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Happening in Healthcare

  • Mission Health Named a ‘Top 15’ Health System in the Nation – April 24, 2017

    For a remarkable fifth time in the past six years, Mission Health has been named once again one of the nation's Top 15 Health Systems by Truven Health Analytics, an IBM Company and part of IBM Watson Health. The Truven Health study identifies the nation's 15 best health systems based upon objective care quality standards and is the only study that aggregates both individual hospital and health system-level performance to allow health system leaders and consumers to identify and compare true leaders in clinical quality and efficiency.

    "Receiving this recognition for an unprecedented fifth time in six years recognizes our unwavering commitment to exceptional care, clinical excellence and evidence-based, standardized care and, most importantly, our dedication to the community we are so privileged to serve," said Ronald A. Paulus, President and CEO of Mission Health. "Our physicians, nurses and other team members are simply extraordinary. Each strives to exceed our patients' expectations and to improve every aspect of the care we provide to the people across western North Carolina. Our relentless focus on quality, safety and compassion has resulted in outstanding care for our patients and the ongoing pursuit of our BIG(GER) Aim: to get each person to their desired outcomes, first without harm, also without waste and always with an exceptional experience for each person, family and team member."

    The winning health systems were announced in the April 22 edition of Modern Healthcare magazine.

    Mortality rates at the top-performing systems were 13.4% lower than their peers and complication rates were 8.5% lower. The average length of stay was 10.2% shorter and wait times in the emergency department were 17.5% shorter compared with the benchmark. Mission Health has consistently outperformed other local, regional and national providers by saving more lives and causing fewer complications, following industry-recommended standards of care more closely, making fewer patient safety errors and scoring better on overall patient satisfaction.

    The Truven Health analysis is an objective, quantitative IBM Watson study that identifies 15 health systems with the highest achievement on clinical performance, efficiency and patient satisfaction based on Truven's 100 Top Hospitals National Balanced Scorecard methodologies. For the 2017 rankings, Mission Health was part of 337 health systems in the study — almost every U.S. system with two or more acute-care member hospitals, including critical access hospitals. Truven's researchers analyze public information, including Medicare cost reports, Medicare Provider Analysis and Review (MedPAR) data, and core measures and patient satisfaction data from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website.

    Previously, Mission Health has received this esteemed recognition for the four-consecutive year period of 2012, 2013, 2014, and 2015. No other health system in America has achieved this recognition in four consecutive years.

     

  • What’s Next for Healthcare Reform - April 3, 2017

    In a stunning move last month, the House GOP leadership pulled its American Health Care Act repeal-and-replace legislation from a scheduled vote because of the apparent lack of votes to pass the legislation. What does this mean for healthcare? Simply, the Affordable Care Act continues. Yet, changes are still possible and parties are weighing their options.

    • Senate Democrats are urging President Trump to overturn his January 20 executive order to overturn the Affordable Care Act and abandon all efforts to repeal the law. In exchange, they offer to work with the Administration on healthcare. In the letter, the lawmakers suggest that such a step would go a long way towards a bipartisan effort to repair the law.
    • U.S. Department of Health and Human Services Secretary Tom Price may start using regulatory avenues to make changes to the Affordable Care Act, according to reporting by The Wall Street Journal.
    • Insurance marketplaces remain unstable in various parts of the country, and insurers start filing 2018 plans as early as April.
    • HHS has launched a new page on its website aimed at providing more information for patients on the current healthcare law and to support a more patient-centered healthcare system. According to HHS Secretary Price, HHS is "taking action to improve choices for patients, stabilize the individual and small-group insurance markets, and expand access to more affordable coverage," adding updates on ongoing efforts will be shared there.
    • The Medicaid expansion is secure for now.

     

  • Business North Carolina Ranks Mission Hospital No. 1

    Mission Hospital has been ranked No. 1 (tied with Duke University Hospital) in Business North Carolina magazine’s Best Hospitals in North Carolina annual listing.

    Importantly, the article states a fact that is particularly relevant in western North Carolina:

    "The cost of hospital services has increased 33% over the last six years, federal statistics show, outpacing price hikes of insurance premiums and prescription drugs. With higher costs comes more pressure to perform, which makes Business North Carolina’s annual quality rankings of the state’s adult, acute-care hospitals with at least 50 beds ever more relevant."

    Click here to read more

  • Mission Health and Healthcare Reform - February 20, 2017

    We are strong advocates for responsible healthcare reform – reform that doesn't negatively impact access, services, programs and jobs that are vital to the health and wellbeing of our communities.

    It's imperative that our elected representatives don't repeal ACA without a simultaneous and effective replacement. When combined with further payment cuts to essential programs like Medicare and Medicaid the results would be extremely harmful to our community. We need to ensure the following:

    1. ACA repeal must occur only with simultaneous replacement, otherwise, the effects would be devastating to the health and wellbeing of the people of western North Carolina and for most communities in the country. The impact from coverage loss with further program cuts would be severe, with harm to the physical and financial health of our patients, families, team members region and state.

    • Many hospitals across the nation – and particularly rural hospitals - would be forced to close programs or shut their doors entirely, resulting in a loss of services and a loss of jobs if a responsible replacement isn't simultaneously provided. It is critical to remember that hospitals are responsible for 1 in every 9 jobs in America and they are often the largest employer, particularly in rural communities.
    • With respect to an ACA repeal, Mission Health is forecasted to lose ~$500 million (2018-2026).
    • A replacement plan that builds upon what has clearly worked (insuring many more Americans, preventing discrimination based upon pre-existing conditions or gender, allowing market-based approaches such as competitive insurance exchanges to play a role, etc.) while improving upon what clearly hasn't worked (not enough insurers in many markets, bad estimates of newly insured utilization that led to large premium increases, failure to attract enough younger, healthier enrollees, etc.) should be the goal.

    2. ACA replacement must occur without delay to avoid harm to essential care and services.
    • The ability for Mission to provid access to the safe, quality patient care that our communities expect, to make investments in our team members, charity care, community services and new equipment and facilities will be greatly compromised without an effective replacement.
      • In 2015 alone, Mission contributed nearly $150 million in total community investments and unreimbursed costs of government programs.
      • We have numerous construction projects active throughout the region to replace old and impossible to maintain facilities, including a new hospital for McDowell County, new Emergency Departments in Transylvania and Highlands, and the Mission Hospital for Advanced Medicine in Asheville.

    Our patients and their families are the most likely to be hurt due to lack of coverage. We serve nearly 1 million patients who are on average older, poorer, sicker and less likely to be insured than state and national averages.
    • ~75% of our patients are currently government insurance beneficiaries (Medicare and/or Medicaid) or they are uninsured.
    • More than 50% of our patients are covered by Medicare and ~ 20% are covered by Medicaid.
    • Mission provides more than $40 million to offset unreimbursed care provided to patients covered by government programs.
    • As a non-profit health system providing care to the underserved, our costs outpace revenue growth. Without ACA replacement, it will be nearly impossible to continue finding ways to eliminate millions in operating expenses while maintaining an exceptionally high level of care.

    Here's what's at stake for all of us:
    • Patients & Families – Our patients and their families would be hurt due to lack of coverage, challenges with access and potentially loss of jobs.
    • Jobs and a Healthier Local Economy – As one of the largest employers in the region, Mission Health has created and sustains almost 13,000 good jobs, providing critical services to our patients and strong contributions to the local economy – both of which are in jeopardy if responsible reform doesn't occur. Our impact on the regional economy is valued at nearly $2 billion.
    • Programs & Services – As a non-profit we invest all funds directly back into communities, programs and services. Our excess revenue or so-called "profits" – critical to be able to maintain our programs and services and make necessary investments in new equipment and facilities - are in danger if responsible reform doesn't occur. It is this excess revenue that enables us to invest in programs and services that help our most vulnerable and at-risk populations.
    • Community Partner Support – In 2015 alone, we provided ~$1.4 million in grant funding to community partners, including:
      • All Souls Counseling, providing accessible mental healthcare
      • Children's services organizations like CARING for Children and Children First
      • Buncombe County Department of Health
      • MANNA Foodbank
      • YMCA of Western North Carolina.
    • Capital Investments – Part of ensuring the wellbeing of our community is through investment in valuable services, facilities and technologies. Examples include everything from advancements in cancer and genetics, to initiatives in virtual care and behavioral health. Through Mission Future Ready, we are also investing nearly half a billion dollars region-wide. Such investments are at risk in the event of delayed ACA replacement and further program cuts.

    Given what's at stake, we are optimistic that responsible reform will happen. It's in everyone's best interest to make sure that hospitals remain strong and that healthcare jobs and vital programs and services are preserved. We are therefore optimistic responsible reform will happen, but we are leaving nothing to chance.

    We are working at every level to help realize healthcare reforms that are in the best interest of our mission, our team members and the health and wellbeing of western North Carolinians.
  • President Trump Issues Executive Order to Ease Affordable Care Act Regulations - January 26, 2017

    In his first executive order, President Trump directed government agencies to scale back as many aspects of the Affordable Care Act as possible. The one-page order gives no specifics about which aspects of the law it is targeting, nor does it take away anyone's current healthcare insurance coverage or end any specific programs or initiatives. But its broad language gives federal agencies the ability to change, delay or waive provisions of the law that are deemed too costly for insurers, drug makers, doctors, patients or states.

  • Mission Health Makes Important Changes to Ensure Against Discrimination - December 8, 2016

    Section 1557 of the Affordable Care Act has created strengthened non-discrimination provisions for health care entities. In addition to prohibiting discrimination based on race, sex, national origin, disability, and age, Section 1557 creates new protections for patients with Limited English Proficiency, and also prohibits discrimination based on gender identity. Mission has created a work group to help us comply with these complex new requirements.


    Some new things you will be seeing as we comply with Section 1557:

    • A Notice of Non Discrimination link on the home pages of Mission Health System websites
    • The Notice of Non Discrimination posted in patient registration areas and waiting rooms
    • Non-discrimination language in patient-facing documents such as:
      • Educational materials
      • Marketing and outreach materials
      • Notices
  • Court Orders Special Election in 2017 - December 1, 2016

    A federal court on Tuesday ordered North Carolina to hold a special legislative election in 2017 after 28 state House and Senate districts are redrawn to comply with a gerrymandering ruling. This follows a ruling earlier this year that rendered those districts unconstitutional because they were found to have been drawn with racial considerations. That ruling, though, allowed the 2016 election to continue under the old maps, but ordered legislators to draw new districts in 2017. Tuesday’s order settled the question of whether the new districts would take effect for the regularly scheduled 2018 election cycle, or if a special election would be required. The order gives legislators until March 15 to draw new district maps. Every legislator whose district is altered will have their current term shortened. A primary would be held in late August or early September – the legislature is responsible for setting the exact date – with the general election in November, the order says.

  • Congress Tackles Federal Funding - September 22, 2016

    The House and Senate reconvened this month under great pressure to pass legislation to renew federal funding, which expires on September 30. Lawmakers have no appetite to be tainted with a government shutdown so close to the elections, forcing progress on consensus around a continuing resolution. While a group of Republicans, among others, are pushing for a six-month spending bill, the most likely scenario is passage of a stop-gap measure that would provide federal funding through mid-December to buy time for an agreement on a longer-term package during a lame-duck session. Whether emergency funding to combat the Zika virus will be part of that equation, considered separately, or punted to the new Congress remains to be seen. Odds favor resolving the standoff.

  • Mission Health and GE Partnernship - August 26, 2016

    GE Healthcare and Mission Health Launch First of a Kind Outcomes-Based Innovation Collaboration


    New Care Process Models to Benefit Health Systems Nationwide

    • Emphasis on driving meaningful, measurable outcomes for the next decade that are scalable nationwide
    • Mission targeting $40 million in direct, operational savings through focus on optimizing radiology, streamlining biomedical services and replacing monitoring and telemetry equipment system-wide

    ASHEVILLE, NC – August 26, 2016 – Today, Mission Health and GE Healthcare announced a novel, 10-year outcomes-based agreement that will help drive significant value for patients, Mission Health, GE and health systems nationwide. As a non-academic, regional integrated health system that includes a 730 bed, high-volume, high-acuity tertiary-quaternary hospital, Mission is looking to balance clinical quality with significant cost savings and efficiency across their system — the same challenge facing nearly all healthcare systems nationwide.

    “This is an innovative, collaborative, outcomes-driven relationship focused on developing new, transformational ways of caring for patients at Mission Health and nationwide,” said Ronald A. Paulus, MD, President and CEO, Mission Health. “The challenges we face at Mission are like so many health systems across the nation. Our goal is to improve our margin, drive system-wide efficiency and deliver an exceptional, transparent experience for every patient, family and team member. The solutions that we develop and cost savings we achieve with GE will be scalable and applicable to other similar healthcare systems. This is truly exciting for Mission and the industry.”

    “To make this level of partnership possible, it takes two organizations to think both differently and collaboratively,” said John Flannery, President and CEO, GE Healthcare. “We are honored to work with Mission Health and strongly believe that this strategic, outcomes-based agreement will ensure alignment and focus on shared priorities. We are passionate about delivering on our commitment while helping to enhance clinical quality, patient experience and operational efficiency.”

    Mission Health and GE Healthcare will work in partnership to solve the system’s most complex challenges delivering over $40 million in savings for Mission Health over the course of the relationship:

    • First of a Kind, Co-created Innovation Collaboration: Mission Health and GE Healthcare will co-develop, pilot and deploy transformational healthcare solutions focused initially on two areas: optimizing imaging experience and utilization and smoothing patient care transitions.

      • Imaging: The focus will be on supporting a patient’s ability to make informed choices based upon key variables such as comparative costs and wait times while providing rapid results. From the provider perspective, the focus will be on streamlining the complex process of getting patients to the right imaging modality, at the right time, in the right place across the system while balancing capacity and availability.

      • Care Transitions: The approach will leverage predictive modelling and other analytics to ensure that the patient receives the right care in the right setting with the right technology to maximize patient outcomes, experience and minimize costs.

      By leveraging GE’s deep technology, consulting, software, IT and workflow expertise and Mission’s in-depth clinical experience and “real world learning laboratory”, Mission and GE Healthcare will help shape the next generation of technology, tools, and processes to support healthcare’s transformation. This is less about one product or capability and more broadly aligned around how technology and services can work together to deliver outcomes for patients. Many of the findings and solutions developed through this collaboration can be transferred and used by systems nationwide.

    • Key areas of operational focus within mission health include:

      • Radiology Optimization: Imaging is a core component of many service lines and care plans – yet in most organizations it is optimized or structured to function as a central backbone of care delivery. A systematic focus on imaging/radiology drives system-wide efficiency by improving speed to diagnosis, increasing asset utilization, reducing un-necessary retakes, reducing overall care costs and reducing waiting time for patients and clinicians system-wide. As care shifts to a value-based model, radiology must transform from a simple revenue or cost center to one that actively supports risk-based care models and helps Mission achieve its goal of providing same day, cost-effective care.

      • System-wide Bedside Monitoring Transformation: Mission Health is replacing its bedside monitoring and telemetry at all seven facilities to support rapidly increasing inpatient acuity, reduce internal and cross-facility transfers and provide seamless care regardless of site. The new monitoring platform will ensure that all equipment is interconnected and that data is readily available to the clinician in the moments that matter most. By providing immediate access to critical data, especially in areas like the emergency department, caregivers can improve patient safety and speed to diagnosis and reduce patient wait times, reduce false positive and optimize patient placement keeping patients close to home as much as possible.

      • Radiology and Biomedical Services with Asset Optimization: GE Healthcare will assume responsibility for servicing diagnostic and biomedical equipment at Mission Health. This will drive standardization, consistency and overall increased reliability and quality of care.

      This relationship is the culmination of a significant investment by GE Healthcare Partners, the management consulting arm of GE Healthcare. Partners have built capabilities to advise and execute services that connect GE’s products to clients like Mission Health to improve quality, reduce cost, and increase access. GE Healthcare Partners offers broad advisor services, analytics & predictive modeling capabilities, and has expertise implementing outcomes across the healthcare continuum.


    ____________________________________
    Mission Health is the only tertiary-quaternary healthcare provider in western North Carolina, has been named a Top 15 Health System (Truven Health Analytics) in four of the past five years and recently had the lowest readmission rate of any general acute care hospital in the nation (Modern Healthcare). The health system and its leaders already have developed several solutions that are being used and distributed nationwide.



         
  • House Passes Mental Health Bill - August 4, 2016

    The House has passed by a 422-2 vote the Helping Families in Mental Health Crisis Act (H.R. 2646), bipartisan legislation to reform our nation’s mental health system. The Congressional Budget Office estimates that the bill would save Medicaid $5 million over 10 years, with the costs of paying for some services provided by Institutions for Mental Disease offset by savings from an electronic visit verification system for personal care and home health providers.

  • Mission Health’s President and CEO Testifies during U.S. Senate Hearing - July 12, 2016

    Ronald A. Paulus, MD, President and Chief Executive Officer of Mission Health testified today before the Senate Finance Committee at the hearing “Examining the Stark Law: Current Issues and Opportunities.” Senator Richard Burr (R-NC) introduced Dr. Paulus. "After testifying today, I am encouraged by the bipartisan discussion on the well known difficulties that the Stark Law presents in our efforts to provide value based, high quality care. This well intended but antiquated law creates a thick fog of uncertainty that handcuffs our efforts to work in partnership with our physicians to fundamentally improve care, lower costs and more fully engage patients. I look forward to the continuing dialogue with the Committee to bring needed reforms in this critical area," Dr. Paulus said.

    Senate Finance Committee Chairman Orrin Hatch (R-Utah) convened the hearing to examine ways to improve and reform the Stark Law. Given the importance of improving care coordination for seniors, the Committee is reviewing the Stark law's impact on Medicare and the seniors this program serves.

    “The Stark Law was designed in an era when fee-for-service was Medicare’s primary payment model. But now, as providers move to alternative payment models, the law presents practical and outdated barriers in need of updating,” Hatch said. “This hearing will give members of the Committee the opportunity to hear how the Stark Law works in practice for today’s healthcare providers and what reforms are needed to streamline the law to make it work for providers, patients and taxpayers.”

    The hearing was live streamed on the Senate Finance Committee’s website, and a printed transcript can be found here.

  • Mission Health Awarded 2016 Culture of Excellence Award - July 8, 2016

    Mission Health recently received the 2016 Culture of Excellence Award from the Excellence in Healthcare Conference for the healthcare system’s commitment to improving its patients’ experience. ”Focusing on the experience of the patient is paramount when seeking to continuously improve how we deliver care – it’s our most sensitive quality measure,” said Ronald A. Paulus, MD, President and CEO of Mission Health. “We also believe that it’s past time to extend that focus on providing the best possible experience to our caregivers.” To that end, Mission Health has invested millions in programs to help train and reduce stress and burnout for its doctors, nurses and employees (See previous item). The healthcare system is also investing in new equipment and upgrading facilities throughout western North Carolina to ensure quality care and comfort for patients and staff. 

  • Medicaid Reform Waiver Highlights - June 23, 2016

    On June 1, North Carolina Department of Health and Human Services Secretary Rick Brajer submitted the state’s plan to reform its Medicaid program to the federal government for approval. In the “Section 1115 Demonstration Waiver” DHHS sent to the Centers for Medicare & Medicaid Services (CMS), it identified five core initiatives designed to improve healthcare access, quality and cost efficiency for the growing population of Medicaid beneficiaries, while moving from a fee-for-service to a capitated, or fee-per-enrollee, payment model. These initiatives include: 

    • Building a system of accountability for outcomes.
    • Creating person-centered health communities.
    • Supporting providers through engagement and innovations.
    • Connecting children and families in the child welfare system to better health.
    • Implementing capitation and care transformation through payment alignment.
  • State Senate Leaders are Expected to Release Their Chamber’s Proposed Adjustments - June 2, 2016

    State Senate leaders are expected to release their chamber’s proposed adjustments to the 2016-2017 state budget this week. Proposed tax changes and teacher pay increases put the chamber at slight odds with the House. But despite these differences, both Senate President Phil Berger (R-Rockingham) and House Speaker Tim Moore (R-Cleveland) said they want a budget passed before the new state fiscal year, beginning on July 1, and to adjourn for the year shortly thereafter.

    Early Voting Open for June 7 Primary

    Early voting for the June 7 primary began last week. During this primary, North Carolina voters will choose contenders for the U.S. House of Representatives races that were postponed from March, following a federal court ruling to redraw the state’s 13 Congressional Districts. As a result of the abbreviated election cycle, the top vote-getters in the primary will advance to the general election. Voters will also choose judicial candidates for the N.C. Supreme Court and Superior Court. Some municipal contests also will take place.

  • Lawmakers Return to Raleigh for General Assembly’s Short Session - May 6, 2016

    State lawmakers last week returned to Raleigh to start their “short session” of legislation. Held every two years, the short session is used to tweak the biennial budget, approved at the conclusion of the long session the prior year, to consider legislation that has passed at least one chamber during the previous year, and to consider legislation proposed by interim committees. Among the healthcare issues Raleigh insiders believe will be considered during the short session are:

    • Medicaid Reform – Department of Health and Human Services (DHHS) officials said they are on target to submit a federal waiver by June 1 to privatize the state’s Medicaid program. DHHS officials are likely to ask the General Assembly to allow them to tweak the privatization guidelines to allow three statewide plans and up to 12 regional Provider-Led Entity (PLE) plans operating in six regions and to exclude Native American tribes from mandatory enrollment, among other slight changes.
    • LME/MCO Mergers – DHHS officials are moving forward to consolidate the number of behavioral health managed care companies (LME/MCOs) in the state from eight to four as part of Medicaid reform and in response to national trends to integrate physical and behavioral health approaches. NC DHHS Secretary Rick Brajer is meeting with the CEOs and boards of the LME/MCOs and has promised to keep the legislature apprised of developments.

    GOVERNOR MCCRORY UNVEILS BUDGET RECOMMENDATIONS

    To coincide with the start of the General Assembly’s short session, Gov. Pat McCrory unveiled his full recommendations for the 2016-2017 State Budget. Overall, McCrory wants to spend $22.3 billion to pay for state government services and programs. This represents a spending increase of 2.8 percent, which is below last year’s increase of 3.1 percent and below the rate of population plus inflation.

    Our budget builds on our commitment to strengthen education, enhance public safety, improve the health of our citizens, build new roads that connect our communities, all while reforming government to make it more accountable and efficient,” he said.

    Among the governor’s recommendations, he proposed a 1.7 percent decrease, equaling about $319 million, to the Health and Human Services part of his budget. Experts say a decrease in Medicaid enrollment and use of its services is driving this recommendation.

    Other recommendations to the state’s Health and Human Services budget include:

    • Investing $30 million to implement transitional housing, case management, mental health first aid training, child crisis centers and tools to combat addiction, suggestions made by the Governor’s Task Force on Mental Health and Substance Use.
    • Adding $4 million to expand Medicaid and state services to older adults, including those with Alzheimer’s disease and their caregivers.
    • Expanding Medicaid services for people with developmental disabilities, adding $2.5 million for community services. This includes funding for 250 new Medicaid Innovations Waiver slots.

    UNITEDHEALTH CUTTING HEALTH EXCHANGE PARTICIPATION

    United Health, the nation’s largest health insurer, will stop offering individual coverage in North Carolina under the Affordable Care Act in 2017. In a call to investors, UnitedHealth Group CEO Stephen Hemsley reiterated concerns about the financial viability of the law’s health insurance marketplaces. UnitedHealth is the second insurer, following Humana, to decide not to participate in North Carolina’s ACA market. Last fall, Humana withdrew its proposal to offer individual coverage through the federal exchange in four counties, and the company never sold ACA coverage here. The state’s biggest insurer, Blue Cross and Blue Shield, has said it’s also considering whether to stop selling ACA policies here. Insurance Commissioner Wayne Goodwin, a Democrat up for re-election, approved an average 32.5 percent rate increase for Blue Cross this year, but has expressed concern that the market is unsustainable and will drive out all remaining insurers.

    FEDERAL

    MORE PUBLIC DATA RELEASED ON NURSING HOMES

    The Centers for Medicare & Medicaid Services (CMS) added six new quality measures to the Nursing Home Compare website, including three that are not self-reported by nursing homes. The agency added measures on the percentage of short-stay residents who were successfully discharged to the community; the percentage of short-stay residents who had an outpatient emergency department visit; the percentage of short-stay residents who were re-hospitalized after a nursing home admission; the percentage of short-stay residents who made improvements in function; the percentage of long-stay residents whose ability to move independently worsened; and the percentage of long-stay residents who received an anti-anxiety or hypnotic medication. This is the first time CMS is including quality measures not based solely off the providers’ self-reported data.


    MEDICAID CAN COVER ELIGIBLE PERSONS ON PROBATION, PAROLE, OR IN-HOME CONFINEMENT

    Individuals on probation, parole or in-home confinement who are Medicaid­eligible can get coverage under the program, the Centers for Medicare & Medicaid Services said in guidance issued last week. Individuals in these circumstances are not considered inmates of a public institution, so states can receive federal Medicaid funds for coverage provided to them. Existing Medicaid law prohibits the federal government from paying for medical services provided to inmates, except when that person is being treated in an inpatient facility, such as a hospital.


    GOVERNMENT INITIATIVE DESIGNED TO STEER AMERICANS INTO HEALTHCARE JOBS

    The Obama administration announced a new proposal, Health Careers Pathways, to help steer Americans to work in the healthcare sector across the next decade. The effort builds on a Department of Labor effort to help community college graduates match with employers’ needs.

  • Hospital ‘Immersion Day’ Gains National Attention - April 21, 2016

    The New England Journal of Medicine featured Mission Health’s innovative “Immersion Day” program in its March 31 edition. Immersion Day began three years ago as a way to give Mission Health Board members insight into the real-world challenges and opportunities facing hospitals and the country’s healthcare system. Following positive reaction and support from the Board, the program was expanded to invite journalists, policymakers and community leaders to participate. The program has produced real change for Mission Health by strengthening governance and fostering trust among our community, staff and physicians. We hope Mission Health’s example will inspire others to follow suit and similarly benefit communities’ appreciation of their local hospitals.

    Mission Hospital Recognized for Healthy Workforce Initiatives

    For the second consecutive year, Mission Hospital has earned Excellence Recognition for its commitment to the health of its employees. Healthy Together NC, in partnership with The Duke Endowment and the NC Hospital Association, recognized Mission for its policies, programs and benefits to support employee health, optimize employee productivity and integrate wellness into daily operations. Mission earned straight As in four modules of WorkHealthy America, a Prevention Partners initiative that addresses tobacco use, physical activity, nutrition and the overall culture around health and wellness. The Centers for Disease Control and Prevention (CDC) has acknowledged the WorkHealthy America Excellence standard as one of the highest achievements in building a healthy workplace.

    Angel Medical Center to Welcome More Doctors for Training

    Thanks to $8 million designated in the state’s most recent budget to create new residency programs for surgeons, psychiatrists, family physicians and OB/GYNs, Angel Medical Center will welcome an influx of medical students and post-graduate physicians over the next few months and years. According to a recent article in The Franklin Press, which quoted Mission Health president and CEO Ronald A. Paulus, M.D., the Mountain Area Health Education Center (MAHEC) is expanding the residency programs into the outlying areas of its 16-county service area to address a severe shortage of rural doctors, surgeons and behavioral health specialists. The article cites state data that indicates there is only one primary care doctor for every 1,462 residents in Macon County, well below the state average. Dr. Paulus told the newspaper he hopes training physicians in the rural mountain communities will persuade these doctors to stay here and practice.

    State

    Budget Priorities for Health Services Released

    Gov. Pat McCrory unveiled his Health and Human Services budget priorities last week. Among the governor's health-related recommendations are:

    • Providing funding for emergency housing to transition adults who are diagnosed with a primary substance-use disorder or serious mental illness out of emergency departments, correctional facilities or institutions.
    • Devising and funding a new case management model for adults with mental health and substance-use issues that will create personalized plans and prevent hospitalization or interactions with the justice system.
    • Proposing legislation that would authorize access to Naloxone at pharmacies in North Carolina. Naloxone is a lifesaving drug for anyone who overdoses on prescription opioids or heroin.
    • Increasing funding for family caregiver support services, including respite care for caregivers.
    • Adding 250 Medicaid Innovations Waiver slots to provide services to help individuals with developmental disabilities live successful lives in the community.

    State lawmakers will make changes to the 2016-2017 Budget when they return for the legislative short session next week.

    Behavioral Health Mergers

    As part of the Medicaid reform package that the North Carolina Department of Health and Human Services is working to implement, Secretary Rick Brajer announced last month the consolidation of the state’s eight behavioral-health managed care organizations (LME/MCOs) into the following four, based on geographic location:

    • Western Region: Partners Behavioral Health Management and Smoky Mountain Center
    • North Central Region: CenterPoint Human Services and Cardinal Innovations Healthcare Solutions
    • South Central Region: Sandhills Center and Alliance Behavioral Healthcare
    • Eastern Region: Eastpointe and Trillium Health Resources

    In a letter announcing the mergers, Brajer said having four regions for behavioral health services instead of eight will improve consistency of care, decrease administrative burdens on providers serving more than one LME/MCO and allow for better coordination of care for people, such as children in foster care, who may temporarily move into a different service area.

    Federal

    Senate Committee Approves Package of Mental Health Bills

    The Senate Health Committee last month approved a package of mental health and opioid-abuse bills that encourages the use of an overdose-reversal drug and allows doctors to treat more substance abuse patients with medication-assisted treatment.

    House Leaders Fight Proposed Medicare Advantage Cuts

    Leading House Republicans are urging the Centers for Medicare & Medicaid Services to scrap planned cuts to Medicare Advantage’s retiree plans. Those plans, which served 3.1 million seniors last year, are facing an average cut of 2.5 percent under CMS's payment proposal for 2017. Opponents of the cuts say the policy changes could hurt retirees who would lose coverage that coordinates their care.

  • Transylvania Regional Hospital, an 'Outstanding Community Champion' - March 18, 2016

    We are so proud of the many achievements throughout the Mission Health system and want to highlight a few recent recognition.


    Transylvania Regional Hospital, an 'Outstanding Community Champion'

    United Way of Transylvania County recently recognized Transylvania Regional Hospital as this year's Outstanding Community Champion, as reported in the Transylvania Times. The hospital and its employees support United Way in a variety of ways, from financial contributions to facilities use. Additionally, the hospital, led by President and Chief Nursing Officer Cathy Landis, was recognized with the Highest Campaign Award.

    Mission Health Member Hospitals' Home Care Receive 5 Stars

    In addition to Care-Partners Home Health Services, which we reported on last month, Angel Home Care and Transylvania Home Care have also received 5-star ratings for patient satisfaction. Ratings are based on a national survey that asks patients about their recent experiences with a home health agency.

    Mission Health Gives $1 million to A-B Tech

    Mission Health has promised $1 million to furnish and equip a new conference center at Asheville-Buncombe Technical Community College. The Mission Health/A-B Tech Conference Center was purchased by A-B Tech and has been designed as a multipurpose building that can be used as an auditorium or divided, according to an article in the Citizen-Times. A-B Tech President Dennis King told the Citizen-Times that Mission's contribution furthers an existing relationship between the two organizations that has also resulted in financial aid and practical experience for A-B Tech students at Mission, equipment donations and several joint programs.

    State

    New Primary Date and Process for Congressional Election

    As a result of the ruling by a three-judge panel on February 5 that rendered North Carolina's 13 Congressional Districts unlawful, the General Assembly quickly moved to redraw the districts and postpone the Primary Election for U.S. House seats until June 7. In addition to opening a new candidate filing period – March 16-25 – for these seats, Gary Robertson of the Associated Press reported in the Citizen-Times that the updated election schedule eliminates all primary runoffs in 2016. And, instead of the top two vote-getters advancing to a runoff if the first-place candidate fails to receive more than 40 percent of the vote, the leading candidate will now advance to the general election no matter what percentage of the vote he or she garners. Also, a provision in the redistricting legislation allows state candidates who won their primary on March 15 to file and run for their respective congressional district seats on June 7.

    Federal

    Medicare Advantage Continues Strong Growth

    United Health Care, Humana, Kaiser, Aetna and Anthem are the top five insurers for Medicare Advantage, according to newly released data. Total Medicare Advantage enrollment as of February 1 stood at 18,203,676, with a net gain of 927,534 members, year-over-year. According to the Centers for Medicare & Medicaid Services, 33 percent of the 54.8 million people eligible for Medicare are enrolled in Medicare Advantage plans.

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