IHA Daily Briefing: June 3

Monday, June 3, 2019
IHA Issues End of Session Report
Supreme Court Sides with Hospitals on Medicare DSH
Cancer Mortality Falls, Incidence Rises In Women
Free IHA Webinar: Learn How to Address Staff Turnover

IHA Issues End of Session Report
Earlier today, IHA sent members a special report on the Illinois General Assembly’s spring session, which ended Sunday evening, two days beyond the regularly scheduled adjournment date.

The report highlights the outcomes of the key issues for IHA and the hospital community, including:
Comprehensive Medicaid managed care reforms;

  • An FY2020 state budget with no Medicaid cuts, but with $3 million for the Illinois Poison Center and $1.2 billion in bonding to reduce the state’s backlog of unpaid bills;
  • No nurse staffing ratios;
  • $200 million Hospital and Healthcare Transformation Capital Investment Grant Program;
  • 5-year extension of the nonprofit hospital sales tax exemption;
  • $55 million correction in Critical Access Hospital assessment rates; and
  • Compromise legislation on changes in Certificate of Need and Certificate of Exemption processes.

In addition, IHA successfully opposed or favorably modified many bills that would have imposed onerous burdens or requirements on hospitals and health systems. For example, bills that would have required metal detectors at all hospital entry points did not advance; IHA helped shape a package of bills concerning maternal and infant health and mortality.

IHA greatly appreciates the strong support and advocacy of our members that enabled IHA and the hospital community to work through the many critical issues addressed during the legislative session. That includes the outstanding response to our many calls to action on Medicaid managed care, with members sharing their stories that showed the urgent need for legislative action to address the MCOs’ most abusive practices—and on nurse staffing ratios, contacting and meeting with legislators many times to explain why ratios would be harmful to patients and healthcare. On the nurse staffing ratios issue alone, members filed more than 1,600 witness slips and sent more than 6,000 emails to legislators opposing ratios.

The General Assembly will return to Springfield for its fall Veto Session on Oct. 28-30 and Nov. 12-14.


Supreme Court Sides with Hospitals on Medicare DSH
In a 7-1 decision (Justice Brett Kavanaugh recused), the U.S. Supreme Court ruled today that the Department of Health and Human Services (HHS) improperly changed the formula used to calculate disproportionate hospital share (DSH) payments, resulting in billions in cuts to hospitals. The case was brought by Allina Health Services, which claimed HHS failed to use the notice-and-comment rulemaking process required to make such significant changes. The decision, which encompasses federal fiscal years from 2005 through 2013, could affect between $3 and $4 billion in Medicare payments to hospitals.

At issue were changes included in both a 2004 final rule and re-adopted in a 2013 rule for calculating Medicare DSH payments to hospitals. Those final rules stipulated that inpatient days attributable to Medicare Advantage patients must be included in the Medicare DSH calculation because those patients were “...entitled to benefits under Medicare Part A.” Inclusion of those patient days in the denominator of the Medicare Supplementary Security Income (SSI) DSH calculation fraction reduces a hospital’s Medicare DSH ratio and consequently, its Medicare DSH payment amount. Because CMS attempted to implement this policy without going through the formal rulemaking and comment process. Allina sued HHS, making the argument that the significant changes to the Medicare DSH program such as this violated the Administrative Procedures Act, which requires the use of notice-and-comment rulemaking. The Supreme Court affirmed the decision reached by the Court of Appeals.

IHA is reviewing the ramifications of this decision on its members and will send out more information in the coming days as it becomes available.


Cancer Mortality Falls, Incidence Rises In Women
Deaths due to all cancers fell 1.8% per year among men and 1.4% per year among women between 2012 and 2016, according to the National Cancer Institute’s 2019 annual report.

The latest Annual Report to the Nation on the Status of Cancer also addresses the rate of new cancers among adults ages 20 to 49, showing a:

  • 2.1% annual decrease in incidence among men between 2011 and 2015; and
  • Stable incidence rate among women during the same time frame.

The average annual incidence rate for all invasive cancers in the defined age group was 115.3 per 100,000 men, compared with 203.3 per 100,000 women from 2011 to 2015.

Both incidence and mortality rates were higher in women—with incidence rates rising—in the defined age group. Cancer incidence rates increased 1.3% per year among women while decreasing 0.7% per year among men between 2011 and 2015. The cancer death rate was 27.1 per 100,000 women and 22.8 per 100,000 men between 2012 and 2016.

The most common cancers and their incidence rates among women were:

  • Breast (73.2 per 100,000 women);
  • Thyroid (28.4); and
  • Melanoma of the skin (14.1).

The most common cancers and their incidence rates among men were:

  • Colon and rectum (13.1);
  • Testis (10.7); and
  • Melanoma of the skin (9.8).

The full report, shareable resources and key points are available online. See the press release on the report.


Free IHA Webinar: Learn How to Address Staff Turnover
In a demanding industry like healthcare, fluctuating staff needs and turnover are common challenges. Find out how your organization can efficiently meet staffing needs during a complimentary IHA webinar on July 16.

IHA Strategic Partner FocusOne Solutions is hosting Solutions for Today’s Healthcare Staffing Challenges to introduce a staffing strategy many hospitals have adopted: working with a managed services provider (MSP).

From 10 to 11 a.m., FocusOne business development executives Courtney Dobernecker and Dan Nordstrom will explore the benefits of using an MSP, including:

  • Maintaining direct oversight of hiring, while the MSP handles onboarding and management of staff;
  • Placing candidates in difficult-to-fill roles; and
  • Leveraging the expertise of the MSP to improve your hiring strategies.

FocusOne has a proven track record of helping hospitals in Illinois, as well as nationwide. Drawing on nearly 30 years of combined experience, Dobernecker and Nordstrom will provide valuable solutions you can apply to avoid spending excessive time on staffing—while acquiring high-quality personnel and controlling your labor spend.

The following hospital leaders are encouraged to attend:

  • CEOs, CFOs and CNOs;
  • Vice Presidents and Directors of Human Resources; and
  • Vice Presidents of Patient Care Services.

Register today.