IHA Daily Briefing: Feb. 9

Friday, February 9, 2018

IHA Advocacy Alert: Support Hospital Assessment Redesign
Budget Deal Reached, Funded Until March 23
CDC: Asthma Attacks Decline in Children
Attend the Conference on Enterprise Excellence
Briefly Noted

IHA Advocacy Alert: Support Hospital Assessment Redesign
Legislation strongly supported by IHA, Senate Bill 1773, to reauthorize the Hospital Assessment Program, has been introduced in the General Assembly.  The Illinois House and Senate may begin taking action on the bill as soon as Tuesday, February 13.

IHA members—Meet with or talk to your state Senator and Representative and urge them to support and vote Yes on Senate Bill 1773 to continue the Hospital Assessment Program. It is critical that legislators hear from you about the importance of this program and the urgent need to pass legislation as soon as possible. Look up your local legislators and their contact information and fill in the “Find Officials” box.

See IHA’s alert for more details, including talking points. A fact sheet and “Illinois is Getting Shortchanged” map/chart (showing Illinois is 50th in the U.S. in federal support per Medicaid beneficiary) are also available for your advocacy efforts.

While meeting with or calling your legislators is the most effective approach, you may also send them an email message.


Budget Deal Reached, Funded Until March 23
Early this morning, the U.S. House and Senate passed a budget deal to end a five-and-a-half-hour government shutdown. The Senate voted 71-28 and the House passed it 240-186. President Trump signed the legislation that funds the federal government through March 23.

Of interest to hospitals, the legislation:

  • Extends funding for the Children’s Health Insurance Program for an additional four years on top of the six years included in the last continuing resolution, through fiscal year (FY) 2027;
  • Extends for five years, through FY 2022, the enhanced Low-Volume Adjustment Program, which expired Sept. 30, 2017. However, the legislation changes the program so that, for FYs 2019 through 2022, the add-on payment will be a sliding scale adjustment ranging from 25 percent for low-volume hospitals with total discharges of 500 or fewer, to no adjustment for hospitals with more than 3,800 total discharges. The legislation also requires a study to examine payments made under the program;
  • Extends for five years, through FY 2022, the Medicare-dependent Hospital Program, which expired Sept. 30, 2017, and requires a study to examine payments made under the program;
  • Extends the 2 percent urban and 3 percent rural ambulance add-on payment for five years through calendar year (CY) 2022. It also extends the “super rural” add-on through CY 2022;
  • Reinstates the add-on for rural home health agencies through 2022, the amount of which would be based on the population of the county in which the agency is located.  It also limits the market basket increase for all home health agencies to 1.5% in FY 2019.
  • Delays $5 billion in Medicaid Disproportionate Share Hospital reductions scheduled for FYs 2018 and 2019;
  • Amends the Health Information Technology for Economic and Clinical Health Act to remove the mandate that meaningful use standards become more stringent over time;
  • Includes $6 billion in additional funding for combatting the opioid epidemic;
  • Includes $4.9 billion in additional Medicaid funding for Puerto Rico and the U.S. Virgin Islands;
  • Repeals the Independent Payment Advisory Board;
  • Eliminates a geographic requirement under Medicare for the use of telehealth services for stroke patients, beginning in January 2019;
  • Permanently repeals the Medicare payment caps for outpatient physical, speech language and occupational therapy services beginning Jan. 1, 2018 and lowers the threshold for targeted manual medical review to $3,000 from $3,700. The legislation also reduces payments for physical or occupational outpatient therapy services provided on or after Jan. 1, 2022 to 85 percent of the otherwise applicable Physician Fee Schedule amount in certain circumstances;
  • Extends funding for Community Health Centers for two years;
  • Reduces payments to hospitals beginning in FY 2019 when a hospital discharges a patient to hospice care early in their stay, similar to the Centers for Medicare & Medicaid Services’ post-acute care transfer policy; and
  • Reduces the annual update to the conversion factor for the physician fee schedule for CY 2019 from 0.5 percent to 0.25 percent.

In addition, the spending deal raises the debt ceiling and sets spending levels for the next two years, raising defense and domestic spending by approximately $300 billion. It also includes about $90 billion in disaster relief funding for areas hard hit last year by hurricanes and wildfires.


CDC: Asthma Attacks Decline in Children
According to a new Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC), children with asthma in the U.S. are having fewer asthma attacks, missed school days and visits to the hospital. Still, asthma remains the most common chronic lung disease of childhood, affecting approximately six million children in the U.S. Using data from the 2001–2016 National Health Interview Survey for children aged 0–17, the report finds that:

  • More children with asthma are getting asthma action plans and being taught how to recognize the symptoms of an asthma attack and respond quickly;
  • Boys, children ages 5-17 years, non-Hispanic black children, children of Puerto Rican descent, and children from low-income families are more likely to have asthma;
  • The percentage of children with asthma who experienced one or more asthma attacks in the preceding 12 months declined from 61.7 percent in 2001 to 53.7 percent in 2016;
  • In 2016, asthma attacks were most common among children 4 years old and under;
  • Asthma hospitalizations for children with asthma declined from 9.6 percent in 2003 to 4.7 percent in 2013; and
  • In 2016, one in six children with asthma visited the emergency department, and about one in 20 were hospitalized.

To help prevent asthma attacks, the CDC report recommends doctors, nurses and other healthcare providers:

  • Work with children and parents to determine the severity of each child’s asthma, develop an action plan for each child and share the plan with families, schools and others;
  • Teach children and parents how to manage asthma by using control and rescue medicine properly and avoiding asthma triggers such as tobacco smoke, mold, pet dander, and outdoor air pollution; and
  • Work with community health workers, pharmacists and other community providers to help ensure that children with asthma receive needed services.

For more information, see CDC’s press release and childhood asthma website.


Attend the Conference on Enterprise Excellence             
IHA is partnering with IMEC and the ILPEx Recognition Program at the 2018 Conference on Enterprise Excellence and ILPEx Awards for Excellence dinner on Feb. 22 in Oak Brook. This conference will feature recognized leaders from a variety of industries in Illinois, including healthcare, who have used the Baldrige Excellence Framework to lead their teams and organizations to high performance in the areas of leadership, strategy, customer engagement, operations, workforce, and technology.

For more information, see the conference agenda and a related press release. Register online.


Briefly Noted
The Illinois Department of Healthcare and Family Services announced on its website that the Centers for Medicare & Medicaid Services has approved an increase the current Hospital Access Payments to account for those persons that are newly eligible under the Affordable Care Act. Calculation and payment information is available.

The Centers for Disease Control and Prevention has released its flu surveillance report for week 5 (Jan. 28 – Feb. 3). Illinois is one of 43 states still experiencing high flu activity.