MHA Monday Report Feb. 19, 2024

MHA Monday Report

Workforce and Innovation Addressed by MHASC Board and HR Council

The MHA Service Corporation (MHASC) board focused its Feb. 7 meeting on supporting the MHA Strategic Action Plan priorities to address workforce support and innovation, viability, behavioral health improvement, health equity and more. The board …


Registration Open for 2024 Communications Retreat

Registration is open for the 2024 MHA Communications Retreat scheduled Tuesday, May 7 from 8:30 a.m. to 4 p.m. at the Henry Center for Executive Development in Lansing. The daylong event is geared toward the …


Online Learning Modules Created to Support Health Equity Programming

The MHA Keystone Center recently published an online learning module series to support hospitals and health systems in establishing and maintaining a health equity program compliant with new requirements from The Joint Commission and …


New CPT Codes for RSV Vaccine Administration

The Centers for Medicare & Medicaid Services added two new Current Procedural Terminology (CPT) codes for administration of monoclonal antibodies (Nirsevimab) for respiratory syncytial virus (RSV), for dates of service on and after Oct. …


Act Fast: Register for 2024 MHA HR Conference

Registration is open for the 2024 MHA Human Resources Conference, scheduled for March 5, 2024 at the ACH Hotel Marriott University Area, Lansing. Attending the conference provides human resource (HR) professionals with an opportunity …


Latest AHA Trustee Insights Highlights AI Controversies and Philanthropic Strategy

The February edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), includes articles on artificial intelligence (AI) and philanthropy. There is no question that artificial intelligence will fundamentally transform healthcare. It …


The Keckley Report

Two Lawsuits. Two Issues. One Clear Message.Paul Keckley

“Last Monday, two lawsuits were filed that strike at a fundamental challenge facing the U.S. health system …

The issue is this: is a health system’s liable when its consolidation activities result in higher prices for services provided communities and employers in communities where they operate? Is there a direct causal relationship between a system’s consolidation activities and their prices, and how should alleged harm be measured and remedied? …

Healthcare organizations and their trade groups can no longer defend against lack of transparency by defaulting to the complexity of our supply chains and payment systems. They’re excuses. The realities of generative AI and interoperability assure information driven healthcare that’s publicly accessible and inclusive of prices, costs, outcomes and business practices. In the process, the public’s interest will heighten and lawsuits will increase. …”

Paul Keckley, Feb. 12, 2024


News to Know

  • MHA offices will be closed and no formal meetings will be scheduled Feb. 19 in honor of President’s Day.
  • The MHA is offering its popular Healthcare Leadership Academy program March 13-15 and May 1-2.
  • The AHA’s Institute for Diversity and Health Equity recently launched their 2024 Diversity, Equity and Inclusion Survey.

New CPT Codes for RSV Vaccine Administration

The Centers for Medicare & Medicaid Services (CMS) added two new Current Procedural Terminology (CPT) codes for administration of monoclonal antibodies (Nirsevimab) for respiratory syncytial virus (RSV), for dates of service on and after Oct. 6, 2023.

  • 96380 – This provider administers a monoclonal antibody product to protect the patient against respiratory syncytial virus. This is a seasonal dose injected into muscle. A physician or other qualified healthcare professional also provides counseling related to the administration.
  • 96381 – This provider administers a monoclonal antibody product to protect the patient against respiratory syncytial virus. This is a seasonal dose injected into muscle.

More information can be found on the CMS or AMA websites. Members with questions may contact Kelsey Ostergren at the MHA.

MHA Monday Report Jan. 8, 2024

MHA Monday Report

MHA Partners with AAPL for CME Courses

The MHA is pleased to partner with the American Association for Physician Leadership (AAPL) to provide a series of in-person Continuing Medical Education (CME) courses in 2024 at the MHA headquarters at 2112 University Park Drive, Okemos, MI …


The Joint Commission Revises Definition of Suicide in Sentinel Event Policy

The Joint Commission has updated the definition of suicide in its Sentinel Event Policy to include time frames with the highest risk for suicide and highlight the healthcare organization’s continued responsibility for ongoing assessment …


MDHHS Expands Medicaid Coverage to Include CHW Services and Releases Beginner Guide

The Michigan Department of Health and Human Services (MDHHS) recently announced an expansion of Medicaid coverage effective Jan. 1, 2024 to include community health worker (CHW) services. The MDHHS also issued a final policy establishing this coverage for Medicaid …


Nominations Open for Hometown Health Heroes Award

The MHA is pleased to sponsor Michigan Public Health Week, scheduled for April 10, 2024, with the theme of “Protecting, Connecting and Thriving: We Are All Public Health.” MHA members are encouraged to submit nominations …


MHA CEO Report — Vaccinations & Respiratory Illness Season

The last four years have generated tremendous awareness about vaccines, but also a large public health challenge as disinformation has exploded and anti-vaccine sentiment has emerged from the fringes to become widely embraced. This likely isn’t news to any of you, but the …


The Keckley Report

Paul KeckleyAn Open Letter to Hospital Boards of Directors: Long-Term Strategic Planning needs Your Attention

As 2023 comes to an end and prognostics for 2024 pepper Inboxes, high anxiety is understandable. The near-term environment for hospitals, especially public hospitals and not-for-profit health systems, is tepid at best: despite the November uptick in operating margins to 2% (Fitch, Syntellis), the future for hospitals is uncertain and it’s due to more than payer reimbursement, labor costs and regulatory changes. …

Hospitals are not alone in dealing with money-driven pressures that seem out of sync with lofty aims like ‘student athletes’ and ‘community benefits.’ That’s why hospitals must embrace long-term strategic planning with an outside-in frame of reference now.”

Paul Keckley, Jan. 1, 2024


MHA in the News

The MHA received media coverage over the holidays during the weeks of Dec. 18, Dec. 25 and Dec. 31. Topics covered include the healthcare workforce, the MHA Keystone Center, air ambulance services and a review …

MHA CEO Report — Vaccinations & Respiratory Illness Season

“An ounce of practice is worth more than tons of preaching.” Mahatma Gandhi

MHA CEO Brian Peters MHA Rounds graphicThe last four years have generated tremendous awareness about vaccines, but also a large public health challenge as disinformation has exploded and anti-vaccine sentiment has emerged from the fringes to become widely embraced. This likely isn’t news to any of you, but the issue is once again top of mind because this time of year is respiratory illness season, whether it be the flu, RSV and now COVID. Thankfully, we have vaccines available to blunt the severe impacts of these illnesses, but it falls on both healthcare providers and public health professionals to appropriately communicate the benefits of vaccines to our patients and the public.

The recent reports from the Centers for Disease Control and Prevention (CDC) are concerning, as they are warning providers about the low vaccination rates for each of these diseases. Flu vaccination rates are down across all age groups compared to last year, while COVID vaccine uptake is the same as last year at just 17% of adults; similarly, only 17% of adults 60 years of age and older have received an RSV vaccine.

Due to these low vaccine rates, the CDC reported Dec. 14 that over the past four weeks, hospitalizations across the country increased 200% for the flu, 51% for COVID and 60% for RSV. In Michigan, we need look no further than last year to see how a surge of RSV illness can dramatically challenge the statewide capacity of our children’s hospitals. We know more can be done and it isn’t too late for people to receive their vaccines that are proven to reduce the risk of severe illness and hospitalization.

The MHA has a long history of support for vaccinations, as we continue to work with the Alliance for Immunizations in Michigan, the Parent Information Network, I Vaccinate and others to measure, educate and promote appropriate vaccinations for all Michigan residents. I Vaccinate specifically has been a terrific statewide public awareness campaign to connect with parents on the value of making sure you keep your children up to date on their vaccinations as they grow up. The bottom line is that the safety and efficacy of numerous vaccines has been supported and documented by not only the CDC, but the World Health Organization, and many other academic and clinical organizations.

We also know healthcare personnel play a key role in limiting the spread of illness during these months. For some time, we have collaborated with the Michigan Department of Health and Human Services to encourage vaccination policies for healthcare personnel against preventable diseases, such as the flu and pertussis.

Healthcare personnel are also important messengers when it comes to vaccines. We highly encourage all patients with questions about vaccines to contact their healthcare provider. These are important decisions and healthcare providers are uniquely qualified to provide accurate information about the benefits and any potential risks associated with any treatment. They also do so with care and respect for their patients. The MHA provides additional vaccine resources to healthcare leaders on our MHA vaccinations webpage.

Since the pandemic, the MHA has engaged in numerous ways on healthcare supply chain issues. On that note, another key challenge has been the available supply of Beyfortus, the monoclonal antibody for infants to prevent severe RSV illness. The MHA has been actively collaborating with stakeholders to navigate these supply concerns, as well as to provide reimbursement clarity. The good news is we have plenty of patients wishing to have their infants immunized, but due to manufacturing and distribution issues, there simply is not enough supply for all these young children. Thankfully the Biden administration recently announced 230,000 additional doses of RSV immunizations for infants will be available this month.

Realistically, we know we won’t change declining vaccination trends overnight, in a society that is as polarized as ever. Yet, I’m hopeful that over time we will be able to turn the tides, much as healthcare providers have for over a hundred years in using this valuable tool to eradicate harmful illnesses. It all starts with individual conversations from trusted messengers, but at the end of the day, we need to practice what we preach.

As always, I welcome your thoughts.

MHA Monday Report Dec. 18, 2023

MHA Monday Report

MDHHS Expands Medicaid Coverage to Include CHW Services

The Michigan Department of Health and Human Services (MDHHS) recently announced an expansion of Medicaid coverage effective Jan. 1, 2024 to include community health worker (CHW) services. The MDHHS also issued a final policy establishing …


Hospital-based Substance Use Disorder Consultation Reimbursement Coverage

Physicians and other qualified practitioners will be reimbursed for substance use disorder (SUD) consultations in the inpatient hospital or emergency department setting effective Jan. 1, 2024. These services include assessment, evaluation, diagnosis and treatment of individuals during …


Coverage of Office-based Substance Use Treatment Services

Primary healthcare providers will be reimbursed for substance use disorder (SUD) treatments that are provided in an office-based primary care setting effective Jan. 1, 2024. This applies to providers who do not have a specialty SUD benefit services contract with a Prepaid .…


Guide and Action Plan Created to Support Health Equity Programming

As strides are made to address inequities and disparities in healthcare, governing and regulatory bodies including The Joint Commission and the Centers for Medicare & Medicaid Services have created guidelines, benchmarks and policies that evolve over time. The MHA Keystone …


Enrollment Deadline Friday for MHA Governance Affinity Group

The deadline to enroll a trustee in the new MHA Governance Affinity Group is Friday, Dec. 22. The benefits of a well-run meeting go beyond parliamentary procedure. Proper communication and facilitation skills needed to make decisions about strategic issues drive performance and .…


Hospital Vaccine Resources Available

The MHA is at the forefront of advocating for vaccination awareness and education, particularly focusing on the challenges associated with the Beyfortus (nirsevimab) monoclonal antibody for infants entering their first respiratory syncytial virus season. The association is …


Latest AHA Trustee Insights Outlines the Board’s Role in Patient Experience

The December edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), includes an article on the board’s role in patient experience. The average hospital has turned over 105% of its workforce in the last five years and national …


The Keckley Report

Paul KeckleyThe Affordable Care Act is Back on Stage: What to Expect

“In the last 2 weeks, the Affordable Care Act (ACA) has been inserted itself in Campaign 2024 by Republican aspirants for the White House …

It’s no surprise. Health costs and affordability rank behind the economy as top issues for Republican voters per the latest Kaiser Tracking Poll. And distaste with the status quo is widespread and bipartisan: per the Keckley Poll (October 2023), 70% of Americans including majorities in both parties and age-cohorts under 65 think “the system is fundamentally flawed and needs major change.” To GOP voters, the ACA is to blame. …

The ACA is back on the radar in U.S. healthcare. Stay tuned.”

Paul Keckley, Dec. 10, 2023


News to Know

  • Clarence RuckerClarence Rucker, manager, patient safety and quality, MHA Keystone Center, is featured in COLOR Magazine’s 40 Under 40 Powerlist.
  • Due to the holidays, Monday Report will not be published Dec. 25 and Jan. 1, and will resume its normal schedule Jan. 8.

 


MHA in the News

The MHA received media coverage the week of Dec. 11 related to post-secondary nurse degree programs and telehealth.

Hospital Vaccine Resources Available

The MHA is at the forefront of advocating for vaccination awareness and education, particularly focusing on the challenges associated with the Beyfortus (nirsevimab) monoclonal antibody for infants entering their first respiratory syncytial virus (RSV) season. The association is actively collaborating with stakeholders to navigate reimbursement and supply concerns. A resolution of these issues is being diligently worked towards, with additional manufacturing and distribution channels being explored. Resources on Beyfortus and other vaccinations can be found on the MHA vaccinations webpage.

Additionally, the MHA, in collaboration with the Michigan Department of Health and Human Services, encourages hospitals and health systems to adopt vaccination policies for healthcare personnel against preventable diseases, especially focusing on COVID-19, influenza and pertussis. There are additional resources on the MHA website for hospitals to assess and improve vaccination protocols.

Members with questions may contact Kelsey Ostergren with the MHA.

Beyfortus Supply Shortages & CDC Guidelines

Beyfortus (nirsevimab) is a long-acting monoclonal antibody for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in infants approved by the U.S. Food and Drug Administration in July 2023. The MHA has heard significant concerns from members about the cost of purchasing and administering Beyfortus for infants entering their first RSV season since the drug was approved and has been working diligently to alleviate barriers.

The MHA sent letters to Blue Cross Blue Shield of Michigan (BCBSM) and the Michigan Association of Health Plans (MAHP) Oct. 23 to encourage coverage of Beyfortus so cost is not a barrier to adequate protection for the most vulnerable infants. Additionally, the MHA has engaged in conversations with the Michigan Department of Health and Human Services and the Medicaid health plans to confirm Beyfortus is covered through the federally funded Vaccines for Children program. Updates on coverage will be shared as soon as they become available.

The Centers for Disease Control and Prevention (CDC) released a Health Alert Network (HAN) advisory Oct. 23 providing guidance for clinicians in administering Beyfortus given current supply shortages. This follows release of a statement from Sanofi, Beyfortus’ manufacturer, indicating demand for the product has been higher than anticipated and supply has not kept pace, despite an aggressive supply plan.

The CDC’s interim recommendations for prioritizing Beyfortus administration include prioritizing administration of 100mg nirsevimab doses for:

  • Infants younger than six months old.
  • American Indian and Alaska Native infants younger than eight months old.
  • Infants between six to eight months with underlying health conditions that put them at high risk of severe RSV disease.

In addition, children eight to 19 months old should not receive nirsevimab, if they are eligible for palivizumab (Synagis). Lastly, providers should not utilize two, 50mg nirsevimab doses in lieu of one, 100mg dose for infants greater than 11 pounds.

Members may refer to the CDC HAN advisory for the complete recommendation. Members experiencing challenges with billing or reimbursement for Beyfortus administration should contact Kelsey Ostergren at the MHA.

Headline Roundup: Hospital Viability

Brian Peters

The MHA received media coverage the week of Dec. 5 following a virtual press conference Dec. 6 on the financial and staffing challenges impacting hospital viability, as well as topics including hospital capital improvements, mergers and acquisitions and respiratory illness hospital admissions driven by RSV and COVID-19. Stories include comments from MHA CEO Brian Peters, MHA Executive Vice President Laura Appel and MHA Board Chair T. Anthony Denton.

Below is a collection of headlines from around the state that includes interviews or statements from MHA representatives.

Sunday, Dec. 11

Friday, Dec. 9

Thursday, Dec. 8

Wednesday, Dec. 7

Tuesday, Dec. 6

Monday, Dec. 5

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

 

Media Recap: Pediatric RSV Surge

Laura Appel

Laura AppelThe MHA received media coverage during the weeks of Nov. 21 and 28 on the capacity status of hospital pediatric units amid the surge of hospitalized pediatric patients with respiratory illnesses driven by respiratory syncytial virus (RSV).

The Detroit Free Press published an article Nov. 23 on the status of hospitals throughout the state caring for a large number of children and requests made by hospitals to add additional licensed beds. Laura Appel, executive vice president of government relations and public policy, MHA, is quoted in the story on how staffing challenges continue to hamper hospitals, even for those with declining pediatric patient census.

“It’s worth noting that even where hospitalizations have receded, many of our members continue to face severe space and staffing challenges,” said Appel

Additional stories were published by The Detroit News, The Center Square and Chief Healthcare Executive.

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

MHA CEO Report — Pediatric Capacity Crisis

MHA Rounds Report - Brian Peters, MHA CEO

Every child begins the world again.Henry David Thoreau

MHA Rounds Report - Brian Peters, MHA CEOIn all of my life experiences to date, none have been so challenging in every sense as those times when my young children were hospitalized in the NICU, fighting for their very lives. We were incredibly fortunate to have positive outcomes with both of them, thanks to the efforts of our Michigan hospitals and the incredible people who work there every day.

I share this perspective because there is a crisis throughout Michigan that truly hits home with me. I know the angst and exhaustion being felt by far too many parents right now – emotions that are also being acutely felt by our heroic caregivers. In short, it feels like déjà vu in Michigan’s children’s hospitals, but instead of a surge of COVID-19 patients stressing capacity to the limits, our facilities are strained by a high number of pediatric patients suffering from respiratory illnesses largely driven by RSV. Similar tactics that have been implemented in prior years, such as initiating incident command systems, have been in operation to ensure appropriate direction and communication is occurring throughout those systems impacted by this crisis.

Hospitals operating at capacity is nothing new and the staffing challenges that continue to result in Michigan operating with 1,700 fewer staffed beds than we had prior to the pandemic are well documented. What we’re seeing today is the real impact of what those staffing challenges mean: longer wait times in the emergency department, lack of available beds for patient transports (particularly in rural Michigan) and pediatric ICUs operating at beyond 100% capacity.

There are few professionals in the world that have proven to be more resilient than healthcare workers, whether they are physicians, nurses, respiratory therapists, environmental service workers…the list goes on and on (and I am proud to say that the MHA Keystone Center has played an important role with the launch of our WELL-B initiative that continues to provide resiliency tools for our clinicians and other team members). But as residents of our communities, we can no longer take our healthcare workers and the access to care they provide for granted. These workers, and their organizations, need help.

Thankfully, the Michigan Legislature provided funding earlier this year through Public Act 9 to improve the recruitment, retention and training of healthcare workers. So far, over 69,000 healthcare workers have benefitted from that funding and it has helped to stabilize existing staffing levels. Hospitals are also exploring innovative ways to grow the talent pipeline, such as investment in higher education partnerships and other apprenticeships. However, while impactful, this funding is a finger in the dyke. Without additional attention, the problem will persist.

Addressing the strain on our children’s hospitals is a multi-pronged approach, and in addition to the aforementioned work of our MHA Keystone Center, we are also deriving input and guidance from our MHA Council on Children’s Health, led by Laura Appel, executive vice president for government relations and public affairs, as well as our system chief medical officer (CMO) group, led by our own CMO Gary Roth, DO.

While the MHA will continue to pursue legislative and regulatory solutions to the staffing crisis, there are actions anyone can undertake to help our healthcare workers caring for very sick children across Michigan, particularly as COVID-19, RSV and the flu converge to drive hospitalizations.

First and foremost, ensure that both you and your children are up to date on all the relevant vaccinations that are now readily available. The MHA is a long-time supporter of I Vaccinate which is a good source of information on vaccines, and our MHA Senior Vice President of Public Affairs and Communications Ruthanne Sudderth continues to be our point person with this organization. Second, practice proper hygiene, including handwashing and staying home when sick. Third, seek the appropriate setting for care; visit the hospital for emergencies but contact your primary care physician or an urgent care facility for testing or care for mild symptoms. Lastly – and very importantly – be sure to express some grace and appreciation for any healthcare worker you meet. As we approach the winter and holiday season, they are here to provide exceptional care to all who need it and deserve to be treated with respect both on and off duty.

If you have not done so already, please join me in sharing this messaging within your networks. Our hospitals need the support from our partners in healthcare, the business community and in Lansing and Washington, DC to weather this storm. Respiratory illnesses will always be here, but there are many small actions we can take to care for the health and wellness of our communities well into the future.

As always, I welcome your thoughts.