Combating the Novel Coronavirus (COVID-19): Week of April 5

MHA Covid-19 update

MHA COVID-19 UpdateMichigan hospitals are quickly reaching inpatient capacity as coronavirus variants spread throughout the state and contribute to a severe surge in COVID-19. The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Chief Medical Officers Urge Michiganders to Help Prevent COVID-19 Spread

The MHA released a media statement April 9 on behalf of Michigan’s hospital/health system chief medical officers urging people to protect those who cannot be vaccinated by taking the responsible, proven preventive measures. The statement provides context on the increased transmission and risks of the virus and associated complications for children.

In addition, Gov. Gretchen Whitmer held a news conference April 9, which also featured Tina Freese Decker, Spectrum Health president and CEO and MHA board chair-elect, outlining Michigan’s COVID-19 caseload and the need to stop the spread of the virus. The governor is urging federal agencies to redirect resources, including a large influx of vaccine, to Michigan as soon as possible. Her administration has indicated it is focused on getting more vaccine supply to providers/mass vaccination clinics where it can be administered most quickly to stop viral spread.

The Protect Michigan Commission is also planning regional press events, some of which will include hospital/health system participants, to promote the need for everyone eligible to get vaccinated as soon as possible. The MHA will keep members apprised and share any messaging or materials that hospitals can use on their own platforms to amplify the message.

Questions on COVID-19 vaccines should be directed to Ruthanne Sudderth at the MHA.

Testing and Vaccination Key to Curtailing Viral Spread

The Michigan Department of Health and Human Services (MDHHS) is offering free, on-site rapid COVID-19 testing in partnership with Michigan's intermediate school districts, local school districts and local health departments for residents returning from spring break travel. These fully staffed events are open to students, educators, district staff and community members, and will be scheduled prior to classes restarting. The current list of locations is available on the MDHHS website. Members with questions on testing sites should contact Laura Appel at the MHA.

As part of a virtual session with MHA staff April 5, U.S. Rep. Elissa Slotkin (D-Holly) outlined two strategies hospitals can follow to help address vaccine hesitancy in their communities. She encourages hospitals and health systems to use every patient interaction as an opportunity to discuss the COVID-19 vaccine, regardless of the reason for the visit. In addition, she suggested facilities provide vaccine educational opportunities in the form of webinars, town halls and other events that feature physicians and can reach vaccine-hesitant groups.

As the vaccine becomes more widely available, hospitals are encouraged to revisit offers to vaccinate employees who declined vaccines when first made available to them. Some may have wanted to wait for a single dose vaccine or a more convenient time, were reluctant to get the vaccine while pregnant, or faced other circumstances that may have since changed. In addition, as the state receives media requests, it is expected to begin sharing data on healthcare personnel vaccination rates. To ensure healthcare organizations are accurately represented in any data sharing that occurs, members are urged to confirm their employee vaccine data is up to date in the state’s EMResource portal.

MDHHS Reinstates 14-Day Quarantine, Reminds Providers to Use Michigan EUA Fact Sheets

Due to increasing case rates and variant spread in Michigan, the MDHHS is reinstating a 14-day quarantine for anyone who experiences close contact with a COVID-19-positive person, removing the option for a 10-day quarantine. The department’s COVID-19 public health frequently asked questions document has been updated to reflect the change.

The department also reminds vaccinators that they need to provide the Michigan versions of the emergency use authorization (EUA) fact sheets available on the MDHHS website. Each fact sheet has been updated and includes information on the Michigan Care Improvement Registry.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).

Federal Final Rule Requires Health Insurers to Make Prices Transparent

The U.S. Departments of Health and Human Services, Treasury and Labor recently released a price transparency final rule affecting health insurers. A similar rule requires hospitals to post price information beginning Jan. 1, and a Nov. 10 webinar has been scheduled to assist members with compliance. Both price transparency rules stem from a recent executive order from President Donald Trump.

The final rule for health insurers:

  • Requires most health insurers to provide personalized out-of-pocket cost information and the underlying negotiated rates for all covered healthcare items and services, including prescription drugs, through an internet-based, self-service tool and in paper form upon request. Information will be required to be available for an initial list of 500 shoppable services as determined by the departments for plan years beginning on or after Jan. 1, 2023, with the information required for all items and services beginning Jan. 1, 2024.
  • Requires most health insurers to make available to the public three separate machine-readable files that include pricing information for plan years beginning on or after Jan. 1, 2022. Plans are required to display these data files in a standardized format and provide monthly updates. The files include:
    • Negotiated rates for all covered items and services between the plan and in-network providers.
    • Historical payments to and billed charges from out-of-network providers, with a minimum of 20 entries required to protect consumer privacy.
    • In-network negotiated rates and historical net prices for all covered prescription drugs by plan at the pharmacy location level.
  • Modifies the medical loss ratio (MLR) rules, allowing plans to receive credit in their MLR calculations for savings shared with enrollees that result from the enrollees shopping for and receiving care from lower cost, higher-value providers.

Members with questions should contact Vickie Kunz at the MHA.

Medicare Advantage Enrollment Continues to Rise

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1,015,000 in October, an increase of 12,000 beneficiaries since July. The October MA enrollment is spread across 43 MA plans that are currently operating in the state, with approximately 44 percent of Michigan's 2.3 million Medicare beneficiaries covered by an MA plan. Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 24 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on October enrollment. In addition to the 43 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Kellen Teel at the MHA.