KHA s Current Report February 9, 2018

KHA s Current Report February 9, 2018 President's Perspective Recognizing Kim Moore's Contributions to Kansas Healthcare Allow me to take a few minutes this week to honor Kim Moore, who recently retired as the president of the United Methodist Health Ministry Fund. UMHMF was formed in 1986 by the Kansas West Conference (now Great Plains Conference) of the United Methodist Church. Since its founding, the Hutchinson-based health fund has invested more than $68 million in grants to improve the health of Kansans, with a special focus on the western two-thirds of the state. Since that time and until his retirement, the UMHMF had only one president Kim Moore. Many of you know Kim and his consistent support of healthcare in Kansas. What you may not know is prior to becoming the UMHMF president 30 years ago, Kim was a successful practicing attorney with the Foulston Siefkin law firm and also had distinguished himself by serving as law clerk for Judge Delmas C. Hill of the United States Tenth Circuit Court of Appeals. The legal system's loss was clearly a gain for access to healthcare in Kansas. It would take a book to review all of Kim's contributions to Kansas healthcare. It's not an exaggeration to state that many positive developments in Kansans' access to care can be traced to Kim's vision, passion and ability to analyze problems and see solutions. Our community health safety net is stronger; our recognition of the importance of oral health has grown; our awareness of the role of childhood toxic stress is increasing; the Kansas telemedicine network continues to develop; and support for innovation in rural healthcare delivery has never been greater all due, at least in part, to the leadership of Kim Moore. The Kansas Hospital Association recognized Kim's contributions when we awarded him the Donald A. Wilson Visionary Award in 2015. Luckily, Kim has not retired from his role as a board member of Hutchinson Regional Medical Center. We also are very fortunate that Kim will continue to serve on the KHA Board. Thank you, Kim, for everything you've done, and continue to do, for healthcare in Kansas. --Tom Bell

Bipartisan Legislation Passes Avoiding another Government Shut-Down A bipartisan deal that sets spending levels for fiscal years 2018 and 2019 was approved by Congress earlier this morning. The budget bill has many items sought for by health care interests. Extensions of the low-volume hospital adjustment and the delay of disproportionate share hospital cuts headline the list. Potentially harmful items like changing the payment structure for the use of swing beds at CAHs were avoided. Therapy caps were eliminated entirely, and the Children's Health Insurance Program received an additional four- year extension beyond the six years that passed last month. In general, the bill gives everyone certainty until Sept. 1, 2019. Sequestration continues to cause difficulties for hospitals and it went unaddressed except in the case of military spending, where the caps were lifted. While this is disappointing, we will continue to fight for the end of sequestration as it concerns hospital payments. Hopefully, voiding the caps for defense spending will be the first of many similar changes in federal budgeting over the next few years. The Kansas Hospitals Association thanks everyone who weighed in with our Kansas Congressional delegation members on this legislation. Toward that end, KHA will continue to keep our delegation informed about our positions on the various bills to stabilize the Affordable Care Act, fight for the 340B Drug Reimbursement Program and look for ways to engage Congress on new models of care for rural hospitals. --Chad Austin KDHE Healthcare Coalition Restructuring Plan As the Kansas Awardee for the National Hospital Preparedness Program, the Kansas Department of Health and Environment recently announced plans to restructure the Kansas healthcare coalitions. This plan impacts the current boundaries of all seven current regions resulting in the HCC regions no longer being aligned with hospital districts, EMS and trauma regions and many other already established regions. The new boundaries have the potential to disrupt existing working relationships among HCC members built over the years and could result in increased travel time and expenses. The plan also make changes in the fiscal administration of the HCC operations. The Kansas Hospital Association has provided a response to KDHE regarding this restructuring plan addressing our concerns and those of our members. In an effort to work more collaboratively with the HCCs and their members, KDHE has scheduled a conference call from 10 to 11 a.m. on Wednesday, Feb. 14, to include all HCC members who would like to participate. The purpose of this call will be to allow concerns to be heard and for the collection of any additional data to support a final decision. An agenda for the meeting will be provided early next week, along with a compiled list of all the data collected. The conference call number and a GoToWebinar link have been provided for anyone who would like to listen in. The GoToWebinar is for viewing of any supplemental documents. Call-in information: Conference call number: (866) 620-7326 Conference code: 9427100260 Webinar ID: 123-648-027 --Ron Marshall

Noon Briefing: An Overview of Qualis Health Feb. 22 Last year, the Kansas Department of Health and Environment awarded the contract for Medicaid fee-for-service, inpatient hospital utilization review services to Qualis Health, a Seattle-based company with a local office in Topeka. Effective July 1, 2017, Qualis Health assumed the function of performing Medicaid inpatient reviews, previously performed by the Kansas Foundation for Medical Care, Inc. Since the transition of inpatient reviews, Qualis Health also has requested records to review some hospital outpatient services, including emergency room services. Please join Kansas Hospital Association staff for a Noon Briefing on Thursday, Feb. 22, to learn more about the reviews being conducted by Qualis Health. In addition, participants will receive an overview of the Qualis Health provider portal, their process for requesting medical records, and an opportunity to ask questions. Please direct questions to the KHA Education Department at (785) 233-7436. --Hayley Finch-Genschorck KHA Discharge Data Submission Training Feb. 28 Current, reliable data for strategic and financial planning is critical to hospital leadership. The Kansas Hospital Association appreciates that need and offers a variety of data-related products and services to members. One of these is the inpatient and outpatient data collection program. KHA member hospitals submit inpatient and outpatient discharge data directly to the Hospital Industry Data Institute. HIDI is a data company within the Missouri Hospital Association and our primary data partner. Please join us at 10 a.m. on Wednesday, Feb. 28, for a review of the Kansas hospital inpatient and outpatient data submission process. Kevin Stock, HIDI programmer/analyst, will provide a review of the data submission process from the point of submission to reviewing Edit and Verification reports. A question and answer session will follow. This is an excellent opportunity for those responsible for submitting the data and for those that use the data (through Analytic Advantage) to support strategic planning and market share analysis. Understanding the data submission and editing process facilitates improvement in the quality of the data; thus, improving the quality of the KHA hospital reports. --Sally Othmer

Recognize Your Trustees on March 1-2 At the Critical Issues Summit, the Kansas Hospital Association's Trustee Recognition and Accountability Program annually recognizes trustees for the standards of excellence they uphold, governance best practices they adhere to, and the education in which they have invested. We encourage you to complete a Trustee Accountability and Recognition Program form to recognize your hospital and trustees specifically that: Understand and embrace the need for governance accountability; Govern according to a standard of excellence; Are willing to formally recognize their adherence to governance best practices; Embrace community accountability; and Structure their community benefit and outreach programs to meet identified community needs. Please complete a recognition form by Feb. 26 and send it to Cindy Samuelson by email or by fax to (785) 233-6955. --Cindy Samuelson Register Now for the Critical Issues Summit March 1-2 The Kansas Hospital Association is happy to announce the keynote speaker for the 2018 Critical Issues Summit for Hospital Boards will be Evan Benjamin, MD, MS, FACP, chief medical officer at Ariadne Labs, a joint center of health care innovation at Harvard School of Public Health and the Brigham and Women's Hospital in Boston. Dr Benjamin's presentation is entitled: Organizational Leadership for Care Transformation: Creating a Culture of Quality and Patient Safety. Hospital executives and boards face an increasingly complex environment in which to create and sustain a culture of quality and patient safety. A hospital board's interest and investment in better patient care is essential. In this session, participants will learn what the best hospitals and their boards do to improve quality and reduce patient harm. Participants will hear insights about characteristics of hospitals and their boards that have created organizational change resulting in clinical and operational breakthroughs. This year's summit will be March 1-2 at the Hyatt Regency Wichita. Please contact the KHA Education Department (785) 233-7436, if you have any questions. --Hayley Finch-Genschorck

Hotel Deadline Approaching for the Infection Prevention Conference March 8 Time is running out to reserve a room at the DoubleTree by Hilton Wichita Airport and receive the special rate for this year's Infection Prevention Conference. KHA has reserved a block of rooms for the night of March 7 at the rate of $114, plus tax. The hotel room block will be available until Feb. 15. After that, reservations will be taken on a space-available basis. Call (316) 945-5272 and ask for the Kansas Hospital Association room block to receive the special rate. The Infection Prevention Conference will prepare infection preventionists to be facilitators and provide resources for assessing, reporting and providing stewardship in the realm of infection prevention in multiple settings. Attendees will receive an overview of infection prevention, information about preparing for state surveys and ways to leverage resources in infection prevention. The course is designed for experienced professionals, as well as those new to the specialty. Please direct questions to Jared Martin, KHA Education Department at (785) 233-7436. --Hayley Finch-Genschorck Top Five Tax Reform Provisions Affecting Tax-Exempt Health Care Providers The Tax Cuts and Jobs Act includes numerous provisions that will affect tax-exempt health care providers. BKD has provided a list of things hospitals need to know. The Tax Cuts and Jobs Act represents one of the most significant revisions to the Internal Revenue Code in more than 30 years. Many provisions took effect Jan. 1, 2018, and the Tax Cuts and Jobs Act will affect virtually all U.S. taxpayers. Tax-exempt health care providers are no exception. View the full article on the top five tax reform provisions that will affect a significant number of tax-exempt health care providers online. You'll find a brief overview of each provision and see a consistent theme that additional guidance is needed in several areas. 1. Separate Tracking of Unrelated Trade or Business Activities 2. UBTI Increased by the Amount of Certain Fringe Benefits 3. Excise Tax on Excess Tax-Exempt Organization Executive Compensation 4. Modification of NOL Deduction 5. Reduction in the Corporate Tax Rate If you have questions about tax reform, please contact Jason Barb, Joe Watt or another trusted BKD advisor. --Cindy Samuelson

MIPS Reporting Deadlines Fast Approaching: 10 Things to Do and Know Deadlines are fast approaching if you plan to submit data for the 2017 Merit-based Incentive Payment System performance period. Don't wait until the last minute to submit your data. Submit early and often. The two key dates are: March 16 at 7 p.m. for group reporting via the CMS web interface March 31 for all other MIPS reporting, including via qpp.cms.gov Now is the time to act. Here are the top 10 things you need to do and know if you are an eligible clinician. This list focuses on reporting via the qpp.cms.gov data submission feature, not on group reporting via the CMS Web Interface and not on individual reporting on Quality measures via claims submission data. Note: If you're not sure if you are required to report for MIPS, enter your National Provider Identifier in the MIPS Lookup Tool to find out whether you need to report. Additionally, if you know you are in a MIPS APM or Advanced APM, you can use the APM Lookup Tool. Visit qpp.cms.gov and click on the "Sign-In" tab to use the data submission feature. Check your data to assure you are ready to submit. You can submit data for the Quality, Improvement Activities, and Advancing Care Information performance categories. Have your CMS Enterprise Identity Management credentials ready, or get an EIDM account if you don't have one. An EIDM account gives you a single ID to use across multiple CMS systems. Sign in to the Quality Payment Program data submission feature using your EIDM account. Begin submitting your data early. This will give you time to familiarize yourself with the data submission feature and prepare your data. The data submission feature will recognize you and connect your NPI to associated Taxpayer Identification Numbers. Group practices: 1. A practice can report as a group or individually for each eligible clinician in the practice. You can switch from group to individual reporting, or vice versa, at any time. 2. The data submission feature will save all the data you enter for both individual eligible clinicians and a group, and CMS will use the data that results in a higher final score to calculate an individual MIPS-eligible clinician's payment adjustment. 3. You can update your data up to the March 31 deadline. The data submission feature doesn't have a "save" or "submit" button. Instead, it automatically updates as you enter data. You'll see your initial scores by performance category, indicating that CMS has received your data. If your file doesn't upload, you'll get a message noting that issue. 4. You can submit data as often as you like. The data submission feature will help you identify any underperforming measures and any issues with your data. Starting your data entry early gives you time to resolve performance and data issues before the March 31 deadline. 5. For step-by-step instructions on how to submit MIPS data, check out this video and

If you are in an ACO or other APM, make sure you are working with your ACO or APM to make sure they have any patient information they need to report. Remember, you need to report on Advancing Care Information measures on your own. Questions about your participation status or MIPS data submission? Contact the Quality Payment Program Service Center by: Email: qpp@cms.hhs.gov Phone: (866) 288-8292 (TTY: (877) 715-6222 --Karen Braman Save the Date Summit on Quality Mark your calendars and plan to attend the Summit on Quality, Friday, May 4, at the Hyatt Regency Wichita. The Kansas Healthcare Collaborative and the Kansas Foundation for Medical Care, Inc. will jointly host the Tenth Annual Summit on Quality. The program is designed specifically to educate Kansas physicians and health care professionals. Registration will be available mid-march. A block of rooms has been reserved at the Hyatt Regency Wichita for the evening of Thursday, May 3, at the rate of $125 plus tax. Call (316) 293-1234 and ask for the Kansas Healthcare Collaborative room block for the Summit on Quality to receive the special rate. The hotel cutoff date is April 11, 2018. --Hayley Finch-Genschorck Tips for Registering Online for KHA Events The Kansas Hospital Association is pleased that many of you are registering for KHA events online. Registering online for KHA events is easy; however, we're providing these helpful tips to make your registration experience better: To register for an educational event, click on "Education" and "Register Online" or go directly to https://registration.kha-net.org. After you type in the required fields (first name, last name and email address), please look for typographical errors before continuing because the automatic registration confirmation will be sent to the email address provided. Also, your name and contact information will be added into a new record if they don't match the record we already have in our system. Click only once on the "Process Card" button to avoid any duplicate charges. Note: If you get an error message, please contact KHA right away. KHA will refund any duplicate charges; however, we are trying to alleviate any unnecessary processing. If you have questions and/or if you are unable to register, please contact our KHA Education Department at (785) 233-7436. --Cheryl Carson

Federal Focus CDC: Flu Hospitalization Rate Highest Since 2009-2010 The flu hospitalization rate rose last week to 51.4 per 100,000 people, the highest rate for this point in the year since the Centers for Disease Control and Prevention began enhanced surveillance of laboratory-confirmed flu hospitalizations during the H1N1 flu pandemic in 2009-2010, CDC Acting Director Anne Schuchat, MD, said at a news briefing this week. The H3N2 strain predominant this flu season has been associated in past years with more hospitalizations and deaths in older adults and young children. Nearly 14,700 flu hospitalizations and 53 flu-associated pediatric deaths have been reported so far this season. If the current hospitalization rate continues, the 2017-2018 flu season could exceed the 710,000 hospitalizations for the 2014-15 flu season, said Dan Jernigan, MD, director of the CDC's Influenza Division. In other news, Food and Drug Administration Commissioner Scott Gottlieb, MD, last week said the agency is working with several manufacturers to ramp up production of empty intravenous containers to help hospitals mitigate the shortage of IV saline for flu and other patients. CDC recommends treating all hospitalized, severely ill and high-risk patients who have suspected or confirmed influenza with antiviral medications as soon as possible. The agency also continues to recommend flu vaccination for everyone aged 6 months and older, since flu viruses are likely to continue circulating for weeks. MLN Connects Provider enews Available Updates to MLN Connects Provider enews were issued by the Centers for Medicare & Medicaid Services. enews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following: Patients over Paperwork: January newsletter Merit-Based Inventive Payment System: Call for advancing care information measures and improvement activities Long-Term Care Hospital quality reporting program: Materials for December training Home health review and correct report: Correction NHSN Requires Updated Consent Forms The Jan. 30 release of the National Health Safety Network 8.8.1 application introduced an updated Agreement to Participate and Consent for current NHSN facility users who enrolled in NHSN before Dec. 2, 2017. Facilities that enrolled in NHSN on or after Dec. 2 already have accessed this new consent form and will not need to accept it again if they have already done so. Primary contacts or facility administrators should agree to this updated consent form for each component by April 14, or risk losing access to NHSN. An alert appears on all NHSN component home pages, and facility administrators and primary contacts received an email notification. Additional information, including FAQs and the updated NHSN Purposes and Assurance of Confidentiality, is available on the CDC NHSN website. Questions may be referred to NHSN@cdc.gov with the subject line "NHSN Re-consent."

CMS Announces VBP Webinar An outreach and education webinar for participants in the Hospital Value-Based Purchasing Program is scheduled at 1 p.m. Tuesday, Feb. 20. Registration is required for the webinar, Hospital Value-Based Purchasing Program: Overview of the Fiscal Year 2020 Baseline Measures Report. CMS Releases HQRP, HIS and Hospice CAHPS FY 2020 Requirements The Centers for Medicare & Medicaid Services released documents containing details about the fiscal year 2020 hospice quality reporting program. The HQRP consists of the Hospice Item Set and the Hospice Consumer Assessment of Healthcare Providers and Systems. TJC Releases Specifications Manual Version 2018A Specifications Manual for Joint Commission National Quality Measures, version 2018A, is available on The Joint Commission Performance Measurement System Extranet Track. The manual is effective for discharges from July 1 through Dec. 31. Report Charts Distribution of High-Cost Enrollees in Commercial Insurance Plans The Health Care Cost Institute issued a short report on the enrollees and services that generate a disproportionate share of spending in commercial health insurance plans. The assessment spans from 2012 to 2015 and encompasses more than 9 million enrollees under age 65. The top 5 percent of spenders generated more than 50 percent of spending in each year studied, but there was considerable turnover among them. CMMI Cancels Beneficiary Engagement Model The Centers for Medicare & Medicaid Innovation Center announced the cancellation of the Direct Decision Support Model. The model was established to test whether engaging Medicare beneficiaries about their overall health and specific clinical conditions outside the clinical care setting would have a positive impact on decision making, utilization and cost of care. CMS Releases Overview and Upcoming Events for BPCI Advanced The Centers for Medicare & Medicaid Services published a fact sheet about the Bundled Payments for Care Improvement Advanced. The fact sheet includes an overview of the program, key milestones and dates, key stakeholders, and details about how the program will be structured. CMS also has released recordings and upcoming events about BPCI Advanced, including the following: BPCI Advanced open door forum 11 a.m. Thursday, Feb. 15 Webcast overview of the BPCI Advanced Model and Application Process BPCI Advanced request for applications HQRx News Blast Available The Hospital Quality Reporting News Blast includes an update on the transition to the new Medicare cards. HRSA Offers NURSE Corps Loan Repayment Program The Health Resources & Services Administration's NURSE Corps Loan Repayment Program offers loan repayment assistance to registered nurses, nurse practitioners, advanced practice nurses and nursing school faculty who agree to work in underserved areas. HRSA encourages interested applicants to read the application instructions, which are available on the program website.

2019 Medicare Advantage Plans Proposed 1.84 Percent Increase in Payments The Centers for Medicare & Medicaid Services released the 2019 Medicare Advantage and Part D Advance Notice Part II and Draft Call Letter. Within the notice, CMS is proposing to increase payments to Medicare Advantage companies by 1.84 percent, up from 0.45 percent in 2018. After coding adjustments, the increase amounts to 3.1 percent. CMS also proposed payment and policy changes for the Part D program and includes important new steps to ensure new patientdoctor-plan communication in combatting the opioid crisis. Comments on the proposals must be submitted by Monday, March 5. The final 2019 rate announcement and final call letter will be published Monday, April 2. CMS Releases Hospital Compare Preview Reports The Centers for Medicare & Medicaid Services released April 2018 Hospital Compare preview reports for participating hospitals. CMS encourages hospitals to access and download reports early in the preview period to have time for a thorough review. The preview reports are only available during the preview period, which ends Friday, March 2. The data in the preview reports will be reported on Hospital Compare.