MHA CEO Report — The State of Healthcare

“Mankind’s greatest achievements have come about by talking, and its greatest failures by not talking. It doesn’t have to be like this. Our greatest hopes could become reality in the future. With the technology at our disposal, the possibilities are unbounded. All we need to do is make sure we keep talking.”
Stephen Hawking

The new year always brings two traditional speeches from lawmakers: Gov. Whitmer just recently delivered her annual State of the State address, while President Biden will share the annual State of the Union address on March 7. While the economy, housing, education, border security, climate change and other important issues are featured in these speeches, the reality is that healthcare remains a top concern for millions of Americans, and therefore will continue to be front and center for elected officials and candidates at the state and federal level throughout this election year.

The bottom line is that the fragility of the healthcare continuum was exposed during the pandemic and four years later, the aftershocks can still be felt. Let’s touch on just a few issues that dictate the state of healthcare in 2024:

Healthcare Workforce

Michigan hospitals employ roughly 219,000 people and are desperately trying to hire thousands more in every corner of the state. A survey we conducted last year showed there were over 27,000 job openings in Michigan hospitals. Hospitals are often the largest employer in their respective communities and serve as critical economic engines. It takes longer to deliver care when hospitals don’t have enough staff, impacting the experience of patients and families.

Much like other industries in Michigan, healthcare has a supply and demand issue, but we feel it in a uniquely acute manner: the aging population not only contributes to an exodus of talent from the field, but it increases demand for healthcare services at the same time. And because we are classic “price-takers” when it comes to a huge share of our business (i.e. Medicare and Medicaid tell us what they are going to pay), our ability to pass rising labor (and supply chain) costs along to consumers is extraordinarily limited. The financial performance of hospitals across the state and country has been negatively impacted as a direct result, and it fuels our advocacy efforts related to our ongoing viability.

Healthcare needs to continue to refill the talent pipeline and we’re making progress on these efforts. From the MI Hospital Careers campaign to the individual partnerships created between health system and secondary-education institutions, the effort is being made to increase the supply of future professionals. I’m encouraged to hear Gov. Whitmer’s proposal for tuition-free community college for all Michiganders who graduate from a Michigan high school. We have been active in advocating for such a policy to improve the number of students pursuing these pathways to address the nursing shortage.

Behavioral Health

Behavioral healthcare in Michigan continues to be in crisis. We need to fund, support and reform our systems to better meet the behavioral healthcare needs of our communities.  Responding to MHA advocacy, the Michigan Legislature provided $50 million in grant funding last year to increase access to pediatric inpatient behavioral health services. We are encouraged by what our member hospitals have planned to improve access, but more needs to be done. This will be a focus area for us in Lansing through the rest of the year, specifically looking at solutions that include continuing to expand care locations, clarifying insurance coverage policies and increasing the number of providers.

Prescription Drug Affordability

Increasing prescription drug costs are a key driver of escalating healthcare costs. These increased costs are not just experienced by patients at their local pharmacies, but hospitals are also large purchasers of prescription drugs and are experiencing the same costs, threatening their viability. Data shows drug costs rose by 36.9% from 2019 to 2021 and currently account for the largest portion of healthcare insurance premiums, costing 22.2 cents for every dollar.

With these dramatic cost increases, the 340B drug pricing program has never been more important. This critical program allows safety net hospitals and other community care organizations to access certain outpatient prescription drugs at discounted prices. It does not require any state taxpayer dollars and has contributed to supporting access to care to Michigan’s most vulnerable patients for more than 30 years. We’re hopeful to see legislation passed to protect these hospitals and the benefits they provide, such as supporting OB services, financial assistance programs for low-income patients or lowering the cost of prescription drugs.

Emerging Technology and AI

Technology continues to provide many opportunities and growth for healthcare. It can serve as a “force-multiplier” that allows our staff to work smarter, extending their impact. If used correctly, technology can improve the patient experience, care delivery, worker satisfaction and more. We’re already seeing it with the dramatic growth in the utilization of telehealth and the emergence of artificial intelligence (AI) applications throughout healthcare. Technology can help expand access to care for many of our rural or disadvantaged residents who are confronted with a variety of social barriers.

We’re seeing great innovation when it comes to technology and I expect even more in the years ahead. The “disruptors,” that is to say, the large, global companies known for their technological innovation (and deep financial resources) are increasingly turning their attention toward the $4 trillion American healthcare market. These entities could be viewed as a potential threat to traditional healthcare providers, payors and others in the health ecosystem – but could also be viewed as potential collaborators and strategic partners. Without a doubt, the future delivery and financing model will be shaped in some way by this development.

At the same time, the rise of sophisticated technology and the inter-connectedness between healthcare entities, their patients and the rest of the world gives rise to the specter of cybercrime. This topic is worthy of its own special focus (stay tuned for more on that in the months ahead), but for now, let me just point to the fact that the MHA was proud to be ahead of the game in this regard, helping to launch our own healthcare-focused cybersecurity operations center right here in Michigan with MHA Endorsed Business Partner CyberForceQ.

These are just a few of the countless, complex issues that will impact Michigan healthcare in the year ahead. Plenty to be concerned about, for sure. But I remain fundamentally optimistic and hopeful about the future. Our healthcare workers are committed and resilient. And our policymakers continue to acknowledge the dependent relationship their communities have with healthcare. While I know better than to predict much of anything in an election year, I feel confident in predicting healthcare will continue to help make Michigan a better place, no matter what the political winds bring our way. All we need to do is continue our most human connection – let’s keep talking with each other and craft a positive future together.

As always, I welcome your thoughts.

Headline Roundup: Nurse Degree Programs & Telehealth

MHA CEO Brian Peters

The MHA received media coverage the week of Dec. 11 related to post-secondary nurse degree programs and telehealth. Below is a collection of headlines from around the state, which include an interview with MHA CEO Brian Peters.

Thursday, Dec. 14

Tuesday, Dec. 12

Monday, Dec. 11

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

MHA Monday Report Oct. 16, 2023

MHA Monday Report

First Legislative Policy Panel Meeting New Program Year

The MHA Legislative Policy Panel met Oct. 11 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals. The meeting focused on state legislative updates for the new members of …


Auto No-Fault Hearings Continue, Interstate Compacts Advance

The Michigan Senate Finance, Insurance and Consumer Protection Committee continued to hear testimony during the week of Oct. 9 on Senate Bills 530 and 531. Introduced by Sen. Mary Cavanagh (D-Redford Township) and Sen. Sarah …


ANA-MI Opposes Mandated Nurse Staffing Ratio Legislation

The American Nurses Association – Michigan (ANA-Michigan) publicly announced their opposition Oct. 11 to Senate Bill 334 and House Bill 4550, which require state mandated ratios for hospital nurses. The ANA-MI joins the MHA and …


DEA Plans to Extend Telemedicine Rules for Controlled Substances Through 2024

The Drug Enforcement Administration (DEA) announced pandemic-era rules allowing controlled substances to be prescribed via telemedicine will be extended through Dec. 31, 2024. This extension follows significant opposition to the DEA’s plan to curtail these …


MHA Keystone Center 2022-2023 Annual Report Highlights Quality and Safety Priorities

The MHA Keystone Center recently released its 2022-2023 Annual Report, showcasing its dedication to advancing patient and workforce safety alongside member organizations. The report highlights the healthcare safety and quality improvements made through MHA Keystone Center-led …


MHA to Host Virtual DEI Certificate Program

Save the date for a Diversity, Equity and Inclusion in Healthcare certificate program scheduled for Dec. 7 and Dec. 8 from 11 a.m. to 3 p.m. EST. The event, hosted by the MHA and other …


MiCARE Project Discontinued

The Michigan Care Access Referral Exchange (MiCARE), hosted by Bamboo Health’s OpenBeds solution, will be discontinued effective Oct. 31, 2023. The goal of MiCARE was to create a comprehensive network of behavioral health treatment providers, …


MHA Podcast Covers Program Year Priorities: Behavioral Health, Workforce Restoration, Health Equity and More

The MHA released a new episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan discussing key issues that impact healthcare and the health of communities. The October 2023 episode, …


The Keckley Report

Paul KeckleyAs HLTH 2023 Convenes, Three Themes speak Volumes about Where U.S, Healthcare is Headed

“In Las Vegas this week, 10,000 healthcare entrepreneurs, investors, purchasers and industry onlookers are gathered to celebrate the business of U.S. healthcare. It follows the inaugural Nashville Healthcare Sessions last month that drew a crowd to Music City touting “the premier healthcare conference set in the most relevant, exciting, and welcoming city in the south.“ …

The root causes of the system’s poor performance are understood and considered: they’re daunting. But that does not impede the willingness of private investors to make bets presuming the future of the U.S. healthcare is not a repeat of its past.“

Paul Keckley, Oct. 9, 2023


MHA CEO Brian PetersMHA in the News

The MHA received media coverage the week of Oct. 9 on rural healthcare challenges and legislation proposing state mandated nurse-to-patient staffing ratios. The Detroit Free Press published an article Oct. 12 on the closure of …

MHA Monday Report Aug. 21, 2023

MHA Monday Report

MHA Joins Partners to Urge Childhood Vaccinations

The MHA participated in a press conference Aug. 17 alongside representatives from I Vaccinate, the Franny Strong Foundation, the Michigan Department of Health and Human Services, Ascension Michigan and Pontiac Middle School, to urge families …


Opportunities for Training and Placement of CHWs Available to Hospitals

The MHA has multiple higher education partners that recently received Health Resources and Services Administration grants to increase the number of community health workers (CHW) and health support workers, and these institutions are …


DEA Listening Sessions on Prescribing Controlled Substances via Telemedicine

The United States Drug Enforcement Administration (DEA) will be hosting two listening sessions to receive additional input concerning the practice of telemedicine with regards to controlled substances. Hosted virtually and in person from 9 a.m. …


MHA Webinar on Maximizing Contributions of Physician Board Members

How can leadership utilize the distinct skills and expertise of physician board members? The MHA webinar Maximizing Contributions of Physician Board Members will take place from noon to 1 p.m. EST Oct. 17 will present …


The Keckley Report

Paul KeckleyNot for Profit Hospitals: Are they the Problem?

“The issues facing the U.S. health industry are complex. The role hospitals will play is also uncertain. If, as polls indicate, the majority of Americans prefer a private health system that features competition, transparency, affordability and equitable access, the remedy will require input from every major healthcare sector including employers, public health, private capital and regulators alongside others. It will require less from DC policy wonks and sanctimonious talking heads and more from frontline efforts and privately-backed innovators in communities, companies and in not-for-profit health systems that take community benefit seriously.

No sector owns the franchise for certainty about the future of U.S. healthcare nor its moral high ground. That includes not-for-profit hospitals.

The darkening cloud that hovers over not-for-profit health systems needs attention, but not alone, despite efforts to suggest otherwise. Clarifying the community-benefit standard is a start, but not enough. Are NFP hospitals a problem? Some are, most aren’t but all are impacted by the darkening cloud. …”

Paul Keckley, August 14, 2023


News to Know

  • The Healthcare Association of Hawaii has compiled a list of trustworthy local organizations that are accepting monetary contributions amid the recent wildfires of Maui, Hawaii.
  • The MHA encourages MHA chief nursing officers and other Michigan hospital leaders to register for Hospitals for Patient Access Advocacy Day from 8 a.m. to 4 p.m. Sept. 13.
  • QURE Healthcare was approved for associate membership June 2023.

MHA in the News

The MHA received media coverage the week of Aug. 14 following a press conference Aug. 17 where Michigan health officials urged families to get kids up-to-date on routine vaccines ahead of the new school year. …

Michigan Society of Anesthesiologists Address Legislative Policy Panel

MSA President Neeju Ravikant, MD, MS, presents to the MHA Legislative Policy Panel.

The MHA Legislative Policy Panel convened May 24 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals.

The meeting was highlighted by a presentation on potential state licensure of anesthesiologist assistants (AAs) from Michigan Society of Anesthesiologists (MSA) President Neeju Ravikant, MD, MS; Secretary/Treasurer & Legislative Co-Chair Courtney Abernathy, MD; and MSA board member William Peruzzi, MD. Currently Michigan is one of four states that allow practice for AAs via physician delegation. Licensure would still require AAs work under the supervision of a qualified physician anesthesiologist and would have Michigan join 15 other states, the District of Columbia and the US Territory of Guam that have moved over to licensure.

In addition to the presentation, the panel recommended the MHA support telehealth parity and discussed issues around pharmaceutical manufacturers discriminating against covered entities based on their contract pharmacy relationships.

The panel received updates on other issues including a review of the MHA Strategic Action Plan from MHA CEO Brian Peters, a federal update from federal lobbyist Carlos Jackson with Cornerstone Government Affairs and state updates on the budget and nurse staffing ratio legislation.

For more information on the MHA Legislative Policy Panel, contact Adam Carlson at the MHA.

MHA Monday Report May 15, 2023

MHA Monday Report

capitol buildingHarmful Nurse Staffing Legislation Introduced in Michigan Legislature

Harmful nurse staffing legislation was introduced May 11 in the Michigan Legislature that would mandate nurse staffing ratios, require public disclosure of the ratios and restrict mandatory overtime for nurses. The bill package is pushed by the Michigan Nurses Association and was ….


Behavioral Health ED Boarding Data Available

Behavioral health emergency department (ED) boarding data the MHA has been collecting on a weekly basis from acute care hospitals across Michigan since March 2023 is now available on the Health Data webpage of the …


Annual Meeting iconMHA Annual Membership Meeting Includes Ways to Support Michigan Hospitals

The MHA membership will convene in person for the MHA Annual Membership Meeting June 28 through 30 at Grand Hotel on Mackinac Island. The annual meeting will feature an outstanding lineup of speakers, the family …


DEA Issues Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

After delaying the final rule for ending COVID-19 telehealth prescribing rules, the Drug Enforcement Agency (DEA) has issued a temporary rule to allow the following: The full set of telemedicine flexibilities regarding prescription of controlled …


Upcoming Webinars on Medicare FFS Quality-based Programs

The MHA is partnering with DataGen to host two free webinars focused on Medicare fee-for-service (FFS) quality-based programs, which can reduce hospital inpatient FFS payments by up to 6%, depending upon hospital performance. The webinars …


Webinar Outlines Practices to Re-engage Patients and Families in Care

Fractured social contracts in today’s world have changed the healthcare landscape and culture. There is a convergence of patient consumerism and digital transformation happening, and those who focus on patient-centered care and person and family …


MHA Keystone Center PSO Safe Table – Health IT & Risk Safety

The MHA Keystone Center PSO is hosting a Health IT & Risk Safety Safe Table from 12:30 to 3 p.m. June 14. The event will be held at Goshen Health, located at 200 High Park …


Direct Care and Behavioral Health Workforce Assessment: Regional Feedback Sessions

Public Sector Consultants and Health Management Associates are partnering with the Michigan Department of Health and Human Services to gather the perspectives of people impacted by the direct care worker and behavioral health workforce …


MHA Webinar Focuses on Building Trust and Relationships for Trustees

When stakeholders gather to discuss community vitality, the health and wellbeing of the community is not only about access to safe, affordable healthcare, but about non-medical health influences that have an impact on the community. …


MDHHS Releases Beginner Guide for Doula Providers

Michigan Medicaid began reimbursing doula services provided to individuals covered by or eligible for Medicaid as of Jan. 1, 2023. Doula providers are required to be on the Michigan Department of Health and Human Services …


The Keckley ReportPaul Keckley

The End of the Pandemic Health Emergency is Ill-timed and Short-sighted: The Impact will further Destabilize the Health Industry

“The national spotlight this week will be on the debt ceiling stand-off in Congress, the end of Title 42 that enables immigrants’ legal access to the U.S., the April CPI report from the Department of Labor and the aftermath of the nation’s 199th mass shooting this year in Allen TX.

The official end of the Pandemic Health Emergency (PHE) Thursday will also be noted but its impact on the health industry will be immediate and under-estimated. …

In the weeks ahead as the debt ceiling is debated, the Federal FY 2024 budget finalized and campaign 2024 launches, the societal value of the entire health system and speculation about its preparedness for the next pandemic will be top of mind. …“

Paul Keckley, May 8, 2023


News to Know

  • Upon the end of the COVID-19 Public Health Emergency, the Health Resources & Services Administration will end a 2020 policy allowing hospitals to use 340B drugs for eligible patients in new hospital locations, even if they have not yet appeared on a filed Medicare cost report.
  • The MHA is hosting the webinar MHA Programs of All-Inclusive Care for the Elderly (PACE): An Alternative to Traditional Nursing Home care from 8:30 to 9:30 a.m. May 23.
  • Completed 2022 occupational mix surveys must be submitted by acute care hospitals paid under the Medicare prospective payment system to the Medicare Administrative Contractor by June 30, 2023.

Brian PetersMHA in the News

The MHA received media coverage the week of May 8 regarding nurse staffing legislation, healthcare worker shortages, the ending of the COVID-19 public health emergency and more. A joint media statement was published May 11 …

DEA Issues Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

After delaying the final rule for ending COVID-19 telehealth prescribing rules, the Drug Enforcement Agency (DEA) has issued a temporary rule to allow the following:

  • The full set of telemedicine flexibilities regarding prescription of controlled medications that were in place during the COVID-19 public health emergency (PHE) will remain in place through 11, 2023.
  • Additionally, any practitioner-patient telemedicine relationships established on or before Nov. 11, 2023 will continue to be permitted the full set of telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID-19 PHE through a one-year grace period until Nov. 11, 2024. In other words, if a patient and a practitioner have established a telemedicine relationship on or before Nov. 11, 2023, the same telemedicine flexibilities that have governed the relationship to that point are permitted until Nov. 11, 2024.

In the meantime, the DEA is continuing to evaluate the rule and anticipates implementation of a final regulation permitting the practice of telemedicine under certain circumstances. The goal of this temporary rule is to ensure a smooth transition for patients and practitioners that have come to rely on the availability of telemedicine for controlled medication prescriptions, as well as allowing adequate time for providers to come into compliance with any new standards or safeguards put into place by the DEA.

Members with questions should contact Renée Smiddy at the MHA.

MHA Monday Report May 8, 2023

MHA Monday Report

capitol buildingState Legislation Introduced to Address Violence Against Healthcare Workers, Strengthen Healthy Michigan Plan and Expand Organ Donor Registration

Legislation to increase the penalties for assaulting healthcare employees and volunteers was introduced in the state House of Representatives during the week of May 1. Additional legislation was introduced to remove unnecessary provisions of the …


Michigan’s Largest Private-sector Employer Remains Healthcare

The Partnership for Michigan’s Health reports healthcare directly employed nearly 568,000 Michigan residents in 2021, demonstrating that healthcare remains the largest private-sector employer in the state despite continued staffing losses attributed to the COVID-19 pandemic. …


Webinar Reveals New Tool to Improve Person and Family Engagement

The MHA is hosting a webinar from 8:30 to 10 a.m. May 24 to review the newly released MHA Person & Family Engagement Roadmap, which includes recommended policies to re-engage patients and caregivers and …


Final Medicaid Bulletin on Continuous Glucose Monitoring Systems

The Michigan Department of Health and Human Services issued a final Medicaid Policy Bulletin May 1 with revisions to the Continuous Glucose Monitoring Systems Policy. In response to the proposed policy issued April 1, …


speak upE.W. Sparrow Hospital Nurse Receives Q2 MHA Keystone Center Speak-up! Award

The MHA Keystone Center presented Cheryl Kay, RN, at E.W. Sparrow Hospital with the quarterly MHA Keystone Center Speak-up! Award, which celebrates individuals or teams in Michigan hospitals demonstrating a commitment to the prevention of …


DEA Delays Ending COVID-19 Telehealth Prescribing Rules

The Drug Enforcement Agency (DEA) is delaying draft rules that proposed stricter telehealth limits on providers prescribing controlled substances, like buprenorphine for opioid use disorder or Adderall for ADHD. The DEA will temporarily extend …


MHA Webinar Reviews PACE Programs

With the closure of nursing homes and long-term care facilities, hospitals and health systems need options to care for seniors. Dually eligible frail seniors are one of the most complex cohorts with multiple comorbidities, frequent …


MHA Podcast Explores How Michigan Leaders Can Collaborate to Address Gaps in Behavioral Health

The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan on key issues that impact healthcare and the health of communities. On episode 29, State Representative …


2023 Ludwig Nominee: Priority Health, National Fitness Campaign Partner to Offer Free Fitness Courts

Since 1990, the MHA has honored member healthcare organizations working to enrich the overall welfare of their local communities through the Ludwig Community Benefit Award. This year, the MHA is excited to showcase all award nominees, …


MHA Rounds Report - Brian Peters, MHA CEOMHA CEO Report — Attracting Healthcare Talent

Talent acquisition is always top of mind for all business leaders. Demand for workers now outpaces supply throughout the U.S., but particularly here in Michigan due to our demographic realities, including an aging baby-boom generation entering retirement in significant numbers. …


The Keckley Report

Paul KeckleyThe Tit for Tat Game in Healthcare produces No Winners

“Tit for Tat battles in healthcare are nothing new. Last week, they were on full display. …

Most of the food fights in healthcare like last week’s revolve around each sector’s unique response to the three challenges above. That’s why they exist: to protect the interests of their members and advocate on their behalf. All believe their mission and vision is essential to the greater good and the moral high ground theirs. Some are imperiled more than others: not for profit, rural and safety net hospitals, long-term care operators, direct caregivers and public health programs at the top of this list.

Educating lawmakers is necessary but what’s needed is serious, objective forward-looking definition of the U.S. health system’s future. The tit for tat game will not solve anything. That’s where we are. …“

Paul Keckley, May 1, 2023


News to Know

  • National Hospital Week 2023 is May 7-13.
  • The Michigan Department of Health and Human Services created a series of short videos to help providers and community partners navigate policies impacted by the ending of the federal COVID-19 Public Health Emergency.
  • Registration remains open for the 2023 MHA Annual Membership Meeting, scheduled June 28 through 30 at Grand Hotel on Mackinac Island.
  • Completed 2022 occupational mix surveys must be submitted by acute care hospitals paid under the Medicare prospective payment system to the Medicare Administrative Contractor by June 30, 2023.

MHA CEO Brian Peters speaks with WLNS.MHA in the News

The MHA received media coverage the week of May 1 on the economic impact of healthcare in Michigan and planned state legislation that would require nurse-to-patient staffing ratios in hospitals. Crain’s Grand Rapids Business published …

DEA Delays Ending COVID-19 Telehealth Prescribing Rules

The Drug Enforcement Agency (DEA) is delaying draft rules that proposed stricter telehealth limits on providers prescribing controlled substances, like buprenorphine for opioid use disorder (OUD) or Adderall for ADHD. The DEA will temporarily extend COVID-19 telehealth flexibilities as they “work to find a way forward to give Americans access with appropriate safeguards.” It is unclear how long the extension will last.

The delay follows thousands of complaints filed with the DEA on the proposal to require in-person evaluations to continue controlled substance medications and tighter standards aimed at ensuring patients are adequately screened to prevent improper prescriptions. The MHA submitted a federal comment letter regarding this issue.

Members with questions should contact Renée Smiddy at the MHA.

OCR Ends HIPAA Telehealth Enforcement Discretion

The U.S. Health and Human Services Office for Civil Rights (OCR) will end enforcement discretion for telehealth providers who utilize remote communication products that don’t comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 90-days after the end of the COVID-19 public health emergency. Healthcare providers will need to comply with HIPAA rules when providing virtual care services effective Aug. 9, 2023. All covered entities are expected to be in compliance with HIPPA Privacy, Secuirty and Breach Notification Rules or face penalties for violation.

Members with questions can contact Renée Smiddy at the MHA.