Tag: Vickie Kunz

MHA Monday Report July 29, 2024

Monday Report

Governor Signs FY 25 Budget and FY 24 Supplemental

 

Gov. Whitmer signed the fiscal year (FY) 2025 state budget on July 24. The budget proposal fully funds the Michigan Medicaid program, including significant increases to provider-funded Medicaid reimbursements in FY 24 and 25. The budget also …

 

Governor Signs Law Reducing Medical Waste

Gov. Whitmer signed Senate Bill 482, now Public Act (PA) 105 of 2024, on July 23, which extends the timeline for the disposal of sharps containers. Previously, state law mandated that sharps containers be removed …

 

 

June Medicaid and Medicare Enrollment in Michigan

 

The MHA updated its analysis of Medicaid and Medicare enrollment to reflect June 2024 data. The analysis now includes program enrollment as a percentage of each county’s total population and the split between fee-for-service and …

 

CMS Releases 2025 Physician Fee Schedule Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the physician fee schedule (PFS) payment system effective Jan. 1, 2025. The proposal would: Reduce the PFS conversion factor by …

 

Webinar Explores Connection Between Person and Family Engagement and Performance

The MHA is hosting the webinar Tying Person and Family Engagement (PFE) to Culture and Performance from noon to 1 p.m. Aug. 20. The webinar will provide examples of how peers at hospitals are creating a PFE …

 

Engaging Providers and Transforming Revenue and Quality Performance Simultaneously

The MHA’s Endorsed Business Partner (EBP) program promotes industry-leading firms and connects member hospitals to solutions that alleviate pain points. The MHA recently endorsed ModusOne Health, which is the only physician-founded and operated clinical diagnosis improvement company (CDxI®) …

MDHHS

MDHHS Seeks Feedback from Older Adults and Caregivers on the 988 Suicide & Crisis Lifeline

The Michigan Department of Health & Human Services (MDHHS) is now surveying adults aged 60 and older and their caregivers about their experience with the 988 Suicide & Crisis Lifeline. The survey is scheduled to …

 

Expanding Peer Recovery Coach Services to Improve Patient Outcomes

The fiscal year (FY) 2025 budget includes critical funding to support the work of peer recovery coaches (PRCs) in Michigan hospitals. Kelsey Ostergren, director of health policy initiatives, MHA, and Michelle Norcross, senior director of safety & quality, MHA Keystone Center, share the impact these resources have on patients and communities …

 

Applications are Now Open for the Infection Prevention and Control Scholarship

The Association for Professionals in Infection Control and Epidemiology (APIC) has opened applications for the 2025 Critical Access Hospital (CAH) Scholarship program …

The Keckley Report

Campaign 2024 and US Healthcare: 7 Things we Know for Sure

“Over the weekend, President Biden called it quits and Democrats seemingly coalesced around Vice President Harris as the Party’s candidate for the White House. While speculation about her running mate swirls, the stakes for healthcare just got higher. Here’s why: …

Healthcare, to the Democratic-leaning voters is a right, not a privilege. Its majority think it should be universally accessible, affordable, and comprehensive akin to Medicare. They believe the status quo isn’t working: the federal government should steward something better. …

Regardless of the election outcome November 5, the U.S. healthcare industry will be under intense scrutiny in 2025 and beyond. It’s unavoidable.

Discontent is palpable. No sector in U.S. healthcare can afford complacency. And every stakeholder in the system faces threats that require new solutions and fresh voices.”

Paul Keckley, July 22, 2024

News to Know 

  • July 22 was the deadline to register by mail or online to be eligible to vote in the Primary Election on Aug. 6.

 

 

MHA in the NewsMHA CEO Brian Peters

Becker’s Hospital Review published an article July 23 that includes MHA CEO Brian Peters as one of 76 healthcare executives sharing their focus for the second half of 2024. Peters covered the importance of the …

 

CMS Releases 2025 Physician Fee Schedule Proposed Rule

Member News

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the physician fee schedule (PFS) payment system effective Jan. 1, 2025.

The proposal would:

  • Reduce the PFS conversion factor by a net 2.8% from the current $33.29 to $32.36 after expiration of the 2.93% statutory payment increase for 2024 and a 0% conversion factor update.
  • Refine guidance regarding the complexity add-on code (G2211) for payment of evaluation and management visits.

Extend certain telehealth waivers through 2025 including:

  • Allowing providers to report enrolled practice addresses instead of home addresses when services are performed from their home.
  • Defining direct supervision to include virtual presence via audio/video real-time communications technology.
  • Revise the data reporting period and phase-in of payment reductions for clinical laboratory tests under the clinical laboratory fee schedule by updating the data reporting period to Jan. 1 – March 31, 2025.
  • Extending the phase-in of payment reductions by an additional year meaning that 2024 payments cannot be reduced below 2023 amounts and 2025-2027 payments cannot be reduced more than 15% compared to the previous year.
  • Delay implementation of the CMS’ rebased and revised Medicare economic index until future rulemaking.
  • Codify policies established in revised guidance for Medicare Part B and Part D drug inflation rebate programs and propose new and revised policies for these programs.
  • Exclude suspected anomalous spending from financial calculation for the Medicare Shared Savings Program (MSSP).
  • Add six new measures to the MSSP measure set and streamline reporting options
  • Add six new optional merit-based incentive payment system value pathways for 2025.

The MHA encourages members to contact Vickie Kunz by Aug. 30, regarding issues identified. Hospitals are encouraged to review the proposed rule and submit comments to the CMS by Sept. 9.  The CMS is expected to release a final rule around Nov. 1, for the Jan. 1, 2025, effective date.  Members with questions may contact Vickie Kunz at the MHA.

MHA Monday Report July 22, 2024

Monday Report

Introducing New Infection Prevention Education

The MHA Keystone Center, in partnership with the Michigan Department of Health and Human Services, created a series of online learning modules for infection control and prevention education. The modules cater to the needs …

CMS Releases Medicare 2025 Outpatient Prospective Payment System Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service outpatient prospective payment system effective Jan. 1, 2025. The proposed rule: Provides a net 2.3% increase …

MHA Webinar Reviews CMS Medication Administration and Management Requirement Updates

The MHA is hosting the webinar CMS Medication Administration and Management: IV Medication, Blood Administration and Safe Opioid Use from 10 a.m. to noon ET Aug. 27. Knowing medication is involved in 80% of treatment …

MHA Podcast Welcomes New Board Chair, Explores Healthcare Priorities in Michigan

The MHA released a new episode of the MiCare Champion Cast kicking off the 2024-2025 program year discussing healthcare viability, public health, workforce, cybersecurity, the election and more. The episode, hosted by MHA CEO Brian Peters, features MHA Board Chair Julie Yaroch, DO …

The Keckley Report

Most Hospitals Fall Short on Affordability, Vision and Trust

“This weekend, the American Hospital Association kicks-off its annual Leadership Summit in San Diego. Its agenda is organized around 8 themes: Transforming Care Delivery and Payment, Patient Centricity Through Digital Transformation, Building a More Flexible and Sustainable Workforce, Financial and Operating Excellence, Igniting Innovation, Elevating Health Equity, Improving Behavioral Health and Governance Excellence. They’re important. …

Collectively, that’s welcome news for a nation that’s anxious and divided. The current state in U.S. healthcare is much the same. It needs its hospitals to step up.

Some Boards and their hospital leadership teams take affordability, vision and trust seriously. Some don’t.”

Paul Keckley, July 15, 2024

News to Know

  • July 22 is the deadline to register by mail or online to be eligible to vote in the Primary Election on Aug. 6.

MHA CEO Brian Peters

MHA in the News

The MHA received media coverage the week of July 15 on healthcare priorities in Michigan, the state budget and the intersection between public health and healthcare. Hillsdale Hospital published an episode of the Rural Health …

 

CMS Releases Medicare 2025 Outpatient Prospective Payment System Proposed Rule

Member News

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service outpatient prospective payment system (OPPS) effective Jan. 1,  2025.

The proposed rule:

  • Provides a net 2.3% increase to the OPPS conversion factor from $87.38 to $89.38 for hospitals that report quality measure data.
  • Increases the outlier fixed-dollar threshold by 3.2% from the current $7,750 to $8,000.
  • Modifies the timeframe for standard review of prior authorization requests for hospital outpatient department services from 10 business days to seven calendar days.
  • Uses 2023 claims data and the most updated cost report data from the healthcare cost report information system, primarily from 2022, to set payment rates.
  • Adds three services (CPT codes 0894T, 0895T and 0896T) for liver allograft-related procedures to the 2025 Inpatient-Only List.
  • Updates the core based statistical areas used to determine a hospital’s wage index, consistent with other 2025 proposed rules.
  • Adds two new status indicators (H1 and K1) to identify healthcare common procedure coding system/current procedural terminology (HCPCS/CPT) codes representing separately payable, non-opioid post-surgical pain management products as authorized by the Consolidated Appropriations Act of 2023.
  • Establishes separate payment for diagnostic radiopharmaceuticals with a per-day cost exceeding $630.
  • Excludes qualifying cell and gene therapies from comprehensive ambulatory payment classification packaging.
  • Adopts three measures related to health equity for the Outpatient, ambulatory surgical center (ASC) and rural emergency hospital quality reporting programs, and extending voluntary data reporting for two hybrid measures in the inpatient quality reporting program.
  • Establishes new conditions of participation for hospitals and critical access hospitals focused on obstetrical services and maternal care.
  • Extends the virtual direct supervision of therapeutic and diagnostic services under the physician fee schedule (PFS) through Dec. 31, 2025. The CMS also proposes to extend virtual direct supervision under the OPPS through Dec. 31, 2025, to maintain alignment between the PFS and OPPS.
  • Adds 20 medical and dental procedures to the ASC covered procedures list.
  • Updates the hospital outpatient quality reporting program requirements.
  • Updates requirements for the rural emergency hospital quality reporting program.

The MHA will provide a hospital-specific impact analysis within the next few weeks and encourages members contact Vickie Kunz by Aug. 30 regarding issues identified. Hospitals are encouraged to review the proposed rule and its impact on operations and submit comments to the CMS by Sept. 9.  The CMS is expected to release a final rule around Nov. 1 for the Jan. 1, 2025, effective date.

Members with questions may contact Vickie Kunz at the MHA.

MHA Monday Report July 15, 2024

Monday Report

MHA Service Corporation Board Highlights Solutions and Mission

The MHA Service Corporation board held its final meeting of the 2023-2024 program year June 26 focused on supporting the MHA Strategic Action Plan priorities of workforce support and innovation, viability, behavioral health and …

2025 Medicare Fee-for-Service Home Health Proposed Rule Released

The Centers for Medicare & Medicaid Services recently released a proposed rule to update the home health prospective payment system for calendar year 2025. The rule includes updates to the Medicare …

What I Learned as a Provider Working in Public Policy

Carlie Austin, BSN, RN, shares her journey serving as the maternal infant health policy specialist at the MHA. As a clinician, what drew you to a role tied to public policy? If I had to …

MHA Webinar Tying Person and Family Engagement to Culture and Performance

The MHA is hosting the webinar Tying Person and Family Engagement to Culture and Performance from noon to 1 p.m. Aug. 20. The webinar will outline a process for structuring value-based employee competencies that …

MHA CEO Report — A Program Year in Review

I am pleased to share we just completed a successful MHA Annual Meeting, continuing a long-standing June tradition whereby we celebrate the conclusion of one MHA program year, and prepare for the next. Each program year is unique with the different challenges it presents. …

The Keckley Report

The Healthcare Workforce Crossroad: Incrementalism or Transformation

“Congress returns from its July 4 break today and its focus will be on the President: will he resign or tough it out through the election in 120 days. But not everyone is paying attention to this DC drama.  In fact, most are disgusted with the performance of the political system and looking for something better. Per Gallup, trust and confidence in the U.S. Congress is at an all-time low.

The same is true of the healthcare system: 69% think it’s fundamentally flawed and in need of systemic change vs. 7% who think otherwise (Keckley Poll). And 60% think it puts its profits above all else, laying the blame at all its major players—hospitals, insurers, physician, drug companies and their army of advisors and suppliers.

These feelings are strongly shared by its workforce, especially the caregivers and support personnel who service patient in hospital, clinic and long-term care facilities. Their ranks are growing, but their morale is sinking. Career satisfaction among clinical professionals (nurses, physicians, dentists, counselors) is at all time low and burnout is at an all-time high. …

It’s easier to talk about healthcare’s workforce issues but It’s harder to fix them. That’s why incrementalism is the rule and transformational change just noise.”

Paul Keckley, July 8, 2024

News to Know

  • July 22 is the deadline to register by mail or online to be eligible to vote in the Primary Election on Aug. 6.
  • The MHA recently submitted comments on the Michigan Department of Licensing and Regulatory Affair’s Psychology proposed rules.

 

2025 Medicare Fee-for-Service Home Health Proposed Rule Released

Member News

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the home health (HH) prospective payment system (PPS) for calendar year (CY) 2025. The rule includes updates to the Medicare fee-for-service HH PPS payment rates based on changes by the CMS and those previously adopted by Congress.

Highlights of the proposed rule, which takes effect Jan. 1, 2025, include:

  • A negative 4% adjustment to base payment rates to achieve budget neutrality following the transition to the Patient-driven Groupings Model (PDGM).
  • A 30-day standard payment rate of $2,008.12 ,down 1.5% from the current $2,038.13, for HH agencies that submit the required quality data.
  • Updating core-based statistical areas for wage index purposes, consistent with recent fiscal year 2025 proposed rules.
  • Recalibrating the PDGM case-mix weights, low utilization payment adjustment thresholds, functional levels and comorbidity adjustment subgroups.
  • Revising the fixed dollar loss ratio from 0.27 to 0.38, reducing outlier payments.
  • Requiring HH agencies to report four new patient assessment items in the HH agency Outcome and Assessment Information Set under the social determinants of health category, beginning CY 2027.
  • Adding a new standard within the Medicare Conditions of Participation requiring HH agencies to develop, implement and maintain a patient acceptance to service policy that is applied consistently to each prospective patient referred for HH care.
  • Requiring long-term care facilities to report respiratory illness data as part of their infection prevention and control programs. The CMS proposes that facilities would electronically report weekly data on COVID-19, influenza and RSV in a standardized format through the National Healthcare Safety Network.
  • Requesting information on:
    • HH quality reporting program measure concepts under consideration for future years.
    • Future performance measure concepts for the expanded HH value-based purchasing model.
    • Rehabilitative therapists conducting the initial and comprehensive assessment.
    • Plan of care development and scope of services HH patient receive.

Members are encouraged to review the proposed rule and contact Vickie Kunz by Aug. 19 regarding issues. Comments are due to the CMS Aug. 26, 2024, and can be submitted electronically. The MHA will provide an estimated impact analysis in the near future.

Members with questions should contact Vickie Kunz at the MHA.