2013 Legislative Update2013 Legislative UpdateMarch 26, 2013March 26, 2013

WV Chapter HFMAWV Chapter HFMA2013 Spring Revenue Cycle Workshop

Healthcare Reform - Ready or not, here it is!!

• Affordable Care Act – yes, it’s still here– 1,000’s of pages, 100’s of new regulations1,000’s of pages, 100’s of new regulations– Value Based PurchasingValue Based Purchasing– Hospital Acquired ConditionsHospital Acquired Conditions– HCAHPSHCAHPS– ReadmissionsReadmissions– Partnership for PatientsPartnership for Patients– Meaningful Use, ACO, Etc etc etc!!!Meaningful Use, ACO, Etc etc etc!!!

Journey Through ChangeJourney Through ChangeChange Process Starts Promised

Land

Journey Through Hell

TIME

Morale“Everything looks like

failure in the middle”

Medicare Payment at Risk under CMS Quality-based Payment Reform Initiatives

2010 2011 2012 2013 2014 2015 2016 2017

Readmissions

Hospital Acquired Conditions

Meaningful Use

Value-based Purchasing (VBP)

Inpatient Quality Reporting Requirement (IQR, formerly RHQDAPU)

Hospital Acquired Conditions (HAC)

2% of APU

2%

1%

1%

3%

© 2011 Press Ganey Associates, Inc.

Meaningful Use

Value Based Purchasing

Summary - CURRENT ESTIMATE

West Virginia: ($789,508)

West Virginia: ($3,112,100)

Readmissions

Domain Weighting for FFY2013

30% Patient Experience

Process of Care

Domain weighting for FFY14

HCAHPS 30%

Clinical Process of Care 40%

Outcomes 30%

Readmissions reduction program began Oct. 1

• 34.9% with no penalty

• 40.4% with penalty <0.5%

• 24.7% with penalty between 0.5% and 1%

• NO adjustment for all planned or unrelated admissions

• NO adjustment for socio-economic status

Readmissions

Source: KNG Analysis of 2009 100% Medicare inpatient file and FY2011 Hospital IPPS final rule impact file.

30-Day Readmissions

….the Stakes are High!

20

2013 Legislative Session2013 Legislative SessionStarted: February 13th

Ends: April 13th

• Jeff Kessler Rick Thompson• Senate President Speaker of the

House

• Ron Stollings Don Perdue• Senate Health House Health

• Corey Palumbo Tim Miley• Senate Judiciary House Judiciary

West Virginia

Governor Earl Ray Tomblin

Important Dates

• March 25 - marks the 41st day of the legislative session and the last day to introduce bills in the Senate and House.

• March 31 - Bills due out of committees in house of origin (47th day).

• April 3 - Last day to consider bills on 3rd Reading (passage stage) in house of origin (50th day).

• April 13 - Session adjourns at midnight. (60th day)

Status Report – Keys Bills of Interest

• UPL - SB 195 – Hospital Upper Payment Limit (UPL) Program.Bill has already been approved by the Senate Health Committee and is currently in the Senate Finance Committee likely to be considered this week. The bill as it stands:

Extends the UPL for one year, through June 30, 2014, in order to maximize the financial benefits of the Program.

Reduces the hospital tax rate for this Program from the current rate of 0.88% to 0.45%, almost a 50% reduction;

If the UPL program is not extended past June 30, 2014, the legislation states that any remaining funds (unmatched tax funds) will be split evenly between the Medicaid program, and the hospitals that participated in the private hospital UPL program. 

Status Report – Continued

• SANE - HB 2583 – Creating a Sexual Assault Forensic Examination Commission.

• MEDICAL RECORDS – a bill advocated by some members of the House and plaintiff attorneys around the issue of medical records copying costs.

• NAME TAG BILL - SB 21 - Creating Health Care Provider Transparency Act – aka “Name Tag Bill.”

• MATERNITY HEALTH INSURANCE COVERAGE - SB 22 and HB 2383 – Relating to mandatory maternity coverage for all health insurance plan dependents

• CIGARETTE TAX BILL INTRODUCED - SB 593 – Introduced last week, increasing excise tax on cigarettes and tobacco products .55 cents to $1.55

QuestionsQuestions

March 26, 2013March 26, 2013

Jim KranzVP Professional ActivitiesWest Virginia Hospital Association100 Association DriveCharleston, WV 25311(304) 353-9712

Jim.Kranz@wvha.org