The newsroom includes access to CHA News, which provides timely information to members every Monday and Thursday and is at the core of CHA benefits. In addition, it is also home to resources such as toolkits and talking points designed to help member hospitals and health systems communicate with internal and external audiences on a range of current health care-related issues. Links to CHA media statements and press releases can also be found here.
Covered California is seeking stakeholder feedback on its efforts to promote accountability and support delivery system improvements. In a recently released request for information, Covered California solicits questions and suggestions in four key areas.
Those areas include:
- Guiding Principles for Promoting Better Care and Delivery Reform
- Current Qualified Health Plan Issuer Contract Terms: Quality, Network Management, Delivery System Standards and Improvement Strategy
- Contractual Expectations Domains and Strategies: Right Care/Accountability and Delivery System Improvement
- Enabling Factors that Promote Delivery Reform
Instructions for submitting feedback — due Feb. 15 — are also included in the notice. CHA will engage its Managed Care Committee to inform development of CHA’s comments. Members are invited to provide feedback to Amber Kemp, vice president, health care coverage by Feb. 8. Additional background information about Covered California’s process for refreshing its contractual expectations is available online.
As hospitals actively engage with community partners to comply with a new homeless patient discharge planning law, members of the Legislature heard from advocates last week about the need for a broad transformation in the way California addresses homelessness.
A panel of state and federal experts addressed a joint informational hearing of two Assembly committees — the Housing and Community Development Committee and the Human Services Committee. Among the findings and solution presented, the panelists urged lawmakers to change California’s decentralized homeless shelters from temporary housing stops to a more integrated system that connects people to the services and resources they need, and more quickly places them into housing.
To help hospitals comply with the new homeless patient discharge law, CHA has developed a guidebook titled Discharge Planning for Homeless Patients.
The Centers for Medicare & Medicaid Services (CMS) has announced a new Part D Payment Modernization model, available through the Center for Medicare and Medicaid Innovation, for Part D and Medicare Advantage (MA) drug plans beginning in January 2020.
The voluntary five-year model will test the impact of a Part D payment structure that creates new incentives for plans, patients and providers to choose drugs with a lower list price. The model is open to eligible, standalone prescription drug plans and Medicare Advantage prescription drug plans; CMS will release a request for applications to join the model for calendar year 2020 in the near future.
CMS also announced updates to the MA Value-Based Insurance Design (VBID) model for calendar year 2020. The model will test different service delivery innovations by allowing plans to provide reduced cost sharing and additional benefits to enrollees in a more targeted fashion, bolster the rewards and incentive programs that plans can offer beneficiaries to take steps to improve their health, and increase access to telehealth services. Eligible MA health plans in all 50 states and territories may apply for the health plan innovations being tested under the VBID model, as required by the Bipartisan Budget Act of 2018.
Yesterday, CHA submitted comments on the Office of the National Coordinator’s (ONC) draft strategy to reduce regulatory and administrative burden related to health information technology and electronic health record (EHR) use.
In the letter, CHA urges ONC and the Centers for Medicare & Medicaid Services (CMS), in collaboration with stakeholders, to address gaps in the draft strategy and begin to prioritize specific strategies and recommendations.
CHA urges CMS and ONC to consider California hospitals’ and health systems’ feedback and priorities as the agencies move forward. CHA also encourages them to immediately focus on the current, unnecessary burdens related to clinical documentation, as well as EHR, electronic clinical quality measure and public health reporting.
In addition, CHA requests that the draft strategy articulate in greater detail specific methods that will reduce barriers to interoperable exchange of health information in order to accelerate its adoption nationally.
CHA thanks members for their input, which helped inform the comments.
A new health advisory from the Centers for Disease Control and Prevention shares information about an investigation of a penicillin-resistant strain of Brucella spreading across the U.S. Suspected to be linked to consumption of unpasteurized milk from a farm in Pennsylvania, cases have now been identified in 19 states — including California. More information on the infection and recommended treatment is available in the advisory.
The Emergency Medical Services Authority (EMSA) has released three sets of proposed regulations for a 15-day comment period. The proposals are intended to establish standardized best practices for their respective systems.
This is the second set of revisions to the regulations, incorporating feedback from previous comments received last fall. For more information, see below:
Yesterday, CHA submitted comments on Covered California’s draft Options to Improve Affordability in California’s Health Insurance Market. In the letter, CHA reiterates its readiness to partner with Covered California and the Legislature to build upon the Affordable Care Act by implementing premium and cost-sharing subsidies, an individual mandate and penalty, and reinsurance.
CHA urges Covered California to examine each option to determine how it may impact total enrollment, coverage rates, choice of coverage, new funding for proposed subsidies, and the effect on federal premium tax credits.
CHA commends Covered California for its leadership in this area and looks forward to future collaboration to ensure that all Californians have access to health care coverage.
Last week, Hospital Quality Institute (HQI) President & CEO Julie Morath was honored by the Patient Safety Movement Foundation with its Beau Biden Humanitarian Award. The award recognizes California hospitals’ participation in an effort, led by HQI, to provide consumers with easily accessible, meaningful information about hospital quality.
“California hospitals all committed to demonstrate voluntary transparency and lead in this transformation,” Morath said when she accepted the award. “We are pleased to be part of this community of innovation and commitment.”
Since the initiative began one year ago, 60 percent of California hospitals are publicly displaying website dashboards with information on five hospital-acquired conditions: central line-associated bloodstream infection standardized infection rate, cesarean section delivery rate, sepsis mortality rate, incidence of potentially preventable venous thromboembolism and colon surgery surgical site infection standardized infection rate.
Ninety-six percent of hospitals have either committed to posting the information or are in some stage of completion.
“The award bestowed on the Hospital Quality Institute reflects hospitals’ longstanding and ongoing dedication to be, first and foremost, a safe place for those in need,” said Carmela Coyle, CHA President & CEO. “By committing to full transparency in their quality improvement efforts, hospitals continue to take the lead in ensuring patients receive care that is both compassionate and conscientious.”
The award was presented at the World Patient Safety, Science & Technology Summit, and the initiative was lauded as a model for other states to replicate.
The Patient Safety Movement Foundation is a global nonprofit organization that creates free tools for patients and hospitals, with the goal of eliminating preventable deaths.
CHA has issued a summary, prepared by Health Policy Alternatives, of the Centers for Medicare & Medicaid Services’ (CMS) final rule that accelerates the timeline for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) to take on downside risk.
In addition to policies that were finalized in the calendar year 2019 physician fee schedule final rule, CMS finalizes the following changes to the MSSP:
- Redesign the MSSP to include only two tracks – Basic and Enhanced.
- Allow a maximum of three years of participation in upside-only risk.
- Reduce shared savings rates for upside-only models from 50 to 40 percent.
- Differentiate between “low-revenue” and “high-revenue” ACOs, and require high-revenue ACOs to take on more risk more quickly.
- Increase the length of agreement periods to at least five years.
- Allow all ACOs to elect prospective beneficiary assignment or preliminary prospective assignment with retrospective reconciliation.
- Expand the use of regional factors in the benchmarking methodology.
- Allow ACOs’ risk scores to decrease by an unlimited amount, without the proposed 3 percent cap.
- Increase access to waivers of telehealth and other Medicare payment requirements.
The deadline for organizations to apply for the MSSP program in 2019 was Jan. 18.
At the January meeting, the Medicare Payment Advisory Commission (MedPAC) recommended that Congress increase the rate for hospital inpatient and outpatient prospective payment systems (PPS) by 2 percent in federal fiscal year (FFY) and calendar year (CY) 2020.
The commission also recommended consolidating the Hospital Value-Based Purchasing, Hospital Readmissions Reduction, and Hospital-Acquired Conditions Penalty programs into a new Hospital Value Incentive Program (HVIP). The Inpatient Quality Reporting Program would also be eliminated. The difference between the recommended update and the amount specified under current law would be redirected to the HVIP.
Other recommendations include:
- Increase the long-term care hospital rate by 2 percent in 2020.
- Reduce the inpatient rehabilitation facility rate by 5 percent in 2020.
- Eliminate the FFY 2020 update for skilled-nursing facilities (SNFs), revise the SNF PPS, and annually recalibrate the relative weights of the case-mix groups to maintain alignment of payments and costs.
- Increase the CY 2019 Medicare payment rates for physician and other health professional services by the amount specified in current law, require nurse practitioners (NPs) and physician assistants (PAs) to bill the Medicare program directly, eliminate “incident to” billing for services they provide, and refine Medicare’s specialty designations for NPs and PAs.
- Eliminate the CY 2020 update to the Medicare conversion factor for ambulatory surgical centers (ASCs) and require ASCs to report cost data.
- Reduce FFY 2019 rates for hospice providers by 2 percent.