IHA Daily Briefing: June 6

Wednesday, June 6, 2018

Wilhelmi Talks About the "Future of Medicaid"
MAPS PSO Honors Morris Hospital Patient Safety Champion
IHA Offers Best-in-Class Utilization Review Course
Register Today: Small & Rural Meeting is June 20-21
Briefly Noted

Wilhelmi Talks About the “Future of Medicaid”
IHA President and CEO A.J. Wilhelmi participated in a panel discussion this morning on “The Future of Medicaid in Illinois” at MATTER in Chicago. Sponsored by Health News Illinois, Wilhelmi was joined by Illinois Reps. Greg Harris, D-Chicago and Tom Demmer, R-Rochelle; Stephanie Altman, senior director of policy, Sargent Shriver National Center on Poverty Law; and Samantha Olds Frey, executive director, Illinois Association of Medicaid Health Plans.

Wilhelmi thanked Reps. Harris and Demmer and their colleagues on the bipartisan Legislative Medicaid Work Group for their collaboration with IHA and other stakeholders in many meetings and discussions since last September to develop legislation (Senate Bill 1773) on the redesigned Hospital Assessment Program to preserve $3.5 billion in funding so hospitals can continue to care for their patients and communities and to help hospitals evolve their business and healthcare delivery models with transitional funding support.

During the discussion, Wilhelmi said, “There’s room for improvement across the board” for Medicaid managed care. He noted that the high rate of claims denials is unacceptable and called for more transparency and standardization with the processing of claims.

Other panelists chimed in on other important issues to be addressed in the Medicaid program, including: increasing provider rates to adequate levels, especially related to services for mental health and substance use disorders and access to specialists; boosting telehealth utilization; promoting more innovation and flexibility in the Medicaid program; addressing social determinants of health to improve well-being and quality of life for Medicaid beneficiaries; and expanding healthcare services for beneficiaries beyond “traditional” Medicaid services.


MAPS PSO Honors Morris Hospital Patient Safety Champion
The lead physical therapist at Morris Hospitals & Health Centers was recognized for her work to improve patient safety at a ceremony today in Naperville. Valerie Skroch received the Patient Safety Champion award from the Midwest Alliance for Patient Safety (MAPS) Patient Safety Organization (PSO), an IHA company.

The MAPS PSO committee selected Skroch because of her efforts to improve patient safety organization-wide. She is a part of Morris Hospital's Safe Patient Handling Committee and works on its Fall Tips Project. Skroch has been involved in selecting the organization's new fall risk assessment tool, updating its fall prevention policy and developing a safe patient handling policy.

"Valerie’s resiliency and attention to small signals have resulted in risk reduction and improved safety for patients and staff," said Carrie Pinasco, MAPS PSO program director.

Skroch took action after learning of two recent safety events—a patient fall and an employee back strain from patient handling. Skroch went on rounds and visited patient rooms to understand why the events occurred, finding that gait belts were not available in some rooms. Skroch installed the missing belts and followed up with the Safe Patient Handling Team to ensure all staff had appropriate training on using gait belts and other lift equipment.

The events prompted Skroch to help Morris Hospital become a minimal-lift facility and adopt evidence-based practices to improve patient outcomes. To minimize the risk of patient falls, she formed a multidisciplinary team to develop an evidence-based best practice for early mobility of ventilated patients.

MAPS PSO, federally certified since 2010, assists members with the important work of reducing adverse events so they can provide a safer healthcare experience for their patients. As part of its commitment to member excellence, MAPS PSO established the Patient Safety Champion Program to reward "good catches" at member facilities. Learn how your organization can improve care with MAPS PSO.

For photos of the Patient Safety Champion award recipient and the MAPS Culture of Safety Workshop, see check out Twitter #MAPSCultureSafety.


IHA Offers Best-in-Class Utilization Review Course
Although hospitals have long been required to verify the appropriate utilization of Medicare and Medicaid services, in recent years, the federal government has moved to recover billions of dollars for healthcare services it asserts were improperly furnished. This summer, strengthen your utilization review (UR) and compliance efforts with help from IHA. Join peers from throughout Illinois for HCPro Medicare Boot Camp® - Utilization Review Version, an intensive two-day program led by a nationally recognized leader in healthcare regulation and compliance.

This course, held in Naperville on Aug. 23-24, will examine patient status and UR within the larger context of Medicare rules for coverage, billing, coding and payment. Participants will learn how to maintain regulatory compliance by understanding complex federal rules and appropriately managing patient status.

In addition to the latest Medicare UR requirements, participants will learn how to implement changes to the 2018 inpatient-only list and coverage determinations that affect coverage of cases meeting the two-midnight benchmark.

Learn more about the agenda, expert faculty, fees, and continuing education credits. Among other departments, the program's insights will benefit staff involved with UR, nursing, compliance, and revenue cycle.

Don't wait to reserve your place: Sign up today!


Register Today: Small & Rural Meeting Is June 20-21
Don't miss the 2018 IHA Small & Rural Hospitals Annual Meeting, ALL IN: A Passion for Rural Healthcare. Small and rural hospital and health system leaders, board members and emerging leaders are encouraged to attend this year's meeting on June 20-21 at the Bank of Springfield Center—just two weeks away.

The meeting will feature:

  • National healthcare governance expert Pam Knecht leading two sessions on developing strong boards;
  • Experts from The Advis Group in Mokena offering strategies for the 340B Drug Pricing Program;
  • Executive Coach Bob Berk addressing the leader's role in times of great change and disruption; and
  • Researcher Ron Galloway tackling the "disruptors" in healthcare—Amazon, Google and Apple—and how hospital leaders can respond.

Benjamin Anderson, chief executive office of Kearny County Hospital in Lakin, Kansas, will deliver the keynote address, "An Ethical Case for Excellence in Healthcare Delivery," on June 20. He'll explore the fatalism common in rural communities and the essential steps hospital leaders can take to achieve effective, sustainable reform.

The meeting will wrap up midday on June 21 with an inspiring session led by Dale Smith Thomas, founder and president of Winners By Choice Inc. She'll present fundamental principles to create "your winning edge" in all areas of your life.

For 2018, we've reduced registration fees for full meeting attendance, with 50 percent off for board members. Register today.


Briefly Noted
Yesterday, the Centers for Medicare & Medicaid Services (CMS) released its report on Medicaid Expenditures for Long-Term Services and Supports (LTSS) for federal fiscal year (FY) 2016.  Federal and state spending on Medicaid LTSS totaled approximately $167 billion in FY 2016, a 4.5 percent increase from $159 billion in FY 2015.