IHA Daily Briefing: Sept 10

Thursday, September 10, 2020 
HFS Launches MCO Claims Submission Pipeline
IHA CEO Member Survey
CMS Integrates Care Compare Tools
IHA Webinar Series on SDoH Screening Programs
OAG Training: Sexual Assault Patient Care in the ER
PRF Distribution Summary
State, National, Global COVID-19 Updates
Briefly Noted

HFS Launches MCO Claims Submission Pipeline 
Earlier this month, the Illinois Dept. of Healthcare and Family Services (HFS) began a phased-in launch of its new claim rejection and denial management system, which will provide the agency with real-time data on hospital claim submissions and Managed Care Organization (MCO) payment determinations. IHA advanced this claims “pipeline” as part of last year’s Medicaid managed care reform legislation (SB1322/PA101-0209) to allow for greater oversight of MCO denials.

Since the pipeline operates entirely behind the scenes, hospitals do not need to make any changes to their claim submission processes. 

Claims submitted to the MCOs are scheduled to begin running through the pipeline as follows:

  • Sep. 1 – Blue Cross Community Options

  • Oct. 1 – MeridianHealth

  • Nov. 1 – Molina Healthcare and CountyCare Health Plan

  • Dec. 1 – Aetna Better Health (legacy IlliniCare Health)

For more information, see IHA’s memo.



IHA CEO Member Survey
What challenges does your hospital or health system face? What issues are most important to you? Your response to the IHA’s annual CEO Member Survey is important to us. On Tuesday, a reminder was sent to CEOs who have not completed the survey from Anne Stilwell, Director, Member Relations and Tim Nuding, Senior Vice President, Member Services and Corporate Finance.

Please take the time to share your views with IHA so we can best serve the needs of all our member hospitals and health systems. During this unprecedented time, IHA is focused on supporting you as your organization responds to the pandemic and continues to serve your patients and communities. It is more important than ever that we hear from you in our annual survey.

The survey will be open until September 18. 



CMS Integrates Care Compare Tools
The Centers for Medicare & Medicaid Services (CMS) has launched Care Compare, a streamlined redesign of eight existing CMS healthcare compare tools. CMS says the integrated site will help patients and caregivers “make informed decisions about health care based on cost, quality of care, volume of services, and other data” on doctors, hospitals, nursing homes, and other healthcare services.

“President Trump has long recognized that a free and vibrant health care market is one in which patients have what they need to make informed decisions based on cost and quality,” said CMS Administrator Seema Verma. “By aggregating all eight of CMS’ quality tools into a single interface, patients can easily research different providers and facilities before they entrust themselves to their care.”

As an example, CMS notes that someone who is planning to have bypass surgery would have needed to visit Hospital Compare, Nursing Home Compare, and Home Health Compare individually to research providers for the different phases of their surgery and rehabilitation. Now, that patient can start her/his search at Care Compare to find and compare providers that meet her/his healthcare needs that includes information about quality measures presented similarly and clearly across all provider types and care settings.

CMS says it has also made improvements to other CMS data tools to help Medicare beneficiaries compare costs:

  • Procedure Price Look Up tool now includes physician fees in addition to facility fees, aimed at providing a more accurate prediction of out-of-pocket costs for Medicare beneficiaries; and

  • Provider Data Catalog better serves innovators and stakeholders who are interested in detailed CMS data and use interactive and downloadable datasets.



IHA Webinar Series on SDoH Screening Programs
Americans living in rural areas are more likely to smoke cigarettes and less likely to use seatbelts, according to a 2019 report from the Centers for Disease Control and Prevention. Such social determinants of health (SDoH) have a huge impact on health outcomes, but screening programs can help.

Social Determinants of Health Screenings for Small and Rural Hospitals,” a three-part IHA webinar series in October, will demonstrate how your hospital or health system can partner with community organizations to address the SDoH affecting your patients.

The webinars will take place from noon to 1 p.m. on the following dates:

  • Oct. 8: Impact of SDoH on health outcomes, implementation of a SDoH screening program and gap analysis
  • Oct. 14: Gap analysis tool review, shared learnings, best practices and action planning
  • Oct. 21: Review action planning, implementation testimonial

Quality and safety experts will lead this interactive program, complimentary to IHA members. Organizations with existing SDoH programs will also share their experiences and best practices for improving outcomes.
Case managers, social workers, discharge planners and emergency department leaders are encouraged to attend. Visit our registration page to view the full agenda and to register. 



OAG Training: Sexual Assault Patient Care in the ER
The Illinois Office of the Attorney General (OAG) is offering a “Foundation to Provide Sexual Assault Patient Care in the Emergency Room” webinar, focusing on best practice guidelines for the medical forensic approach to the care of sexual assault patients. The webinar will take place on Tuesday, Sept. 29 from 9 a.m. to 3 p.m., and is designed to improve the response to sexual assault patients, but will not count toward SANE training.
Registration is required by Wednesday, Sept. 23. Because space is limited, early registration is encouraged. To apply to attend this free training, complete the application – click here – and return it via email at sane@atg.state.il.us. For assistance with enrollment, contact Theresa Geary at 1-866-376-7215 (TTY: 1-800-964-3013) or sane@atg.state.il.us.



PRF Distribution Summary
Today, IHA posted a summary of monetary distributions to providers from the Provider Relief Fund (PRF) since April. This summary provides member hospitals and health systems a high-level overview of distribution timing, eligibility and payment formulas. As additional funds are distributed, IHA will update this document, which is posted on IHA’s COVID-19 webpage under Federal Updates.



State, National, Global COVID-19 Updates
The Illinois Dept. of Public Health (IDPH) announced today 1,953 new COVID-19 cases and 28 deaths. The total number of cases in the state is 255,643 in 102 counties, with a total of 8,242 deaths. IDPH says that in the past 24 hours, 48,982 test specimens have been processed, with a positivity rate of 3.99%. The preliminary seven-day statewide positivity rate from September 3 to September 9 is 3.8%. Statewide COVID-19 hospitalizations in the past 24 hours increased from 1,580 patients to 1,609 patients. Of that figure, 346 patients were in the ICU, with 141 patients on ventilators.

Today’s Centers for Disease Control and Prevention (CDC) figures show more than 6.34 million confirmed and presumptive positive cases of COVID-19 in the U.S., with 190,262 deaths.

Today’s WHO Coronavirus Disease Dashboard shows more than 27.7 million COVID-19 cases globally, with more than 899,000 deaths. The Region of the Americas (includes the U.S.) continues to lead the world with more than 14.3 million cases and more than 498,000 deaths.


Briefly Noted
The Chicago City Council yesterday passed an ordinance banning the sale of flavored vaping products in the city – specifically targeting flavored liquid nicotine products that create the taste or aroma of, among other things, menthol, mint, wintergreen, chocolate, vanilla, cocoa, or candy or dessert.

As expected, U.S. Senate Democrats this afternoon blocked a narrow, $500 million COVID-19 legislative proposal from Senate Republicans. The mostly party-line vote of 52-47 was short of the 60 votes needed to overcome a filibuster and likely ends the prospect of a COVID-19 relief bill passing Congress before the November election.