IHA Daily Briefing: Sept. 13

New Sexual Assault Treatment Requirements
Report: Uninsured Rate Remained Steady at 8.8%
CMS Announces Navigator Grant Recipients
First Year Medicare CJR Model Results Released
Briefly Noted

New Sexual Assault Treatment Requirements
House Bill 5245 and Senate Bill 3404, which both unanimously passed both Houses of the Illinois General Assembly, have been signed by the Governor and are now Public Act 100-0775 and Public Act 100-1087, respectively. Both amend the Sexual Assault Survivors Emergency Treatment Act (SASETA) with numerous new requirements for treatment hospitals and P.A. 100-1087 amends several other laws pertaining to sexual assault.

There are numerous implementation details that will need to be addressed with the new legislation and IHA has learned that the Illinois Department of Public Health (IDPH) plans to issue emergency rulemaking in early January for the new requirements that are effective Jan. 1, 2019. All hospitals are on a three-year cycle for submission of treatment and transfer plans to IDPH with most being due during 2019, but a few are due November/December 2018 and some in 2020.

Hospitals are urged to begin working to develop any new protocol and agreements with other entities as necessary. IHA will work with IDPH to assist members with education and resources to meet the new requirements, including a webinar likely in November, and work with the Office of Attorney General (OAG) to ensure appropriate training opportunities for sexual assault nurse examiners are available.

For complete details, see IHA's memo.

Also, The Illinois Office of Attorney General (OAG) will be offering Adult/Adolescent Sexual Assault Nurse Examiner (SANE) Training Nov. 5-7 from 8 a.m. – 5 p.m. at Edward Hospital in Naperville. This program counts toward the certification requirements to become a SANE.

Sixteen hours (two days) of the Adult/Adolescent SANE training are to be completed online prior to the 24-hour (three day) classroom component. Instructions regarding the online component will be released on Oct. 4, and students must complete the online coursework by Nov. 1.

Applicants must:

  • Have a license in good standing;
  • Have a minimum of one year of clinical experience;
  • Acknowledge the requirements of the training (including submitting a recent resume); and
  • Complete the 14 hours of online training and homework by Nov. 1.

Applications are due Oct. 4. Questions about the training program can be emailed to: SANE@atg.state.il.us.

Report: Uninsured Rate Remained Steady at 8.8%
Yesterday, the U.S. Census Bureau released its most detailed look at America’s people, places and economy with new statistics on health insurance, income and poverty. According to the Health Insurance Coverage in the United States: 2017 report, the percentage of people without health insurance coverage for the entire 2017 calendar year was 8.8 percent, or 28.5 million. That figure is not statistically different from 2016 data (8.8 percent or 28.1 million people). Between 2016 and 2017, the number of people with health insurance coverage increased by 2.3 million, up to 294.6 million.

Census Bureau data for Illinois shows 859,000 people uninsured (6.8 percent) in 2017, up from 817,000 (6.5 percent) in 2016.

The Income and Poverty in the United States: 2017 report noted the nation’s official poverty rate in 2017 was 12.3 percent, with 39.7 million people in poverty. The number of people in poverty in 2017 was not statistically different from the number in poverty in 2016. The 0.4 percentage-point decrease in the poverty rate from 2016 (12.7 percent) to 2017 represents the third consecutive annual decline in poverty. Since 2014, the poverty rate has fallen 2.5 percentage points, from 14.8 percent to 12.3 percent.

The median household income in the United States in 2017 was $61,372, an increase of 1.8 percent from the 2016 median income of $60,309. This is the third consecutive annual increase in median household income. The 2017 real median income of family households increased 1.4 percent from 2016 to $77,713.

CMS Announces Navigator Grant Recipients
Yesterday, the Centers for Medicare & Medicaid Services (CMS) announced $10 million in Navigator grants awarded to 39 organizations in states with federally-facilitated health insurance marketplaces. These awards are to support the work of organizations that offer assistance to consumers navigating, shopping for, and enrolling in health insurance coverage for 2019. The awards are for a 12-month performance period from Sept. 12, 2018 through Sept. 11, 2019.

This year, two organizations in Illinois received nearly $400,000: SIHF Healthcare ($180,689) and Planned Parenthood of Illinois Exchange Navigator Program ($208,527). Last year, five organizations in Illinois were awarded almost $1.8 million for Navigator activities throughout the state.

First Year Medicare CJR Model Results Released
According to a report for the Centers for Medicare & Medicaid Services (CMS), payments to hospitals participating in the first year of Medicare’s Comprehensive Care for Joint Replacement (CJR) model (April through Dec. 2016) were approximately 3.3 percent less than payments to non-participating hospitals. The study also found no significant differences among the participants and non-participants in terms of readmission rates, emergency department visits or mortality.

Key findings from the report show:

  • The range in reduction of Medicare payments from low to high episode payments was $577 - $1,127, respectively; and
  • Average total Medicare payments for fractures decreased by an average of $1,345 due to reductions in inpatient rehabilitation services and readmissions.

Participants offered the following reasons for the improvement: early organizational planning; education of patients about post-acute care settings; and coordination with those post-acute providers.

CMS began implementing the five-year model in 2016 in 67 randomly-selected Metropolitan Statistical Areas, including three in Illinois: Cape Girardeau, Decatur and St. Louis. The model also qualifies as an Advanced Payment Model under the Medicare Access and CHIP Reauthorization Act’s Quality Payment Program. The CJR model incorporates an episode-based, bundled payment and quality measurement for an episode of care for lower extremity joint replacements to encourage coordination among hospitals, physicians and post-acute providers from the initial hospitalization through 90 days after discharge.

Briefly Noted
U.S. Senate Majority Leader Mitch McConnell on Wednesday canceled this week's remaining Senate votes, including a vote on an opioid package of more than 70 proposals (the Opioid Crisis Response Act of 2018), because of the risk from Hurricane Florence. The Senate vote on the opioids package is now scheduled for next Monday evening. If approved without amendment, the Senate package would have to be reconciled with the House-passed opioid package.