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Message from Mike
Ben Franklin wisely observed, “When a well is dry, we know the worth of water.” Indeed, sometimes we don’t fully appreciate a benefit until it is no longer there for us.

A recent report from Morgan Stanley concluded that 10 percent of America’s hospitals are at risk of closure, and an additional 10 percent are “performing weakly.” Decreasing revenue leads careful observers of health economics to conclude that hospitals will need to innovate and economize to succeed.

It is in this environment that OHA carries a very aggressive advocacy agenda into a whole new set of political dynamics. A new executive branch, new Speaker of the Ohio House and many new legislators are hearing from us on the priorities facing our industry.

Our advocacy program is designed to deliver real results, and we have done that during the past several seasons. If we hope to continue that success, we must maintain industry unity.
So, you pay too much for a ticket to an NBA game and you come home with a belly full of popcorn, a lighter wallet and … measles?

Measles was eliminated in the U.S. in 2000, in theory, but there is an outbreak in the Pacific Northwest. There are at least 37 cases of measles, and more than 24 cases are with people who were not vaccinated against the preventable disease. One of the sites where people might have been exposed to the virus is the Moda Center, in Portland, Oregon, where 19,000 people showed up to see the Portland Trailblazers play the Charlotte Hornets. Sure, you might have come home with a vaccine-preventable disease, but at least the Trailblazers won, 127-96.

In New York, 200 cases of measles have been confirmed—the worst outbreak since 1989.

While I hate to see disease outbreaks of any kind, I hope these situations will serve as a reminder that vaccines work.
Need to Know
Special Request

OHA Launching Private Payer Scorecard, Participation Deadline March 5

A member-driven Private Payer Work Group has identified a new tool to benefit all OHA members, and we need your help to gather specific data to launch the effort. Hospital finance leaders on Wednesday received materials from Ryan Biles, OHA executive vice president, to submit revenue cycle data.

Please help us help you by encouraging your teams to submit the initial data by the March 5 deadline.

Private payer denials, delayed payments and other administrative burdens are escalating anxiety among our members. OHA’s Private Payer Scorecard has been designed and vetted by various member groups to:
  1. Enhance OHA’s advocacy efforts by providing measurable data that will demonstrate to lawmakers and policymakers the burden hospitals endure in their relations with the payers
  2. Provide data back to participating members to benchmark your organization’s experience with specific payers to facilitate any internal process improvements and to identify opportunities for outreach to payers to resolve issues
Work group and OHA Board members, along with OHA’s Finance, Admitting, Billing & Collection and Small & Rural Hospital committees, have been integral in developing the components and testing the value of the scorecard. No hospital-specific information will be shared or made public, only aggregate data.

New Maternity Practices Survey Sent by ODH

OHA recently became aware of an email communication and survey request sent to hospitals from the Ohio Department of Health, that we wanted to bring to the attention of our member hospitals who provide maternity services. The email, titled “Your response requested for an Ohio patient safety survey,” asks hospitals to complete a survey regarding current practices around maternal care at their facility.

OHA wants to advise our member hospitals that choose to complete this survey that your responses may become a public record. We encourage hospitals to discuss this issue with your appropriate maternity, legal and/or leadership teams to guide your decision and response to the ODH survey request.

OHA and our member hospitals are key partners in improving maternal and infant health outcomes, and the OHA Board of Trustees previously added ‘maternal health’ to the focus areas for OHA’s quality improvement initiatives in 2019.

We will be reaching out to members in the coming months to do our own survey around current hospital practices. This will allow OHA to leverage our hospital encounters database and our experience in statewide initiatives to work with members on a quality improvement initiative. This would also allow for our members to be transparent in their practices, while keeping all hospital-level data secure and unidentifiable.

If you have any questions about the ODH survey, or OHA’s future work in the maternal health space, please contact Ryan Everett, who coordinates the maternal and infant health work for OHA.

House, Senate Select New Leadership

Members of the Ohio House and Senate officially selected new leaders Wednesday.

Leaders of the House Republican caucus include: Rep. Jim Butler (R-Oakwood), speaker pro tempore; Rep. Bill Seitz (R-Cincinnati), majority floor leader; Rep. Anthony DeVitis (R-Green), assistant floor leader; Rep. Jay Edwards (R-Nelsonville), majority whip; and Rep. Laura Lanese (R-Grove City), assistant majority whip.

The Senate GOP announced Sen. Matt Huffman (R-Lima) as floor leader, elevating him from his prior role as majority whip. The lawmaker succeeds former Sen. Randy Gardner (R-Bowling Green), who left the upper chamber in January to serve as chancellor of the Department of Higher Education.

Sen. Jay Hottinger (R-Newark) was selected to replace Huffman in the role of majority whip. Sen. Bob Peterson (R-Sabina) was previously named president pro tempore.

Other previously announced House leadership changes on Wednesday were formally adopted, including the election of Minority Leader Emilia Sykes (D-Akron). Other leadership spots finalized for that caucus include: Rep. Kristin Boggs (D-Columbus), assistant minority leader; Rep. Kent Smith( D-Euclid), minority whip; and Rep. Paula Hicks-Hudson (D-Toledo), assistant minority whip.

The Senate Democratic Caucus will be led by Minority Leader Kenny Yuko (D-Richmond Heights), Sen. Cecil Thomas of Cincinnati, the assistant minority leader, Sen. Sean O'Brien of Bazetta, the minority whip, and Sen. Sandra Williams of Cleveland, the assistant minority whip.

DeWine Will Deliver State of the State Address from Columbus

The date for Gov. Mike DeWine’s State of the State address is official. And he’ll bring the annual event back to the capitol. DeWine’s address will take place at noon March 5 in the Ohio House chamber.

Governor Directs Medicaid to Bid Managed Care Contracts

Gov. Mike DeWine has directed the Ohio Department of Medicaid to begin the lengthy process of putting the state's five managed care plans out for bid. It will be the first time since 2011-2012 that the state has bid out the contracts for Medicaid managed care organizations, which oversee the administration of benefits for most enrollees.

The five current managed care plans – Buckeye Health Plan, CareSource, Molina Healthcare, Paramount Advantage and UnitedHealthcare Community Plan – have been in place since 2013, and the process to select them took about a year and a half.

The state's Medicaid program has seen significant changes since the last procurement process. The Medicaid program still fell under the Department of Job and Family Services in 2012. The state has also expanded Medicaid eligibility under the federal Affordable Care Act and moved additional services, such as behavioral health, into managed care since then.

A spokesman for DeWine said the decision to open a new procurement process stems from a desire to ensure the state is getting a good deal. The goal is to save money and to get the best deal for taxpayers while also addressing concerns about the role of pharmacy benefit managers in the Medicaid program.

ODM last year directed managed care plans to adopt a "pass-through" model for pharmacy benefits, prohibiting the so-called "spread pricing" model that drew scrutiny from lawmakers and others. An investigation by then-State Auditor Dave Yost also called for further study of what he called the "black box" of information on pharmacy benefit costs and legislative leaders have since pushed for more transparency on the PBM issue.

Betti said the process is still in the early stages of its development, and that it will be "transparent." ODM has the authority to terminate agreements at any time, and can renew or revise contracts every six months, he said.
CMS Logo

CEO Webinar Series Continues Feb. 27

OHA’s exclusive CEO webinar series continues at 8:30 a.m. Feb. 27. Please save the date and plan to join us. Staff from OHA’s Health Economics & Policy and Advocacy teams will provide information related to the new federal hospital price transparency reporting requirement, an update on the current legislative landscape and state budget preparations. To register, click here.

2018 OHA Lobbying Expenditure Letter Available

In accordance with federal tax law, the Internal Revenue Service requires hospitals and other facilities to apportion trade association dues related to lobbying expenses. The 2018 Lobbying Expenditure Letter is available here. For questions, contact Erin Biles, director of Accounting, at or 614-221-7614.

ODH Logo

State Hospital Registration, Planning Report due March 1

Ohio hospitals are required by law to submit the Annual Hospital Registration and Planning Report to the Ohio Department of Health each calendar year by March 1.

Information provided consists of data pertaining to the hospital’s location, corporate owner, classification and type. In addition, hospitals are required to provide statistical data including, but not limited to, surgical, neonatal and emergency room services, cardiac catherization and bed utilization.

This information is used not only by the Department for registration purposes, but also by many other interested parties such as hospitals, health service areas, health care consultants and other offices within the Department for planning, comparative studies and trend analysis. For information about how to complete and submit the report, visit the ODH webpage.
340B Drug Pricing Program

Court Filing: AHA Says HHS Should Make 340B Hospitals ‘Whole’

A federal court should order the U.S. Department of Health and Human Services to “make whole” 340B hospitals that received reimbursement reductions resulting from the Centers for Medicare & Medicaid Services’ 2018 outpatient prospective payment system rule, AHA and other hospital plaintiffs said Jan. 31 in a court-ordered brief.

A federal judge Dec. 27 ruled in favor of the AHA and hospital plaintiffs that the Department of Health and Human Services "adjustment" by nearly 30 percent of 2018 Medicare payment rates for many hospitals in the 340B Drug Pricing Program was unlawful. The judge granted AHA's motion for a permanent injunction and ordered supplemental briefing on the question of proper remedy.

In the Jan. 31 filing, the AHA and plaintiffs said that the repayments should not be done in a budget-neutral manner as expenditures need not be budget-neutral when they fix a prior, unlawful underpayment. Read more.

OHA Data Program Participants Receiving Executive Dashboard

CEOs of member hospitals participating in the OHA data program will receive the Q3 2018 executive dashboard enclosed in the print version of this newsletter. The dashboard displays hospital-specific performance around financial, quality and advocacy metrics compared to certain benchmark groups in the state. For questions about this dashboard, contact Amy Andres.
AHA Annual Meeting Banner

Attending the AHA Annual Meeting? Let Us Know

OHA's Advocacy team is preparing several Ohio-specific events and briefings to be held in conjunction with the upcoming American Hospital Association Annual Meeting. Let us know if you plan to attend the conference, and we'll be sure you get the full itinerary as it is finalized.

The 2019 AHA meeting will take place April 7-10 (which is a month earlier this year) in Washington, D.C. For planning purposes, it is very helpful if you can let us know if you and/or other representatives from your organization plan to attend.

You can find information about this year’s event, along with details about how to register, here.

Contact Stephanie Gilligan if you or your hospital representatives are planning to be in D.C. for the AHA conference.
Happening at OHA

OHA Clinical Advisory Committee Webinar – 10
a.m. Feb. 8

Health Economics & Policy Webinar: Rural Ohio Wage Data Review – 10 a.m. Feb. 13

Health Economics & Policy Webinar: Ohio Bureau of Workers’ Compensation 2019 OPPS Brief – 10 a.m. Feb. 19

OHA CEO Webinar – 8:30 a.m. Feb. 27

Engage OHA
Hospital Involvement
In alignment with our mission to collaborate for a healthy Ohio, OHA has a variety of projects, programs, initiatives and activities in which your hospital can participate.
Melvin Creeley Award

Applications for 2019 Melvin Creeley, John Chapman Awards Now Open

Applications for the 2019 Melvin Creeley Environmental Leadership Award and the John Chapman Award are now open through March 1.

Click here to access the application.

Named after Melvin Creeley, former CEO of East Liverpool City Hospital and past chair of OHA’s Environmental Leadership Council, the Melvin Creeley Award recognizes hospitals and health systems that promote sound environmental practices through the implementation of waste reduction programs, recycling initiatives and other activities to preserve the health of the planet for future generations.

To be eligible for the award, hospitals must have signed the OHA Energy Program’s authorization form to allow benchmarking by ENERGY STAR. Hospitals who have already won the Melvin Creeley award may apply again but must indicate progress and any new energy and environmental initiatives undertaken.

Recipients of the Melvin Creeley Award will be eligible for OHA’s highest environmental leadership achievement, the 2019 John Chapman Award. This award recognizes a hospital or health system that has demonstrated leadership in guiding their facility toward the goals of environmental sustainability, regulatory compliance, energy efficiency, and pollution prevention, all of which are proven to result in healthier hospital workforces and communities.

Those interested in the John Chapman award must supply additional documentation indicating their energy and environmental successes. The Melvin Creeley and John Chapman awards will be presented during the OHA Annual Meeting, June 3-5, in Columbus.

Updated Star Ratings and List of HAC-penalized Hospitals Coming this Month

As part of the February refresh of Hospital Compare, the Centers for Medicare and Medicaid Services plans to update its hospital overall star ratings. In addition, CMS is expected to release the performance results from the fiscal year 2019 Hospital-acquired Condition Reduction Program, including the list of penalized hospitals.

The release of these data could generate interest from the media. The American Hospital Association issued a Member Advisory that includes key takeaways on the star ratings and HAC Reduction Program, as well as talking points to help prepare for possible media questions.

Recording Posted of OHA Webinar on IRS Rules for Employee Parking Tax

The IRS in December released preliminary guidance, NOTICES 2018-99 and 2018-100, regarding the parking tax, which taxes exempt employers on the expenses incurred in providing either parking or transit passes to their employees. This provision converts applicable expenses into unrelated business taxable income.

Because the provision was effective for expenses incurred on or after Jan. 1, 2018, exempt organizations had been operating without clarification until the new Notices went out from the IRS in December. OHA worked with Plante Moran to provide members an informational webinar covering details in the IRS Notice.

An archive recording of the Jan. 29 “New IRS Guidance on Parking Tax for Tax-Exempt Employers” webinar is available here along with a copy of Plante Moran’s presentation.

Contact Shawn Stack with questions.
Quick Links

Memorial Health President, CEO to Chair OHA Institute Board

Chip Hubbs, president and CEO of Memorial Health System, last month took the helm as chair of the OHA Institute for Health Innovation Board of Directors. Hubbs has been president and CEO of Memorial Health since March 2004. Prior to arriving in Marysville, he served for four years as CEO of Community Memorial Hospital in Defiance County.

A former chair of the OHA Board of Trustees, Hubbs is joined by new board member Bruce White, president and CEO, Knox Community Hospital and 2018 chair of the OHA Board of Trustees. White was elected to a three-year term on the board.

Established in 2015, the OHA Institute provides resources to develop and implement strategies focused in the areas of accelerating health care quality, integrating transition of patient care, and advancing community health. The Institute’s mission is to evaluate, focus and engage in change activities that lead and enable the pursuit of excellence in safety and quality and in improving the health of our communities.

2019 Federal Poverty Guidelines Released

U.S. Health and Human Services poverty guidelines for 2019 have been released and are effective as of Jan. 11. Publication of the Federal Register notice is delayed due to the federal government shutdown. The guidelines can be found here.

New Law Changes Hospitals’ Palliative Care Responsibilities

As the last legislative session came to a close, Ohio lawmakers passed Substitute H.B. 286 to develop and implement palliative care initiatives and education in the state. The new law, which takes effect March 20, requires hospitals, surgery centers and nursing homes and other providers to establish a system for identifying patients who could benefit from palliative care and providing information to identified patients. Read a brief from Bricker & Eckler LLP on details of the new requirements.
Quick Links
As a busy hospital executive, we realize you may not have time to read every email that lands in your inbox. To that end, we have added these quick links to help you view the latest editions of all OHA newsletters:
Advocacy Adviser — Jan. 28  |  Feb. 4

Advocacy Adviser is published by OHA's Advocacy team and previews key upcoming legislative issues and recaps activity on issues of importance to OHA members.

By the Numbers January edition
By the Numbers is published monthly by the Health Economics and Policy team and covers developments in hospital finance, including updates about Medicare and Medicaid payment systems.

Chief Medical Report Winter edition
Chief Medical Report is a quarterly update for physician leaders at member hospitals about OHA initiatives, developments from OHA’s Physician Leadership Council and the latest regulatory and legislative changes affecting physicians and hospitals.
HIINformation January edition
HIINformation is published monthly for hospitals participating in the Hospital Improvement and Innovation Network.
Ohio Hospital Newswire Jan. 25  |  Feb. 1
Ohio Hospital Newswire is a digest of hospital and health care news happening across the state.