MHA Monday Report Nov. 7, 2022

MHA Monday Report

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 …


Logo for MI Vote Matters, Tuesday Nov. 8Healthcare Community Urged to Vote in Nov. 8 General Election

The MHA encourages its staff, members and other stakeholders in the healthcare community to vote in the state’s general election Nov. 8.- Polls will be open from 7 a.m. to 8 p.m. …


Parents Urged to Take Preventive Measures as Pediatric Beds Fill Up

Michigan children’s hospitals and pediatric healthcare leaders are raising awareness about a pediatric hospital bed shortage and urging the public to help prevent respiratory illnesses, which are rapidly spreading in the form of respiratory syncytial virus (RSV) and influenza …


CMS Releases Final Rule to Update OPPS

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service (FFS) outpatient prospective payment system (OPPS) effective Jan. 1, 2023 …


Provider Enrollment Requirements Reinstated Effective Dec. 1, 2022

The Michigan Department of Health and Human Services (MDHHS) issued MMP 22-38 COVID-19 Response: Termination of Bulletin MSA 20-28, which reinstates provider enrollment requirements …


CMS Releases Final to Update Medicare PPS Effective 2023

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service home health (HH) prospective payment system (PPS) effective Jan. 1, 2023 …


MHA Supports Increased Access to Affordable Post-Secondary Education

The MHA, along with stakeholders across diverse fields, supported record state investment in Michigan’s future workforce. On October 11th, the Governor signed Public Act 212 of 2022 establishing the Michigan Achievement Scholarship, and applications starting with students in the high school class of 2023 will now be eligible for increased state financial aid …


CE Credits Available for Unionization and Legal Guidelines Webinar

The webinar Dispelling Misinformation About Unionization and Legal Guidelines 8:30 – 10 a.m. ET Nov. 11 has been approved by HR Certification Institute® (HRCI®) for 1.5 hours …


MHA Rounds Report - Brian Peters, MHA CEOMHA CEO Report — Your Vote Matters

At the MHA, we often say that politics is not a spectator sport. It requires continual engagement and relationship building so that when you are in a crisis and need assistance, you have trusted friends you can turn to …


The Keckley ReportPaul Keckley

The Three Blind Spots in Hospital Strategic Plans

“For 40 years, I have facilitated Board Retreats for hospitals, health systems, insurance plans and medical groups. At no time has the level of uncertainty about the future for hospitals been as intense nor the importance of a forward-looking strategic vision and planning been as necessary as now. The issues are complicated: lag indicators about demand, clinical innovations, reimbursement, costs et al are a foreboding backdrop for these discussions. And three issues have surfaced as blind spots in the environmental assessments and deliberations preceding the plan …”

Paul Keckley, Oct 31, 2022


Michigan Harvest GatheringsNews to Know

Many Michigan hospitals are underway with their Michigan Harvest Gathering campaign which runs through Nov. 18. Online donations by hospital employees and community members to the Michigan Harvest Gathering program can be made through the Food Bank Council of Michigan’s website …


MHA in the News

The MHA received media coverage on the surge of RSV cases across Michigan’s pediatric hospitals during the week of Oct. 31. The coverage included several comments provided to news outlets and the distribution of a press release Nov. 4 to statewide media …

CMS Releases Final to Update Medicare PPS Effective 2023

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service home health (HH) prospective payment system (PPS) effective Jan. 1, 2023. Key provisions include:

  • A net 1.0% decrease in the national 30-day standardized payment amount from $2,031.64 to $2,010.69 after budget neutrality adjustments, compared to the proposed 6.25% decrease. HHs that fail to comply with HH quality reporting program requirements are subject to a two percentage point reduction and are subject to a rate of $1,972.02.
  • A seven percentage point cut to all payments to achieve budget-neutrality for the Patient-Driven Groupings Model phased in over two years, with a 3.5 percentage point cut in 2023 and 2024.
  • A permanent 5% cap on wage index decreases.
  • Required submission of patient assessment data on all patients, regardless of payer, with a phased approach beginning Jan. 1, 2025, instead of 2024 as proposed.
  • Changes to the Expanded HH value-based purchasing model, including definitions for the baseline and model year and changing the baseline year for the 2023 program year to 2022 to use the most recently available data.

The MHA will provide members with an updated impact analysis and additional details of the final rule within the next few weeks. Members that have not received impact analyses in the past for affiliated, free-standing HH agencies are encouraged to provide the agency’s CMS certification number (also known as Medicare provider number), agency name and federal information processing standards code in order to receive an estimated impact analysis in the future.

Members with questions should contact Vickie Kunz at the MHA.

MHA Monday Report Aug. 15, 2022

MHA Monday Report

Primary Election Sets Field for November
MI Vote Matters


CMS Releases FY 2023 Final Rule to Update Hospital IPPS


CMS Releases FY 2023 Inpatient Psychiatric Facility Final Rule


Final Rule to Update Inpatient Rehabilitation Facilities Payment for FY 2023


CMS Releases FY 2023 Final Rule to Update Long-term Care Hospital PPS


Survey Published for Opioid Use Disorder Contacts


Hospitals Encouraged to Review Medicare Advantage Enrollment Plans


Address Healthcare Employee Retention with Data ToolsSalary.com


Paul KeckleyThe Keckley Report

Solving Healthcare Workforce Shortages Requires Taking Self-care More Seriously

“The Labor Department reported that the U.S. added 528,000 jobs in July including 69,600 in healthcare. The unemployment rate fell to 3.5%, June job openings were down to 10.7 million from 11.3 million in May and government officials announced that the economy has now recouped the 22 million jobs lost in the pandemic.

But the more sobering news is that inflation has negated the workforce’ 5.1% wage gain in the last year and 1 in 5 workers is looking for employment elsewhere for higher pay and better benefits. And it’s even worse in the healthcare delivery workforce—the hospitals, long-term care facilities, clinics and ancillary service providers where 12 million work. During the COVID-19 pandemic, hospital employee turnover increased to 19.5%–five times higher than the general workforce. And today, 45% of physicians report burnout—double the rate pre-pandemic.”

Paul Keckley, August 8, 2022


News to Know


MHA in the News

MHA CEO Brian Peters

CMS Releases FY 2023 Final Rule to Update Long-term Care Hospital PPS

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service (FFS) long-term care hospital (LTCH) prospective payment system (PPS) for fiscal year (FY) 2023, which begins Oct. 1, 2022. The rule will:

  • Increase the standard federal rate by a net 3.8% for cases that meet LTCH criteria for services provided by LTCHs in compliance with CMS quality program reporting requirements.
  • Continue paying cases that fail to meet the required LTCH criteria (diagnosis-related group (DRG), intensive care unit, or ventilator criteria) at the site-neutral rate under the dual-rate payment system implemented in FY 2016.
  • Establish a high-cost outlier (HCO) threshold of $38,518 for cases paid based on the LTCH standard rate, up 17% from the current $33,015 threshold, resulting in fewer cases qualifying for an outlier payment. The CMS adjusts this threshold annually to maintain outlier payments at the targeted 8% of aggregate LTCH payments. Cases paid at the site neutral rate are subject to the inpatient PPS HCO, finalized at $38,859 for FY 2023.
  • Set a permanent cap to limit annual wage index decreases at 5%.
  • Calculate Medicare Severity-Long Term Care-DRG relative weights using an averaging approach, with COVID-19 cases included and excluded and then averaging the two sets of relative weights.
  • Set a permanent cap on annual decreases at 10% for MS-LTC-DRG relative weights to mitigate negative impacts of significant weight decreases.

The MHA is continuing to review the final rule and will provide hospitals with an updated impact analysis in the near future. Members with questions should contact Vickie Kunz at the MHA.

Proposed Rule Released for Inpatient Psychiatric Facilities

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule to update the Medicare fee-for-service prospective payment system (PPS) for inpatient psychiatric facilities (IPFs) for fiscal year (FY) 2022 which begins Oct. 1, 2021.

The IPF proposed rule would:

  • Provide a net 2.2 % increase to the federal per diem base rate, increasing it from $815.22 to $833.50, while also increasing the payment for electroconvulsive therapy treatment from $350.97 to $358.84. IPFs that fail to comply with CMS quality reporting program requirements are subject to a 2 percentage point reduction to the federal rates.
  • Result in a slight decrease to the labor-related share from 77.3% to 77.1%.
  • Decrease the cost outlier threshold by 4% from the current $14,630 to $14,030, which should result in slightly more cases qualifying for an outlier payment.
  • Update the IPF PPS teaching policy for IPF hospital closures and displaced residents, making it consistent with changes included in the FY 2021 inpatient PPS final rule.
  • Modify the IPF quality reporting program by:
    • Adopting voluntary patient-level data reporting for data submitted for payment determination for FY 2023 and mandatory patient-level data reporting for payment determination for FY 2024 and future years.
    • Adopting the COVID-19 Healthcare Personnel Vaccination measure for the FY 2023 payment determination and subsequent years.
    • Adopting the Follow-up After Psychiatric Hospitalization (FAPH) measure for the FY 2024 payment determination and subsequent years.
    • Removing four measures starting with FY 2024 payment determinations:
      • Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention Provided (SUB-2/2a).
      • Tobacco Use Brief Intervention Provided or Offered and Tobacco Use Brief Intervention Provided (TOB-2/2a).
      • Timely Transmission of Transition Record (Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care).
      • Follow-up After Hospitalization for Mental Illness (FUH).

Within the proposed rule is a Request for Information (RFI) seeking input on closing the health equity gap in the CMS quality programs. The agency seeks to base reporting of health disparities on social risk factors and race and ethnicity so it is more comprehensive and actionable for facilities, providers and patients. The CMS will use the feedback to inform a future, comprehensive RFI focused on closing the health equity gap in the CMS programs and policies.

The CMS will accept comments on the proposed rule until June 7. The MHA will provide IPFs with an estimated impact analysis and summary of the proposed rule within the next month. Members with questions should contact Vickie Kunz at the MHA.