MHA CEO Report — Benefits of the State Budget

MHA Rounds Report - Brian Peters, MHA CEO

MHA Rounds Report - Brian Peters, MHA CEO“We must find time to stop and thank the people who make a difference in our lives.” ― John F. Kennedy

We have rightfully spent a lot of time in the past two years thanking the heroes who work in our hospitals and other healthcare settings for the incredible work they have done in the face of extreme challenge.

I want to take a moment now to thank another group of people who have recently helped our cause through their bipartisan actions; our elected officials in Lansing were extremely busy the last week of June passing the fiscal year 2023 state budget, which has since been signed by Gov. Whitmer. Our MHA mission is to advance the health of individuals and communities — and this budget absolutely provides significant help in that regard. While some elements of the new budget represent long-standing MHA priorities, others are new funding items that have the potential to reshape access to care and help our members and the patients and communities they serve.

Our MHA team does a tremendous job advocating for the importance of items such as the Healthy Michigan Plan, graduate medical education of physician residents, disproportionate share hospital funding, maximization of our robust provider tax program and Medicaid payment rates, the rural access pool and obstetrical stabilization fund, and critical access hospital reimbursement rates. Every election cycle, new legislators are welcomed to Lansing and the MHA’s efforts never stop to ensure these decisionmakers are aware of the impact these budget items play in their communities. The bottom line is the financial viability of hospitals is increasingly reliant on these important programs, and the MHA is dedicated to protecting them.

Hospital closures continue to happen across the country. However, they have occurred at a much higher rate in states that have not participated in Medicaid expansion through the Affordable Care Act. Maintaining funding for our expansion program — the Healthy Michigan Plan — has been one of our top priorities, and the pandemic has made the importance of insurance coverage more important than ever. In short, when the pandemic hit and thousands of Michiganders lost their jobs, the Healthy Michigan Plan was there to ensure access to good healthcare.

Our hospitals that treat the highest numbers of uninsured and underinsured patients also qualify for disproportionate share hospital funding, which provides enhanced reimbursement to account for the higher costs of care. This pool is funded through hospital provider taxes that reduce the state’s general fund contribution to the overall Medicaid program.

Small, rural and independent hospitals can often experience financial challenges in a particularly acute way, thus items such as the rural access pool, obstetrical stabilization fund and critical access hospital reimbursement rates also support access to healthcare services in rural areas. Labor and delivery units typically do not contribute to positive margins, but they are extremely important for families and communities. The obstetrical stabilization fund provides additional means for hospitals in rural areas to maintain these services so expectant mothers can avoid driving exorbitant distances for these services. Lastly, the state also included $56 million in new funding to increase Medicaid reimbursement rates for primary care services, which will help individuals on Medicaid receive the necessary primary and preventative care that can help prevent hospitalizations and reduce overall healthcare costs.

The top concern of hospital leaders remains workforce sustainability, and the continued funding for graduate medical education is one tool we must continue to use to maintain the physician talent pipeline that is sorely needed. At the same time, we are extremely happy to see inclusion of state funds to expand access to Bachelor of Science in Nursing degree programs at the state’s community colleges to help address the nurse talent pipeline, a $56 million line item. This proposal was supported by the MHA when it was formally introduced, and we look forward to seeing our post-secondary partners implement it to grow the healthcare workforce.

Lastly, behavioral health investments have been at the forefront of our advocacy efforts for some time and we were very pleased to see new funding to improve and enhance state behavioral health facility capacity. Michigan lacks adequate capacity to treat patients with behavioral and mental illness and this new funding is an important and necessary step to address the shortage. Included is $50 million to expand pediatric inpatient behavioral health capacity, $30 million to establish crisis stabilization units and $10 million to fund the essential health provider loan repayment program to cover behavioral health professionals.

In total, the budget includes $625 million in new investments for behavioral health funding and investments in workforce. While this will not solve all the issues impacting hospitals, it provides needed resources and demonstrates the commitment of lawmakers to a healthy Michigan. This budget also signifies that our work must continue to advocate for the resources necessary for hospitals and health systems to care for all Michiganders. Once again, on behalf of the entire MHA family, I want to acknowledge and thank both Governor Whitmer, as well as lawmakers in the state House and Senate, for their support of this latest state budget. And I would also encourage anyone who cares about access to quality, affordable healthcare to engage in the process, share your stories and input with those who can make a difference going forward. But also remember to say thank you when they support our cause.

As always, I welcome your thoughts.

Fiscal Year 2023 State Budget Signed

capitol building

capitol buildingGov. Whitmer signed July 20 the fiscal year 2023 state budget. Included in the 2023 budget agreement is $625 million in new investments for behavioral health funding and the healthcare workforce. This includes:

  • $50 million to expand pediatric inpatient mental and behavioral health capacity throughout the state.
  • $30 million to establish crisis stabilization units for mental and behavioral healthcare.
  • $10 million to fund the essential health provider loan repayment program to cover behavioral and mental health professionals.
  • New and ongoing funding of $3.5 million to support the statewide trauma system.
  • $56 million to increase Medicaid reimbursement rates for primary care clinician services.
  • $56 million to fund the Michigan Associate Degree in Nursing to Bachelor of Science in Nursing program at community colleges across the state.

Additionally, the state budget provides the resources necessary for hospitals and health systems to continue advancing the health of individuals and communities throughout Michigan. Specifically, the budget reflects the protection or enhancement of many MHA priorities, including:

  • Maintains funding for the Healthy Michigan Plan.
  • Protects funding for the graduate medical education of physician residents.
  • Supports disproportionate share hospitals.
  • Continues funding for the rural access pool and obstetrical stabilization fund.

Each of these funding sources are instrumental to keeping hospitals financially secure, particularly those serving vulnerable and underserved populations. MHA CEO Brian Peters released a statement July 1 applauding the healthcare focus of this budget and highlighting significant investments toward rural and behavioral health. These new appropriations will allow hospitals to continue and expand upon service lines that are in increased demand due to the pandemic.

The governor also made several line-item vetoes that do not directly impact hospital priorities when signing the budget, including vetoes of funding the administration argues is anti-abortion.

Members with questions may contact Adam Carlson.

Fiscal Year 2023 State Budget Advances Health of Individuals and Communities

Brian Peters

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association. *The budget has since been signed by Gov. Whitmer on July 20, 2022.

Brian PetersThe fiscal year 2023 state budget approved by the Michigan Legislature provides necessary resources to assist hospitals and health systems in advancing the health of individuals and communities throughout our state. We appreciate the work and consideration placed by lawmakers that continues to protect hospital priorities.

These priorities include maintaining funding for the Healthy Michigan Plan, graduate medical education of physician residents, disproportionate share hospitals which treat the highest numbers of uninsured and underinsured patients, the rural access pool and obstetrical stabilization fund, and critical access hospital reimbursement rates which all support access to healthcare services in rural areas. Each of these areas are instrumental to keeping hospitals financially secure, particularly in areas serving vulnerable and underserved populations.

We are also extremely happy to see new funding to improve and enhance state behavioral health facility capacity and to address the healthcare workforce. Michigan lacks adequate capacity to treat patients with behavioral and mental illness and this new funding is an important and necessary step to address the shortage. The investment of state funds to expand access to bachelor of science in nursing degree programs at the state’s community colleges is a significant movement towards replenishing Michigan’s healthcare talent pipeline.

We look forward to a signed budget that provides the resources necessary for hospitals and health systems to care for all Michiganders.

Budget Bills Advance in House and Senate

capitol building

capitol buildingThe full Michigan House and Senate advanced their budget recommendations for the fiscal year 2023 budget beginning Oct. 1. The Michigan Department of Health and Human Services budget bills, House Bill (HB) 5784 and Senate Bill (SB) 828, were reported to the opposite chambers for further consideration in the coming weeks. Both budget proposals protect hospital priorities, including maintaining funding for the Healthy Michigan Plan, graduate medical education, disproportionate share hospitals, the rural access pool and obstetrical stabilization fund, and critical access hospital rates.

In the House Judiciary Committee, further testimony was taken on legislation to help guide Michigan’s use of new funding from the $26 billion national opioid settlement. SBs 993, 994 and 995 would create a new restricted fund for the state to house the settlement dollars, establish a new advisory commission appointed by the Legislature and governor to oversee spending, and prohibit future civil lawsuits related to claims covered by this fund. There are identical versions of the bill currently making their way through the Senate as HBs 5968, 5969 and 5970. Either version of the bills could ultimately be sent to the governor’s desk for signature, and the MHA will continue to keep members informed on the legislation’s progress.

The full House of Representatives also voted to advance an MHA-supported bill related to out-of-state prescriptions. SB 166, introduced by Sen. Curt VanderWall (R-Ludington), would allow pharmacies to fill noncontrolled substance prescriptions written by licensed, out-of-state physician assistants and advanced practice registered nurses. There were technical changes made to the bill in the House, so another vote is needed in the Senate before the bill heads to the governor’s desk for signature.

Questions on these issues or other state legislation related to healthcare can be directed to Adam Carlson at the MHA.

MHA Values Work of Michigan Legislature on FY 2022 State Budget

MHA CEO Brian Peters

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

MHA CEO Brian PetersOn behalf of Michigan hospitals and health systems, we value the work of the Michigan Legislature to pass a budget that protect MHA priorities that include fully funding the Healthy Michigan plan, the rural access pool, the obstetrical stabilization fund, and maintaining rate increases for Medicaid and critical access hospitals. We also commend the legislature for expanding postpartum coverage to a full year for mothers on Healthy Michigan. However, more work remains, particularly to address the behavioral health crisis in Michigan. We look forward to working with the legislature through the supplemental appropriations process to secure transformational behavioral health solutions.