospital leaders, who know rural healthcare needs best. Michigan hospitals are set to lose more than $6 billion over the next 10 years due to the federal H.R. 1 Reconciliation Bill. It’s unfortunate Michigan’s application ignored this impact and the intent of Congress to assist rural hospitals most impacted by these federal changes through this program.

This application provided an opportunity to maximize the healthcare impact for rural communities by providing the resources needed by rural Michigan’s leading healthcare providers. While the four initiatives are well intended, the application as submitted fails to maintain access to care in the most meaningful way.

Virtual Media Roundtable Focuses on Medicaid Funding Cut Consequences

MHA CEO Brian Peters speaks during a virtual media roundtable about Medicaid.
MHA CEO Brian Peters speaks during a virtual media roundtable about Medicaid.
MHA CEO Brian Peters speaks April 3 during a virtual media roundtable about Medicaid funding cuts.

A virtual media roundtable hosted April 3 by the Michigan League for Public Policy included MHA CEO Brian Peters as a panelist, where he discussed the consequences for potential Medicaid funding cuts by Congress.

Crain’s Detroit Business, CBS Detroit and MIRS published stories as a result of the roundtable.

“When Medicaid funding reductions force hospitals to curtail services or in fact eliminate entire service lines or in fact close hospitals … the services are no longer available to Medicaid recipients, but they’re no longer available to anyone in the community, either,” said Peters. “The cuts that are being contemplated in Washington, D.C. right now, if those were to be implemented, they would cost jobs. And more importantly, I can tell you, they would cost lives,”

Monique Stanton from the Michigan League for Public Policy.
Monique Stanton from the Michigan League for Public Policy.

Joining Peters during the roundtable were:

  • Monique Stanton, President & CEO, Michigan League for Public Policy
  • Russ Kolski, Interim Executive Director, Ingham Community Health Center
  • Susan Harding, Executive Director, Oakland Livingston Human Services Agency
  • Jenny Wagemann, Manager, Allen Farmers Market and Breadbasket Food Pantry

On a separate note, MLive also published a story April 3 that references the MHA’s healthcare workforce data and the 44% reduction in nursing vacancies in Michigan hospitals from 2023 to 2024. The story shares news on a nursing student loan repayment program announced by the Michigan Department of Health and Human Services. The Detroit Free Press also published an article on the program, citing the MHA’s Economic Impact of Healthcare Report.

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

Peters Appears on The Common Bridge Podcast

MHA CEO Brian Peters

MHA CEO Brian Peters joined The Common Bridge podcast for an episode published Aug. 18 to discuss various healthcare policy topics, particularly those impacting rural Michigan. Areas of focus include the Affordable Care Act, the impact of Medicaid provider taxes, clinical scope of practice, telemedicine, hospital-at-home programs, Medicare Advantage and the 340B drug pricing program.

The episode is hosted by Richard Helppie, founder of The Common Bridge. Episodes from the show focus on non-partisan policy discussions. The episode is available through Apple Podcasts and YouTube.

Peters is also quoted in a press release published Aug. 22 by the Michigan Department of Health and Human Services on the record number of Michigan hospitals who applied for the Maternal Levels of Care verification through The Joint Commission.

“We applaud each of the hospitals and their birthing teams for the time and effort they spent over recent weeks to complete the application process,” Peters. “This work signifies the dedication Michigan birthing hospitals have toward providing high quality and safe care to Michigan mothers and babies.”

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

 

MHA CEO Report — A Program Year in Review

MHA Rounds graphic of Brian Peters

“Winning is not a sometime thing, it is an all the time thing. You don’t do things right once in a while…you do them right all the time.”  — Vince Lombardi

MHA Rounds image of Brian PetersI am pleased to share we just completed a successful MHA Annual Meeting, continuing a long-standing June tradition whereby we celebrate the conclusion of one MHA program year, and prepare for the next. Each program year is unique with the different challenges it presents. At this point five years ago, no one could have predicted how the emergence of COVID-19 would flip healthcare on its head and drastically alter the tactical objectives of our association. However, there is a constant: the MHA continues to rise to any challenge presented to us and we deliver results for our membership to improve the health and wellness of individuals and communities.

The 2023-2024 program year focused intensely on workforce, viability and behavioral health, while addressing the various “wildcard” issues that always come up. We were led with great wisdom and compassion by Shannon Striebich, president and CEO, Trinity Health Michigan, as our board chair. Due to Shannon’s commitment and leadership, the MHA accomplished numerous highly successful and impactful outcomes on behalf of our members.

One of the most significant challenges in this past year was the threat posed by government-mandated nurse staffing ratio legislation. This proposed policy had the potential to dramatically reduce access to care for individuals throughout the state. Our advocacy on the issue lasted throughout the entire year but was highlighted by an Advocacy Day we hosted in September that featured more than 150 hospital representatives, primarily consisting of nurse leaders, who came to the Capitol and conducted 118 meetings with lawmakers that day. Later in the year, the MHA successfully advocated our position at a committee hearing, where more than 60 supporters attended on very short notice to push back on false narratives and to support alternative nurse staffing solutions. As a result of our efforts, no committee votes have been scheduled, and momentum on this harmful legislation has been effectively stalled.

While we had to play defense against this harmful proposed legislation, the MHA spent the program year actively engaged in workforce development and efforts to grow the healthcare talent pipeline. The MHA worked with stakeholders to implement new funding designed to expand access to Bachelor of Science in Nursing degrees through partnerships between community colleges and four-year universities, while also engaged in partnerships with other organizations to promote healthcare careers, increase clinical faculty and nurse preceptors, address high turnover rates in rural areas and promote healthcare career options. We continued our award-winning healthcare career marketing campaign designed to attract future workers and also redeployed our annual hospital workforce survey that shows the efforts of Michigan hospitals to recruit, retain and train healthcare workers is making a real difference. Finally, we hired our first-ever chief nursing officer at the MHA, which is already strengthening our ties to the nursing community throughout the state.

The viability of hospitals was another key focus and was largely supported through our legislative advocacy work. MHA funding priorities continued to be protected in the state budget, which includes $163 million for graduate medical education, $45 million for traditional disproportionate share hospitals, $15 million through the rural access pool and an additional $8 million for the obstetrical stabilization fund. The fiscal year 2024 budget also included $60 million annually to support hospitals with Level I and II trauma centers and $34 million annually to support hospitals that provide inpatient psychiatric care. Besides state funding, the MHA protected Medicaid funding, medical liability, the 340B drug pricing program and certificate of need.

The MHA is also intricately involved in in addressing the behavioral health crisis plaguing our state and country. Expanding access to care is a key focus, which included the MHA administrating a $50 million grant program to expand access to pediatric inpatient behavioral health services. The Michigan Department of Health and Human Services (MDHHS) is a close partner in this work and the MHA participated in the MDHHS Advisory Committee on the creation of a psychiatric bed registry. The MHA launched a new member ED boarding survey to quantify the number of patients struggling with behavioral health access in the emergency department and the MHA is using this data when engaging with lawmakers, stakeholders and the public to explain the scope of the program. These learnings informed the creation of a four-bill package of legislation to address board-identified issues in the behavioral and mental health system, such as coverage parity and community mental health shortcomings.

Much of the work in the past year has focused on maternal and infant health and improving maternal health and birth outcomes. And I am pleased to share that our MHA Board of Trustees just approved the full slate of recommendations emanating from the MHA Community Access to Health Task Force, giving us the support to continue this important journey together.

And as usual, we effectively dealt with a long list of “wildcard” issues that emerged during the program year, including drug shortages, guardianship, infection control, patient transport, population growth and safety and quality. We also continued to strengthen our efforts related to the growing cybersecurity threat. Indeed, the Change Healthcare cyberattack was one of the largest and most impactful attacks ever seen and served as a clear reminder of the importance of our work in this space.

At our Annual Meeting, I spoke to our attendees about “the power of zero.” In the 2023-2024 program year, the following were true:

  • The number of Michigan acute care community hospitals and health systems that are not members of our association is zero. We have everyone at the table, which allows us to speak with one powerful, united voice.
  • We passed 39 MHA-supported bills through the state legislature that were enacted into law, with five more on their way to the governor for her signature. The number of MHA-opposed bills that made their way to the finish line was zero.
  • The MHA now has a full-time chief medical officer and a full-time chief nursing officer (as noted above). How many other state hospital associations can say this? Zero.
  • And most importantly, how many other associations – in any sector – are as relevant, as impactful, as mission-driven and successful as the MHA? I believe that number is zero.

I would like to recognize and thank our outstanding MHA Board of Trustees, our members, sponsors and business partners, but most of all, our incredible MHA staff for coming together to achieve such tremendous results for the patients and communities we collectively serve. I hope you will take the opportunity to celebrate these results with us.

As always, I welcome your thoughts.