President’s ReportBismarck Tribune’s 40 Under 40Washington UpdateFree OSHA 10-Hour Online TrainingPhysician RecruitmentND Medicaid MMIS System TrainingCMS Projects Part D Monthly Premium will Remain Stable in 20162015 NDHA Convention SponsorsNDHA Education UpdateState of Healthcare Associated Infection Nationally & in NDND Critical Access Hosptal Revenue Cycle Webinar

Clink on link to view attachments:http://www.ndha.org/resources/informer/Senator Heitkamp AttachmentBismarck Tribune - Theo StollerSave the Date - Revenue Cycle Webinar

Phone: 701-224-9732Fax: 701-224-9529Web Site: www.ndha.org

Jerry Jurena, PresidentTim Blasl, Vice PresidentCallen Cermak, Finance ManagerLori Schmautz, Executive AssistantPam Cook, Education Director

A portion of this publication is supported by The Center for Rural Health’s Medicare Rural Hospital Flexibility Program. Visit their site at http://rural-health.und.edu/projects/flex/.

The InformerPresident’s Report ~ Jerry Jurena, NDHA PresidentIn This Edition:

Attachments:

NDHA Contacts

July 24, 2015

Senator Heitkamp: On July 17th Senator Heitkamp met with several health care providers in Fargo for her health care review update. The Senator reviewed several ACA bills floating around Washington that afternoon with the group. Per the request of those in attendance she had Megan mail out the bills she referenced; see attached. If you have questions let me know and we can contact Megan.

H.E.N. 2.0: Last week at the SLHQ meeting, AHA’s HRET staff provided information they received from CMS on the next step in improving quality, H.E.N. 2.0. H.E.N. 1.0 ended in December of 2014 and since then we have been told that CMS would be continuing the program.

Funding has been the issue with the continuation of the program. The successes of reducing harm and re-admissions was the focal point in continuing the program. We will again be working with Barb Groutt and the Quality Health Associates (QHA) team for the collection of data. Our budgets had to be in to HRET today giving us less than a week to accomplish this task; however, it is done. Since December we chose not to close down the process of collecting data. We are excited to be moving into the next phase of this project. Going forward it is our understanding that there will be addi-tional criteria to be monitored in this next phase. We know the future will be about outcomes and outcomes will drive reimbursement.

As of this morning Barb let me know that she had a conversation with staff from HRET and was told H.E.N. 2.0 will start October 1st. Sometime in September each state hospital association will be required to have signed contracts with participating hospitals. The contracts will come from NDHA once we get the go-ahead from HRET and NDHA will enter into a new contract with QHA at that time.

Check out the Bismarck Tribune’s write up, included in this weeks Informer attachments, on Theo Stoller, CEO at Jacobson Memorial Hospital in Elgin, ND.

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Washington Update ~ John Flink Regulatory challenges facing critical access and small rural hospitals took center stage this week in the House Ways and Means Health Subcommittee. A panel of four rural hospital leaders urged Congress to support legislation to prevent the Centers for Medi-care & Medicaid Services (CMS) from enforcing a Medicare condition of payment for CAHs that requires a physician to certify that a beneficiary may be reasonably expected to be discharged or transferred to another hospital within 96 hours.

They also urged Congress to provide relief from Medicare rules that require a physician or non-physician practitioner to provide “direct supervision” over numerous routine outpatient therapeutic services and to adopt a default standard of “general supervi-sion” and a process for making exceptions for complex or risky services.

The hearing is one of a series the subcommittee is holding on various aspects of the Medicare program. Last week it heard from the head of the Medicare Payment Advisory Committee. The next hearing will be on graduate medical education.

In related news, subcommittee Republicans are planning a comprehensive Medicare bill that addresses how hospitals are paid for short-term patient stays and will attempt to clear up confusion about whether hospital care for a short visit qualifies as “outpa-tient” or “inpatient,” according to news reports in Washington this week.

Under the bill, any outpatient services, as well as most inpatient stays of less than three days, would be reimbursed at the same rate. All short-term hospital stays for surgeries would be lumped into a single payment system. The AHA and other national hospital groups have said they are likely to oppose the new payment scheme.

The committee proposal will come shortly after CMS outlined major changes to the way Medicare pays for short-term stays, revising the two-year old “two-midnight rule.” The AHA says it is generally satisfied with the new CMS policy.

The subcommittee is also planning to release a new proposal for changing the CMS formula for GME payments.None of these proposals are likely to pass as free-standing bills; however, they could be included in a Republican entitlement re-form bill.

Health subcommittee leaders this week also proposed legislation – H.R. 3298, the Medicare Post-Acute Care Value-Based Pur-chasing Act of 2015 – that would establish a value-based purchasing program across four settings in Medicare – home health agen-cies, skilled nursing facilities, inpatient rehabilitation facilities and long-term care hospitals.

The bill was introduced by House Ways and Means Health Subcommittee Chair Kevin Brady (R-TX) and Health Subcommittee Member Ron Kind (D-WI). Brady and Kind said their bill “focuses performance around one quality metric: the Medicare Spending per Beneficiary measure.”

The bill establishes a shared incentive pool across the four settings; all four post-acute settings will compete with each other to earn bonus payments. To fund the pool, the Centers for Medicare & Medicaid Services would reduce annual payments by 3 percent in FY 2019 and increase the pool by one percentage point each year until it reaches 8 percent in FY 2025, according to a Ways and Means staff analysis.

The House adjourned yesterday for the August recess; the Senate follows suit sometime next week. Both houses return right after Labor Day. All three members of the ND congressional delegation will be in the state in August – which gives us an excellent opportunity to talk about our issues and concerns.

We will have an August recess strategy memo for members on Friday. As always, don’t hesitate to contact me, Jerry or Tim if you have questions or need additional information. And, we’d love to hear how your meetings with the delegation turn out.

Free OSHA 10-Hour Online Training The Loss Control department at Workforce Safety & Insurance (WSI) ran a 6 month pilot program for online OSHA training which ended May 31, 2015. The feedback received was very positive from the individual participants and the employers! WSI will continue offering the OSHA 10-Hour online training for general industry and construction as we feel this will help provide valuable safety training and education to employers and their employees.

The OSHA 10 Online Training Program is now available and open to any ND employer and their ND employees.

We have created a page on the website under the Safety Training & Education section with the details:https://www.workforcesafety.com/employers/safety/safety-training-education/osha-10-online-training-program

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Moving towards the site visit Most candidates will only visit 3-5 sites in their Search process, due to time and current commitments, so our first response to them needs to be quick and is important to see if they may potentially match to our opportunity. If during the phone conversation you believe that the candidate may potentially match to our opportunity, it is important to invite them for a visit. They do not have to decide on visiting right away, but encourage them to come and see for themselves our opportunity. The sooner the candidate decides on the visit, the better for all. I always recommend that candidates include all significant people in their site visit; (Spouse, Significant Other and Children), everyone who will be part of their decision making process.

It is important for us and our candidates to meet for a site visit, before we can determine if a candidate is a potential match for our opportunity and community. Candidates need to experience our community and meet our medical team if they are to consider us as a potential opportunity in their final selection list.

I can be reached at: northdakotarec@comcast.net, 701-320-2109

Physician Recruitment ~ Kevin Malee, NDHA Recruitment Consultant

ND Medicaid MMIS System Training The North Dakota Department of Human Services (DHS) will implement the new ND Health Enterprise Medicaid Management Information System (MMIS) on October 5, 2015.

Based on provider feedback in recent trainings conducted by DHS, a second phase of training specific to provider type and spe-cialty is planned in August 2015. The format for these trainings will be webinar and conference call.

Please click on link for the training dates for each provider type. http://www.nd.gov/dhs/info/mmis/training.html Agenda topics include an overview of ND Health Enterprise MMIS and review of claims submission changes, as well as an in-teractive open line question & answer session. Areas of focus may include claims, referrals and service authorizations. Advance registration is not required.

Training Session Action steps; 1. Launch webinar on your PC using this link: https://xerox.webex.com/xerox/j.php?MTID=m65fb76c536dab976e96e5c5d794c0267

It is recommended that you launch the WebEx 5-10 minutes before the start of the webinar.

2. Call into the conference using this toll free number: 1.866.243.5352

3. Materials for this training are located at www.nd.gov/dhs/info/mmis.html. It is recommended to have a paper or online copy available for taking important notes during the session. Please review this material in advance to determine if you would like to include additional participants from your organization.

If you have additional questions related to training, please contact the ND Health Enterprise MMIS Training Information Center at MMIStraining@nd.gov or (877) 328-7098. We look forward to your active participation and encourage you to share this invitation with colleagues in your provider community.

CMS Projects Part D Monthly Premium Will Remain Stable in 2016 The average monthly premium for a basic Medicare Part D prescription drug plan in 2016 will remain stable at an estimated $32.50, the Centers for Medicare & Medicaid Services announced recently. The projection is based on bids submitted by drug and health plans for basic drug coverage for the 2016 benefit year. The average Part D premium for a basic plan has been between $30 and $32 for the past five years, CMS said. To view the Part D base beneficiary premium, regional low-income premium subsidies, Medicare Advantage regional benchmarks and other data, visit www.cms.gov.

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2015 NDHA Convention SponsorsThank you to the following companies who have committed to sponsoring NDHA’s 2015 Annual Convention!

HSI Solutions - Diamond Level DTB Systems - Bronze Level Sanford Health - Diamond Level B.E. Smith - Bronze Level Perkins+Will - Bronze level HCIS/Coverys - Gold Level Essentia Health - Bronze Level MMIC Group - Bronze LevelAvera eHealth - Silver Level EAPC Architects - Bronze Level Blue Cross Blue Shield ND - Bronze LevelQuality Health Associates of ND - Breakfast CMA Communications - Bronze Level McGough Construction - Bronze Level NorthStar Technology Group - Bronze Level

If you would like to be added to an email distribution list to receive updates on specific education events, please email Pam at pcook@ndha.org.

Follow this link to register for educational events: http://www.ndha.org/education/education-events/

August 5 - Maximizing Value through Shared AccountabilityAugust 6 - Bundled Payments Webinar Series Part 1August 12 - Making Change Work for YouAugust 13 - Quality Checking Your Patient and Family Engagement StrategiesAugust 18 - Payer Audit ActivityAugust 25 - The Power of EmpowermentSeptember 8 - Medical Staff UpdateSeptember 9 - SOS: Strategies of Success for Department HeadsSeptember 10 - Bundled Payments Webinar Series Part 2September 15 - Accelerating Changes: Staying Ahead of the CurveSeptember 18 - CMS Infection Control StandardsSeptember 22 - Conducting a Root Cause AnalysisSeptember 23 - CMS Infection Control WorksheetSeptember 28 - CMS Restraint and Seclusion

Watch your emails within the next 2 weeks for information regarding NDHA’s 81st Annual Convention & Trade Show! Registration will done all online through a new program called RegOnline.

NDHA Education Update

ND Healthcare Emergency Preparedness Conference Mark your calendars and plan to attend the ND Healthcare Emergency Preparedness Conference on August 27, 2015 at the Ramada Bismarck Hotel! Follow this link to register: http://www.ndhealth.gov/EPR/HP/hppconference/

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ND Critical Access Hospital Revenue Cycle Webinar The ND Flex Program is providing a webinar on Thursday, August 27 from 11:00am - 12:30pm CST on the ND CAH Revenue Cycle. This webinar will be presented by Mark Hollan and Phil Schmid, Independent Healthcare Consultants.

See the attachment provided or contact Angie Lockwood at the Center for Rural Health for more information. 701-777-5381 or email angela.lockwood@med.und.edu