Indiana HCAHPS Performance - Patient's Overall Rating of Hospital

The following is the most recent list of Indiana hospitals sorted by the percent of patients rating the hospital 9 or 10 on the HCAHPS question about overall care. This is derrived from the hospital compare database which was updated Dec 2009.

Percentage of patients who gave rating of 9 or 10 (high)
% Hospital
91 WOMEN'S HOSPITAL THE(NEWBURGH)
89 ST VINCENT HEART CENTER OF INDIANA LLC(INDIANAPOLIS)
87 INDIANA ORTHOPAEDIC HOSPITAL LLC(INDIANAPOLIS)
83 MONROE HOSPITAL(BLOOMINGTON)
82 INDIANA HEART HOSPITAL, THE(INDIANAPOLIS)
82 CLARIAN NORTH MEDICAL CENTER(CARMEL)
81 ST FRANCIS HOSPITAL MOORESVILLE(MOORESVILLE)
79 DUPONT HOSPITAL LLC(FORT WAYNE)
79 DEKALB MEMORIAL HOSPITAL INC(AUBURN)
78 PARKVIEW HUNTINGTON HOSPITAL(HUNTINGTON)
78 ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC(FORT WAYNE)
78 ST VINCENT CARMEL HOSPITAL INC(CARMEL)
77 CLARIAN WEST MEDICAL CENTER(AVON)
77 HENDRICKS REGIONAL HEALTH(DANVILLE)
77 PARKVIEW HOSPITAL(FORT WAYNE)
77 MEMORIAL HOSPITAL AND HEALTH CARE CENTER(JASPER)
76 WITHAM HEALTH SERVICES(LEBANON)
76 TIPTON HOSPITAL(TIPTON)
76 PARKVIEW NOBLE HOSPITAL(KENDALLVILLE)
76 PARKVIEW LAGRANGE HOSPITAL(LAGRANGE)
76 SCHNECK MEDICAL CENTER(SEYMOUR)
75 PARKVIEW WHITLEY HOSPITAL(COLUMBIA CITY)
75 WABASH COUNTY HOSPITAL(WABASH)
75 GOSHEN GENERAL HOSPITAL(GOSHEN)
75 FRANCISCAN PHYSICIANS HOSPITAL LLC(MUNSTER)
75 DUNN MEMORIAL HOSPITAL(BEDFORD)
74 LUTHERAN HOSPITAL OF INDIANA(FORT WAYNE)
74 GOOD SAMARITAN HOSPITAL(VINCENNES)
74 ST VINCENT WILLIAMSPORT HOSPITAL INC(WILLIAMSPORT)
74 MARGARET MARY COMMUNITY HOSPITAL INC(BATESVILLE)
74 RIVERVIEW HOSPITAL(NOBLESVILLE)
74 ST FRANCIS HOSPITAL AND HEALTH CENTERS-INDIANAPOLI(INDIANAPOLIS)
74 CLARK MEMORIAL HOSPITAL(JEFFERSONVILLE)
73 ST MARY MEDICAL CENTER INC(HOBART)
73 MAJOR HOSPITAL(SHELBYVILLE)
73 ST MARY'S MEDICAL CENTER OF EVANSVILLE INC(EVANSVILLE)
73 MEMORIAL HOSPITAL OF SOUTH BEND(SOUTH BEND)
73 SAINT JOHN'S HEALTH SYSTEM(ANDERSON)
72 COMMUNITY HOSPITAL(MUNSTER)
72 ST VINCENT HOSPITAL & HEALTH SERVICES(INDIANAPOLIS)
72 JAY COUNTY HOSPITAL(PORTLAND)
72 BLUFFTON REGIONAL MEDICAL CENTER(BLUFFTON)
71 COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY(ANDERSON)
71 COLUMBUS REGIONAL HOSPITAL(COLUMBUS)
71 HARRISON COUNTY HOSPITAL(CORYDON)
71 FLOYD MEMORIAL HOSPITAL AND HEALTH SERVICES(NEW ALBANY)
70 BEDFORD REGIONAL MEDICAL CENTER(BEDFORD)
70 HENRY COUNTY MEMORIAL HOSPITAL(NEW CASTLE)
70 ST FRANCIS HOSPITAL AND HEALTH CENTERS(BEECH GROVE)
69 HANCOCK REGIONAL HOSPITAL(GREENFIELD)
69 ST JOSEPH HOSPITAL & HEALTH CENTER INC(KOKOMO)
69 CAMERON MEMORIAL COMMUNITY HOSPITAL INC(ANGOLA)
69 ST VINCENT FRANKFORT HOSPITAL INC(FRANKFORT)
69 ST VINCENT MERCY HOSPITAL(ELWOOD)
69 ST ANTHONY(CROWN POINT)
******69 Indiana State Average******
68 SCOTT COUNTY MEMORIAL HOSPITAL AKA SCOTT MEMORIAL(SCOTTSBURG)
68 SAINT JOSEPH'S REGIONAL MEDICAL CENTER - PLYMOUTH(PLYMOUTH)
68 ST CATHERINE HOSPITAL INC(EAST CHICAGO)
68 LAPORTE HOSPITAL AND HEALTH SERVICES(LA PORTE)
68 WESTVIEW HOSPITAL(INDIANAPOLIS)
68 KING'S DAUGHTERS' HOSPITAL AND HEALTH SERVICES,THE(MADISON)
67 COMMUNITY HOSPITAL SOUTH(INDIANAPOLIS)
67 DECATUR COUNTY MEMORIAL HOSPITAL(GREENSBURG)
67 MARION GENERAL HOSPITAL(MARION)
67 DAVIESS COMMUNITY HOSPITAL(WASHINGTON)
66 SULLIVAN COUNTY COMMUNITY HOSPITAL(SULLIVAN)
66 ST JOSEPH HOSPITAL(FORT WAYNE)
66 REID HOSPITAL & HEALTH CARE SERVICES INC(RICHMOND)
66 DUKES MEMORIAL HOSPITAL(PERU)
66 SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND(SOUTH BEND)
66 MEMORIAL HOSPITAL(LOGANSPORT)
66 DEACONESS HOSPITAL INC(EVANSVILLE)
66 JOHNSON MEMORIAL HOSPITAL(FRANKLIN)
******65 National Average******
65 HOWARD REGIONAL HEALTH SYSTEM(KOKOMO)
65 ST VINCENT JENNINGS HOSPITAL INC(NORTH VERNON)
65 GIBSON GENERAL HOSPITAL(PRINCETON)
65 CLARIAN HEALTH PARTNERS INC D/B/A METHODIST IU RIL(INDIANAPOLIS)
65 BALL MEMORIAL HOSPITAL INC(MUNCIE)
65 ST VINCENT CLAY HOSPITAL INC(BRAZIL)
64 ELKHART GENERAL HOSPITAL(ELKHART)
64 BLOOMINGTON HOSPITAL(BLOOMINGTON)
64 ST MARGARET MERCY HEALTHCARE CENTERS(DYER)
64 WILLIAM N WISHARD MEMORIAL HOSPITAL(INDIANAPOLIS)
64 UNION HOSPITAL CLINTON(CLINTON)
63 KOSCIUSKO COMMUNITY HOSPITAL(WARSAW)
63 DEARBORN COUNTY HOSPITAL(LAWRENCEBURG)
63 FAYETTE REGIONAL HEALTH SYSTEM(CONNERSVILLE)
63 PORTER, VALPARAISO HOSPITAL(VALPARAISO)
62 ST ANTHONY MEMORIAL HEALTH CENTERS(MICHIGAN CITY)
62 UNION HOSPITAL, INC(TERRE HAUTE)
61 COMMUNITY HOSPITALS OF INDIANA INC (EAST)(INDIANAPOLIS)
61 ST ELIZABETH CENTRAL(LAFAYETTE)
60 TERRE HAUTE REGIONAL HOSPITAL(TERRE HAUTE)
60 ST CLARE MEDICAL CENTER(CRAWFORDSVILLE)
59 MORGAN HOSPITAL AND MEDICAL CENTER(MARTINSVILLE)
56 ST MARGARET MERCY HEALTHCARE CENTERS(HAMMOND)
56 STARKE MEMORIAL HOSPITAL(KNOX)
55 ST MARY'S WARRICK HOSPITAL INC(BOONVILLE)
55 LAFAYETTE HOME HOSPITAL(LAFAYETTE)
54 ST VINCENT RANDOLPH HOSPITAL INC(WINCHESTER)
44 METHODIST HOSPITALS, INC(GARY)
39 SAINT CATHERINE REGIONAL HOSPITAL(CHARLESTOWN)

Commonwealth Fund Highlights Accomplishments of Reid Hospital

Last week the Commonwealth Fund highlighted the SCIP achievements of Reid Hospital (Richmond, IN) by publishing a case study on both the Commonwealth Fund's website
as well as their http://www.whynotthebest.org/ website.

The case study can be download here: http://www.commonwealthfund.org/~/media/Files/Publications/Case%20Study/2009/Nov/1338_Edwards_Reid_Hospital_case_study.pdf

The following is the summary section of the case study with sections of interest in red.

Reid Hospital and Health Care Services is a high performer on process-of-care, or “core” measures. The measures, developed by the Hospital Quality Alliance (HQA), relate to achievement of recommended care in four clinical areas: heart attack, heart failure, pneumonia, and surgical care. This case study focuses on Reid’s achievement in providing recommended care to surgical patients in order to reduce the risk of a hospital-acquired infection.

Quality of care has been high on Reid’s agenda since the late 1990s, when the hospital began using a report card to track health care processes and outcomes. In 2004, the multidisciplinary Surgical Care Improvement Project Quality Action Team was formed, which hospital leaders’ credit with helping to achieve high performance on the surgical measures. The team is supported by:

• a strong board, administrators, and clinical leaders;
• a clinical information system that aligns physicians’ orders with hospital standards, and alerts nurses about the timing of critical care;
• physician and nurse champions;
• performance data analysis and feedback; and
• a "just do it" approach to quality improvement.
  

IHA Update

The following is the most recent legislative update from the IHA. Items that may be of interest to healthcare quality professionals are in red.

General Assembly Faces April 29 Deadline
With the final day for action in the General Assembly less than one week away, conference committees are busy working out compromises between House and Senate versions of legislation. There are plenty of meetings today and rumors that more will be scheduled for Saturday and even possibly Sunday. Needless to say, many members of the General Assembly will not be headed home for the weekend.

Many significant bills failed to clear both chambers, but legislation that previously passed either the House or Senate is usually eligible to be placed into another “live” bill. Check the latest Bill Track to see which bills are headed to conference committee, which ones could be brought back, and which ones likely remain off the table in 2009.

In addition to monitoring the final days of the legislative session, IHA will also participate in the American Hospital Association’s annual meeting in Washington, D.C. and engaging with members of Congress. Key topics that will be addressed are the needs of hospitals in the current economic and financial crisis, concerns over the Employee Free Choice Act, possible reductions in Medicare reimbursement, and national health reform.

HIP Changes in Limbo (SB 472)
IHA has closely followed SB 472, authored by Sen. Pat Miller (R-Indianapolis), even after the hospital assessment and the “HIP 2” proposal was removed earlier this session. As it passed the Senate, this legislation would have allowed certain Hoosiers to buy into the HIP program without state support by paying the full premium as well as making any POWER account contributions. It also would have specified that the minimum POWER account contribution required for HIP enrollees would be $60 (FSSA believes that this minimum payment is critical to maintaining the element of personal responsibility within the HIP program).

In addition to the eligibility changes, SB 472 would have also permitted non-for-profit foundations to contribute to a participant’s required POWER account payments. As passed in the Senate, the amount a not-for-profit could contribute would be 50 percent. Later amendment in the House increased the share to 75 percent.

Other amendments added in the House would have broadened HIP eligibility by reducing the time for which an individual must be without health insurance from six to three months. Another change would increase the share that participating employers can pay for employees’ POWER account payments from 50 percent to 75 percent.

The bill was withdrawn before a third reading vote in the House, and it did not pass before the deadline on April 16. Some raised concerns that certain elements of SB 472 could lead to Hoosiers dropping their private insurance to join HIP. It is important to note that while the cap of 34,000 has been reached for non-parental adults, sufficient funding remains available to enroll thousands more eligible parents or “caretaker adults” in HIP.

The language allowing foundations to contribute to POWER accounts was of particular interest to many hospitals, and it could be revived in a different bill before session’s end. Such language, however, has not yet been inserted into any other conference committee reports.

Indiana Innovation Alliance May Be Funded
There has been only one public conference committee meeting to date on HB 1001, but the prospects for Indiana Innovation Alliance funding improved when it was included in the Senate-passed budget. This proposal is a joint request by Indiana and Purdue Universities, and hospitals may be particularly interested in the component of the program to expand medical education to include two- to four-year programs in Bloomington, Evansville, Fort Wayne, Gary, Indianapolis, Muncie, New Albany, South Bend, Terre Haute, and West Lafayette.

The Senate Republicans’ budget assumed the latest revenue forecast would reflect a shortfall of $1 billion, but by fully-utilizing the significant dollars allocated to Indiana through the stimulus legislation they were able to accommodate this program in their plan.

The Senate provided approximately $26 million for state fiscal years 2010 and 2011 as follows:

• $5 million/year: Medical Education Center Expansion (to increase the medical school class size by 30 percent statewide)
  
• $3.8 million/year: Technical Assistance and Advanced Manufacturing (to expand post-graduate pharmacy residency training for post-graduate biomedical engineering specialization and for the Healthcare TAP program at Purdue)
  
• $11.3 million/year: Core Research
  
• $5.6 million/year: Matching Grants for Federal Research Projects

IU and Purdue were seeking a total of $35 million per year, and the House budget funded the whole program at this level in its one-year budget bill earlier in the session. You can read more about the Alliance at http://www.indianainnovationalliance.org/.

Smokefree Air Legislation Revived
As indicated in the most recent IHA Bill Track, a good deal of legislation that was previously approved by only one chamber remains in play—very little is ever entirely dead during conference committees. HB 1213, the smoke-free air bill, passed the Indiana House by a vote of 70-26, but did not receive a hearing in the Senate Commerce and Public Policy & Interstate Cooperation Committee. However, the author of the original bill, Rep. Charlie Brown, has attempted to insert a revised proposal into HB 1208.

In a conference committee meeting this week, the contents of HB 1208 (establishing a mental health corrections quality advisory committee and a related multi-agency task force) were moved into another bill and replaced with a smoke-free air proposal. The conference committee has not yet acted on HB 1208, but Rep. Brown has asked other legislators to assess what level of support exists for his proposal. To move HB 1208 forward for a full vote in the House and Senate, all four conferees would have to sign off on the report. Rep. Eric Turner, Sen. Connie Lawson, and Sen. Vi Simpson are the other conferees along with Rep. Brown.

The bill as originally introduced contained a comprehensive smoking ban in public places, including bars, casinos, and all other enclosed areas of employment. The bill was lauded by IHA and the Indiana Campaign for Smokefree Air (of which IHA is a member) as a major step forward in protecting the health of Hoosier workers. The bill met a set-back when the House Public Policy Committee passed a heavily amended bill that exempted casinos and most bars.
Rep. Brown has proposed to exempt only casinos in HB 1208. However, since the chair of the Senate Commerce Committee did not hear the original bill, we do not expect that the conferee representing the Senate majority caucus (Sen. Lawson) would sign any conference committee report on this topic.

Admitting Privileges Receive Scrutiny
As it passed the Indiana Senate earlier this session, SB 89 would have required physicians performing abortions in Indiana to have “admitting privileges” at a hospital in that county or an adjacent county. When the bill came to the House Public Policy Committee, IHA was asked to testify on SB 89 solely to provide answers regarding the nature of admitting privileges.

SB 89 was later expanded greatly on the House floor on April 13 and passed the House on April 15. The changes to the bill include requiring any “health care provider licensed by the state” performing a “surgical procedure” to have admitting privileges at a hospital in that county or an adjacent county. “Surgical procedure” was not further defined, which meant that thousands of medical professionals could be impacted.

Although this problematic language passed, other proposals that would have mandated how hospitals award admitting privileges were defeated. It is likely that admitting privileges will continue to receive scrutiny from now until the end of the session on April 29. On Tuesday, the Indianapolis Star published an article on SB 89 and cited information provided by IHA. Read the article here: http://www.indystar.com/article/20090421/NEWS05/904210376.

Sen. Patricia Miller has dissented with the changes made by the House and the matter will likely be taken up by a conference committee. The Senate has appointed conferees and advisers but the House had not yet named its appointments as of April 23. IHA anticipates that the language broadening the requirement to all surgical procedures will be removed. IHA will continue to monitor the bill and defend against any possible attempts to dictate how hospitals grant admitting privileges.

State Revenue Forecast Mixed; Documents Online
The new state forecast projects that Indiana will take in slightly more tax revenue over the biennium than some had feared, but this optimism has been openly questioned by legislators. The budget writers will have about $830 million less than was estimated based on the December 2008 forecast, but some expected the shortfall to exceed $1 billion.

Following the presentation to the State Budget Committee, the forecast documents were posted to the Budget Agency’s website. The “Economic Outlook” document from Nigel Gault, chief U.S. economist for HIS Global Insight, is particularly interesting: http://www.in.gov/sba/2489.htm.

IHA Issues Call for Presentations at Annual Meeting

Posted on the IHA Website today (emphasis added):

IHA has issued a call for presentations for its Annual Meeting set for Sept. 16-18 in Indianapolis. This call is intended to give IHA members, corporate sponsors, and affiliated societies an opportunity to showcase patient safety, quality improvement, and service excellence initiatives that have positively impacted an organization’s bottom line. Application materials can be found at: http://www.ihaconnect.org/Education/IHAAnnualMeeting/default.aspx.

IHA must receive completed proposals by April 29 in order to assure consideration. Contact Cathleen Armold at carmold@ihaconnect.org for additional questions.

IHA News Update - March 11, 2009

The following is the cut and paste of the March 11 IHA News Update. Items of interest to healthcare quality professionals are highlighted in red.


Hospital Leaders Meet With Legislators at Hospital Day
IHA members interacted with more than half of the General Assembly during yesterday’s Hospital Day at the Statehouse. “Hospital Day was a huge success,” said Matthew Bailey, IHA chairman and president of Good Samaritan Hospital, Vincennes. “There was a lot of interaction between members and legislators, and the governor’s address was a great addition to the program.”

The meeting began with a lively Indiana Week in Review panel discussion led by WISH TV’s Jim Shella. Next, IHA presented an award to Gov. Daniels. The governor addressed the group and then took member questions. He commended hospital leaders for their statesmanship and praised members for placing patients’ needs before institutional needs. In particular he noted leadership in regards to patient safety and expanding access through the Healthy Indiana Plan. The governor also talked about improving Indiana’s health status measures and health information technology.

Members were also provided with a legislative update, talking points, and a Statehouse tour. The 2008 PAC awards were also presented. Attendance at the legislator reception exceeded expectations. Many hospitals were able to meet with their legislators during the reception and others scheduled meetings with them during the day.

Click here to view photos from yesterday’s Hospital Day at the Statehouse.

PAC Award Winners Announced at Hospital Day
IHA recognized several hospitals for their performance during the 2008 Friends of Indiana Hospitals campaign at Hospital Day.

The William S. Hall Award, IHA’s “most-improved” award went to Good Samaritan Hospital, Vincennes. Matthew Bailey is president and CEO. Two organizations earned honorable mentions for this category—Bloomington Hospital, Mark E. Moore, president/CEO; and St. Catherine Hospital Inc., East Chicago, Jo Ann Birdzell, administrator.

The highest percentage of goal award went to Henry County Hospital, New Castle. Blake Dye is president and CEO. Honorable mentions for this category went to Dupont Hospital, Fort Wayne, Dr. Michael H. Schatzlein, president/CEO; Bedford Regional Medical Center, Bradford W. Dykes, president/CEO; and Schneck Medical Center, Seymour, Gary A. Meyer, president/CEO.

AHAPAC MVP awards were also presented. The AHA MVP award winners were Blake Dye, president/CEO, Henry County Hospital, New Castle; and Matthew Bailey, president/CEO, Good Samaritan Hospital, Vincennes.

Bloomington, Clarian to Merge
Bloomington Hospital is moving forward with plans to integrate with Indianapolis-based Clarian Health. A definitive agreement has been signed. The merger is expected to be completed in 18 months.

ISDH Alerts Hospitals to Spend Disaster Funds Now
The Indiana State Department of Health is alerting hospitals that all disaster preparedness funds received under the 2008 contract must be spent by June 30 or will be subject to forfeiture to the state. Contract funds received in 2009 must be spent by Oct.7. If additional needs cannot be identified within an organization, funds may also be signed over to their districts for use on projects.

Seventeen percent of funds issued through the ISDH have not been reported as spent. Consult with your disaster preparedness coordinator to ensure that you have appropriately documented and reported your expenditures and that all funds are being used to improve your organization's disaster preparedness.

Program on Stimulus Provisions Set for April 23
Register now for e-Health Care Transformation: Demystifying the Stimulus Bill HITECH Provisions. The program is set for April 23 at the Montage, Indianapolis. Topics to be covered include medical identity theft red flags, mandated e-prescribing, HIPAA privacy and security requirement changes, and the implementation of telehealth to address workforce shortage issues. The program will also provide an overview of the economic stimulus package provisions for information technology and a practical approach to spending stimulus dollars on heath IT projects. To register, visit www.regonline.com/iha2009e-health.

IHA Leadership Conference set for May 21
Mark your calendars for the 2009 IHA Leadership Conference set for May 21 at The Montage, Indianapolis. The program will be led by Sg2 Chairman and CEO Michael Sachs. Sachs will provide demand forecasts using IHA’s inpatient and outpatient data. The forecast will factor in market volatility; alignment changes; demand shifts; and changes in coverage.

Using effective forecasting techniques, this program will help leaders manage uncertainty by projecting how change will impact health care service delivery in the future. Registration information will be available in the near future. To learn more about Sg2 visit their Web site at http://www.sg2.com/.

Registration Deadline for Retention Briefing Extended
The registration deadline for Engaging and Retaining Nurses: A Prescription for Redesign in Tough Economic Times has been extended until Monday. The program is set for March 18 at the Hilton Indianapolis North. Following the session, participants will have: an understanding of the role nurse retention plays in effective and efficient care; knowledge of Transforming Care at the Bedside—its principles, processes, and outcomes; an understanding of “vitality” and its contribution to nurse retention and care redesign; tools for measuring and improving vitality among nurses and other caregivers; a framework for developing nursing leadership competencies to support innovation; and techniques to engage frontline staff. To register, visit www.regonline.com/iha2009rnretention.

careLearning Informational Webinar Set for April 9
careLearning will host an informational webinar on April 9 for those interested in learning more about online education opportunities. The program will feature an overview of careSkills- a competency module that allows health care organizations to identify, assess, and analyze the skills, knowledge, and abilities of its workforce. Several IHA members are already enjoying the numerous benefits careLearning has to offer. Click here to read the careLearning newsletter and to view a list of upcoming webinars. You do not have to be a member of careLearning to participate in the webinars.

WHO to Launch Global Hand Hygiene Initiative
In May, the World Health Organizations will launch a new global initiative called SAVE LIVES: Clean Your Hands. The aim is to globally improve hand hygiene compliance in order to improve patient safety. The WHO hopes to engage 5000 hospitals by 2010. Over 280 hospitals have already indicated their interest in participating. Learn more at savelives@who.int.

IHA News Update - March 4, 2009

The most recent IHA News Update is cut and pasted below. Items of particular interest to Healthcare Quality Professionals are in red.


Stimulus Web Site Launched; Projects Due Monday
Indiana has launched a new Web site, http://www.in.gov/gov/INvest.htm, dedicated to information on the federal stimulus legislation. Of particular interest to hospitals is the section on competitive grants. Hospitals should submit information on potential shovel-ready projects through this Web site. The definition of shovel-ready is: infrastructure projects which have already been thoroughly designed by architects and engineers such that they are ready to be put out for bid for construction. The deadline for submission is Monday.

Although the portal has changed from the Ball State Web site, communicated to you earlier, project information is being collected using the same forms and process. If your hospital has already submitted projects through the BSU Web site it is not necessary to resubmit that information.

Session Hits Halfway Point, Bill Track Updated
The 2009 legislative session has reached the halfway point. Bills have either changed houses or “died”. This year, over 1,700 bills were introduced and only about 450 bills remain. IHA’s Bill Track has been updated and there will be limited action this week as committee hearings are just getting underway.

In addition to active bills, the Bill Track shows several bills that are dead and unlikely to be revived this session. Three bills failing to advance dealt with assignment of benefits. SB 75, authored by Sen. Beverly Gard (R-Greenfield), was strongly supported by provider groups but failed on third reading. The bill was not defeated, but lacked a constitutional majority at 25-24. View the latest Bill Track.

30 Percent Response Rate Needed for AHA Survey
IHA is encouraging community hospitals to participate in an AHA survey—The Economic Crisis: Ongoing Monitoring of Impact on Hospitals. The survey will be fielded later this week. If the response rate in Indiana is at least 30 percent, IHA will receive a copy of the data for its own state analysis.

IHA President’s Op-Ed Featured in Indy Star
The Indianapolis Star published an opinion editorial by IHA President Douglas J. Leonard regarding the need to pass House Bill 1213, establishing smoke-free workplaces for Hoosiers. Read the article.

Hospital Day Set for Next Week; Register Now
Hospital Day at the Statehouse 2009 is next week. So far, nearly 40 Indiana policymakers have registered for the Legislator Reception at the Eiteljorg Museum from 4:30-6:30 p.m. Gov. Daniels is also expected to address the IHA membership. To register, visit www.regonline.com/iha2009hospday.

HHS Adopts Modified Medical Data Code Sets
The Department of Health and Human Services released a final rule modifying medical data code set standards. The rule replaces the code sets now used to report health care diagnoses and hospital procedures with greatly expanded code sets. The final rule is available at http://edocket.access.gpo.gov/2009/pdf/E9-743.pdf.

CMS Begins Dry Run on Nine Quality Measures
On March 2, CMS began a “dry run” for nine patient safety and inpatient quality indicators that will be used to determine payment updates for FY 2009. The dry run provides hospitals the opportunity to review their performance and provide CMS with feedback. Hospital-specific reports can be accessed via QualityNet Exchange. Calculations featured on the dry run reports will be based on Medicare claims for 2006. These reports will not be used in any payment determinations, nor will it be publicly reported. The dry run is intended to familiarize hospitals with these performance measures prior to implementing them for public reporting on Hospital Compare later this year.

IHA Accreditation Webinar Set for March 12
IHA's Accreditation Alternatives webinar is set for March 12 from 3:30 to 5 p.m. The program will feature Joint Commission Executive Vice President Dr. Ann Scott Blouin. Dr. Blouin is responsible for oversight of the accreditation and certification programs for more than 15,000 health care organizations. She will speak on the Joint Commission’s hospital standards and accreditation changes for the new deemed status application.

Additionally, a panel of Indiana hospital representatives will share their experiences with HFAP and ISO 9001 certification. The cost is $100 per connection. It is free to those who participated in the Jan. 20 accreditation webinar. The registration deadline is March 10. To register, visit http://www.regonline.com/iha2009accreditation2-web.

Registration Deadline for Retention Briefing is March 10
March 10 is the registration deadline for Engaging and Retaining Nurses: A Prescription for Redesign in Tough Economic Times. Nurse leaders should register now to secure a spot. The program will be held March 18 at the Hilton Indianapolis North. Presenters from the Institute for Healthcare Improvement’s Transforming Care at the Bedside initiative will lead a discussion on the role nurse retention plays in effective and efficient care. They will also focus on Transforming Care at the Bedside principles, processes, and outcomes. To register, visit www.regonline.com/iha2009rnretention.

Program to Focus on Stimulus Provisions, Register Now
Register now for e-Health Care Transformation: Demystifying the Stimulus Bill HITECH Provisions. It is set for April 23 at the Montage, Indianapolis. The program will provide an overview of the economic stimulus package and explain in detail provisions that will directly impact hospitals including allocations for information technology projects and the significant changes to HIPAA requirements.

Participants will attend two breakout sessions. Topics will include medical identity theft red flags, mandated e-prescribing, HIPAA privacy and security requirement changes, and the implementation of telehealth to address workforce shortage issues. To register, visit www.regonline.com/iha2009e-health.

IHA Members, Affiliates Among Best Places to Work
Several IHA members and affiliate organizations were recognized among the 2009 Best Places to Work in Indiana by the Indiana Chamber of Commerce. Those recognized include:

• BSA LifeStructures, Indianapolis
• Clark Memorial Hospital, Jeffersonville
• Columbus Regional Hospital, Columbus
• Ernst & Young LLP, Indianapolis
• Good Samaritan Hospital, Vincennes
• Goshen Health System, Goshen
• Hancock Regional Hospital, Greenfield
• Ice Miller LLP, Indianapolis
• Schneck Medical Center, Seymour
• St. Joseph Hospital, Kokomo
• Union Hospital Health Group, Terre Haute
• Blue & Co. LLC, Carmel
• Hall Render Killian Heath & Lyman PC, Indianapolis

Regenstrief Institute Receives WHO Designation
The World Health Organization has designated the Regenstrief Institute as its first Center for Medical Informatics. The four-year designation directly connects Regenstrief's medical informatics group with a larger international collaboration of experts. The WHO and Regenstrief Institute will work together on the Open Medical Record System—a free electronic medical record system available to physicians and other health-care providers in countries with limited resources.

Indiana Trauma Evaluation Report Now Available
The final report from the American College of Surgeons’ evaluation of Indiana’s trauma system is now available on the IHA Web site. The report incorrectly lists motor vehicle registrations as a funding source for the trauma system. A note has been sent to ACS to correct the error. Read the report.

Join Sprint Action Day Set for March 10
If your hospital has not yet tested the WHO Surgical Safety Checklist, test it on Sprint Action Day set for March 10. The day is designed to support and accelerate testing and use of the checklist. If you have questions regarding implementation of the checklist, participate in a coaching call on March 10 or March 19. When your hospital has tested the checklist, notify Mikell Brown at 317/423-7726 or mbrown@ihaconnect.org. Learn more at http://www.ihi.org/.

IHA Legislative Update 2-23-09

The IHA issued a "Bill Tracker" last week. My apologies for overlooking it.

You can download it here.

You may need to log in to the IHA website.

Although there is significant items of interest to hospital administrators, there is minimal of immediate interest to the healthcare quality professional. All bills mentioned earlier in this blog appear to be dead for 2009.

IHA News Update

The most recent news from the IHA is cut and pasted below. Items of particular interest to healthcare quality professionals are in red.

State Requests Potential Stimulus Project Information

Indiana is seeking information on projects that could be eligible for federal funds through both last year’s Supplemental Appropriations Disaster Relief Opportunity legislation and the American Recovery and Reinvestment Act. More information on this data collection process is available from the Center for Business and Economic Research at Ball State University: http://www.bsu.edu/cber.

The state will be launching a new Web site to receive applications for stimulus funding, but for now we suggest using the documents on this Web site as a guide for what information the state will require.

IHA continues to encourage members to prepare information on potential “shovel-ready” capital projects, disaster-related construction and repair, health information technology initiatives, and energy efficiency projects. Not all of these projects will be eligible for stimulus dollars, but it is still unclear as to how some of the programs will be implemented. IHA continues to engage the state regarding distribution of the stimulus funding, but please keep these points in mind as you prioritize your efforts:

• Most of the health IT funding will flow directly to hospitals and physicians through a specific formula of incentive payments beginning in 2010 or 2011.


• There is likely no large pool of money available that would allow hospitals to jump-start or complete capital projects, however, the bill did increase funding for certain existing programs like Community Development Block Grants and rural hospital loans/grants under the Consolidated Farm and Rural Development Act.


• Most of the dollars, if not all, for construction are going to be distributed through state and local government. IHA encourages you to contact local officials and ask for their assistance with any “shovel-ready” projects.


• Perhaps the best strategy might be to offer to assist local officials in supporting local infrastructure projects that would indirectly benefit your hospital, such as nearby local road and street improvements.

Hospital Day Approaching; Register for March 10 Event

Hospital Day at the Statehouse 2009 is less than two weeks away. The event will provide hospital leaders the opportunity for relationship building with legislators. You can make a Statehouse visit from 3-4:30 p.m. and/or invite your legislator to the Legislator Reception at the Eiteljorg Museum from 4:30-6:30 p.m. Call your legislators now to invite them to the reception.

Hospital Day will also feature a luncheon panel discussion and an issues briefing from IHA’s government relations team. Gov. Daniels is expected to address the IHA membership. Visit the Hospital Day Web page to learn more. To register, visit www.regonline.com/iha2009hospday.

Save the Date; e-Health Care Program Set for April 23

Save the date; IHA will host e-Health Care Transformation: Demystifying the Stimulus Bill HITECH Provisions on April 23 at the Montage, Indianapolis. The program will provide an overview of the economic stimulus package provisions for information technology and a practical approach to spending stimulus dollars on heath IT projects.

Dr. J. Marc Overhage, director of medical informatics at the Regenstrief Institute and CEO of the Indiana Health Information Exchange, will also discuss a strategy to expand health information technology throughout Indiana using state allocations in the stimulus package. Members will also be invited to participate in two breakout sessions of their choice. Topics include medical identity theft red flags, mandated e-prescribing, HIPAA privacy and security requirement changes, and the implementation of telehealth to address workforce shortage issues. Registration information will be available in the near future.

IHA to Host Part Two of Accreditation Webinar Series

Secure your spot for part two of IHA’s Accreditation Alternatives Series. The educational webinar is set for March 12 from 3:30-5 p.m., EDT. The program will feature Joint Commission Executive Vice President Ann Scott Blouin who will speak on hospital standards and accreditation changes for the new Joint Commission’s deemed status application. In addition, a panel of Indiana hospitals that have achieved HFAP and ISO 9001 certification will share their experiences—highlighting strengths, weaknesses, and lessons learned.

All c-level leaders, board members, quality professionals, Joint Commission liaisons, compliance officers, and hospital legal counsel are encouraged to attend. The price for the webinar is $100 per connection. If your hospital participated in the DNV Accreditation webinar on Jan. 20—part one of the series, there is no registration fee. A discount code will be provided. To register, visit http://www.regonline.com/iha2009accreditation2-web. The registration deadline is March 10.

Nursing Leaders Should Attend Retention Briefing

Indiana’s nursing leaders are encouraged to attend Engaging and Retaining Nurses: A Prescription for Redesign in Tough Economic Times. The program is set for March 18 at the Hilton Indianapolis North. Following the session, participants will have: an understanding of the role nurse retention plays in effective and efficient care; knowledge of Transforming Care at the Bedside—its principles, processes, and outcomes; an understanding of “vitality” and its contribution to nurse retention and care redesign; tools for measuring and improving vitality among nurses and other caregivers; a framework for developing nursing leadership competencies to support innovation; and techniques to engage frontline staff. To register, visit www.regonline.com/iha2009rnretention.

Three Labor Unions for Nurses to Merge

The United American Nurses, California Nurses Association, and Massachusetts Nurses Association will merge to form a new labor union for registered nurses, called the United American Nurses-National Nurses Organizing Committee. Among other priorities, the group says it is resolved to organize all non-union direct-care nurses, advocate for nurse-to-patient staffing ratios, and create a national pension for union RNs.

Red Flag Rule Enforcement to Begin in May

Enforcement of the regulations commonly known as the "red flag rules” will begin in May. Hospitals must identify patterns, practices, and specific activities that could result in a risk of identity theft. Hospitals must implement procedures that mitigate these activities.

IHA’s general counsel, Hall Render Killian Heath and Lyman, has created an implementation guide to assist members in meeting these new regulatory obligations. The cost is $500. If you have any questions regarding medical identity theft, the red flag rules, or require assistance in implementing a program consistent with these new regulatory obligations, contact Michael Batt at 317/ 977-1417 or mbatt@hallrender.com or Jeff Short at 317/977-1413 or jshort@hallrender.com.

Culture of Safety Training Sessions Set for March

The Indiana Patient Safety Center will host training sessions for hospitals interested in participating in the Culture of Safety Survey Program. More than 35,000 Indiana health professionals and physicians are participating.

The program uses a Web-based application of the Agency for Healthcare Research and Quality safety culture instrument. The AHRQ survey allows hospital leaders to gain insight into the perceptions of employees and physicians related to the culture of patient safety within each hospital. The results will provide baseline data from which to measure the impact of hospital-specific and statewide safety interventions.

To participate, each hospital must designate an on-site administrator. Designated survey administrators should participate in a one-hour, Web-based training session.

Training sessions are set for:

March 13: 10 a.m., EDT

March 17: 11 a.m., EDT

E-mail Betsy Lee, director, Indiana Patient Safety Center, at blee@ihaconnect.org, if you are interested in participating in a training session.


Registration Now Open for IHA Management Institute

Registration is now open for the IHA Management Institute set to begin June 29. Classes will be held from June 29 to Dec.14 in Indianapolis. The program provides high impact education for new and experienced hospital leaders covering a range of topics from management style to financial management. Sponsored by IHA and the Indiana University School of Public and Environmental Affairs, the institute consists of 10 classes designed to meet the needs of hospital managers. Those successfully completing nine of the 10 courses will qualify for the Certified Health Care Manager designation. A full program brochure is posted on the Management Institute Web page. To register, visit www.regonline.com/iha2009management-jun.

CMS Says Spending on Hospital Services to Slow

The Centers for Medicare & Medicaid Services reported that growth in U.S. spending on hospital services is expected to slow as use of services slows along with personal income. The recession is also expected to slow the growth in private health spending to a 15-year low. As more people lose their jobs and employer-based insurance, spending by public insurance programs is expected to rise. CMS projects Medicare’s Hospital Insurance Trust Fund could be exhausted one to three years sooner than projected by Medicare trustees last year. The CMS report was published online by Health Affairs.

IHA Bill Tracker 2-16-09

The IHA sent out an update of bills relevant to hospitals in the current session of the Indiana Legislature. You can download it here. You will need to log in.

None of the proposed bills mentioned in this blog over the past month were mentioned in the bill tracker. I guess it means that those bills are dead? (which is not a bad thing)

Feb 11 IHA Newsletter

The most recent IHA newsletter was released on Feb 11. The following is a cut and paste of items relevant to the Healthcare Quality Professional. The full newsletter can be found here.

IHA Board Takes Action on Issues
At its Feb. 6 meeting, the IHA Board of Directors passed a resolution encouraging hospitals to test the WHO Surgical Safety Checklist. A study published in the New England Journal of Medicine demonstrates that use of the checklist during major operations can reduce the incidence of deaths and complications by more than one-third.

More Indiana Hospitals Test Surgical Checklist
More IHA members have reported testing the WHO Surgical Safety Checklist. IHA and IHI are challenging hospitals to test the checklist in one operating room, by one surgical team, one time before April 1. Click here to view the list of IHA members who have already participated. Contact Mikell Brown at 317/423-7726 or mbrown@ihaconnect.org when your hospital has tested the checklist to have your hospital added to the IHA list.

IHA Monitors Stimulus Bill; Compile Project Lists
Congress is still hammering out a compromise between the House and Senate on the stimulus legislation. IHA is uncertain of what will be in the final version of the American Recovery and Reinvestment Act, and even its passage is not guaranteed. However, similarities between the House and Senate approaches allow us to prepare for what the President may sign into law as early as next week.

In the interest of being prepared for funds being available to Indiana’s hospitals, IHA is suggesting that you quickly compile information on projects that could be eligible for grants or other funding assistance. Much of the health care-related funding may flow directly to providers (such as Medicaid dollars and most of the health information technology funding), but state governments may be provided discretion in certain areas. For example, the Senate-passed version of the ARRA appropriates $1.6 billion for “grants to make schools and hospitals, significant users of energy, more energy efficient” (see summary available on http://appropriations.senate.gov/). It is unclear exactly how it would be allocated, but it may be prudent to prepare for some sort of competitive grant process.

Mitch Roob, CEO of the Indiana Economic Development Corporation, has been asked by Gov. Daniels to coordinate the state’s management of stimulus dollars. IHA anticipates that once the final bill is known, we will contact members again with more details on (1) what kind of projects might be eligible for funding; and (2) what information is needed by IEDC or any other grant-making entities.

Based on reviews of the stimulus legislation, the following list is provided as a guideline for you to compile projects in these areas along with supporting information that would likely be needed. IHA cannot be sure that these projects will be eligible for any funding, but we simply want to be prepared. We will follow-up with a more formal survey after passage of any stimulus legislation and additional conversations with IEDC.

NOTE: These categories of projects are listed in the order of the likelihood of available funding.

• Energy efficiency or “green building” projects: Do you have “shovel-ready” energy efficiency or “green building” capital projects in the pipeline on which work could be underway within six months after receipt of federal funding assistance? If so, what phases have been completed and what would be the level of assistance required for completion?
• Health Information Technology: Do you have projects such as electronic health records or upgraded infrastructure/servers/systems in the pipeline? If so, what phases have been completed and what would be the level of assistance required for completion?
• “Brick and mortar” capital projects: Do you have “shovel-ready” traditional capital projects in the pipeline that could be underway within six months after receipt of federal funding assistance? If so, what phases have been completed and what would be the level of assistance required for completion?

Provisions Worth Noting in Senate Stimulus Deal
The Senate Appropriations Committee has released a summary of the stimulus legislation, and there are several health-related provisions worth noting. This summary is available on the Committee's Web page here: http://appropriations.senate.gov/.

The total amount appropriated for health information technology is $3 billion. This is significantly below the $20 billion in the earlier House version. The Senate summary also reports $1.1 billion will be given to the Agency for Healthcare Research and Quality, National Institutes of Health, and the Health and Human Services Office of the Secretary to evaluate the effectiveness of health care services. The House stimulus legislation appropriated $4.1 billion for similar research. In another area of the bill, $1.6 billion would be available in energy efficiency grants for schools and hospitals. More updates will be provided.

Leaders Ask Congress to Replicate Health IT Model
Leaders in Indiana are encouraging Congress to consider replicating Indiana’s Health Information Exchange model as it looks to invest billions in health IT infrastructure as part of the American Recovery and Reinvestment Act of 2009. IHIE provides the country’s best working model of a health information exchange— securely connecting 39 hospitals, 10,000 physicians, and more than 6 million patients. The exchange delivers lab results, reports, medication histories, and treatment histories, in real-time regardless of the hospital system or location. Studies have shown that efficient exchange of medical records among doctors and hospitals in the U.S. could save billions annually. Click here to read IHIE’s letter to Congress.

RAC Rollout to Proceed; Contract Protests Resolved
The Centers for Medicare & Medicaid Services has announced it will now continue with the rollout of the permanent Medicare recovery audit contractor program. The program had been on hold as a result of contract bid protests, which have now been resolved. Details on CMS’ plans to resume the program are pending and will be shared when available. IHA plans to schedule a RAC briefing in the near future.

Registration Now Open for Nurse Retention Briefing
Registration is now open for Engaging and Retaining Nurses: A Prescription for Redesign in Tough Economic Times. It is set for March 18 at the Hilton Indianapolis North. The program will provide Indiana’s nursing leaders with practical strategies that lead to: improved staff satisfaction and retention; improved quality of patient care; more effective care teams; and greater efficiency. The program will use the tested principles and processes of Transforming Care at the Bedside, a program of the Institute for Healthcare Improvement/Robert Wood Johnson Foundation. Presenters will share the evidence base that supports practical tools, techniques, and resources for improvement. To register, visit www.regonline.com/iha2009rnretention.

ECRI Issues High Priority Alert on Bassinet Warmers
ECRI Institute, an independent, nonprofit organization that researches the best approaches to improving patient care, has issued a high priority medical device alert for several older models of infant radiant warmers. ECRI Institute recommends the removal of a series of warmer models manufactured by Borning and Hill-Rom. Complete findings and recommendations are posted for free public access on ECRI Institute's Web site in its Patient Safety Center.

Time Running Out to Register for Just Culture Program.
The registration deadline for the Just Culture Champion Training Session is Feb. 24. The program will be held March 3 at the Montage, Indianapolis. This training session will examine the Just Culture model—focusing on risk, system design, and the management of behavioral choices. The Just Culture Algorithm will also be introduced. The algorithm is a structured process for conducting an investigation of an event or near misses—identifying system contributions and assessing accountability for those involved. The session will be presented by experts from Outcome Engineering, the developers of the Just Culture Algorithm. Following the session, participating hospital teams will be ready to implement the just culture concepts learned during the session into their respective hospitals. To register, visit www.regonline.com/iha2009justculture.

IHA Legislative Update - Feb 6, 2009

The most recent IHA Legislative Update is cut and pasted below (with some minor formatting changes). Items of particular interest to hospital quality professionals are colored in orange.

Deadlines Approaching; Workforce Bills Move Forward
Although conference committee work does not begin until late April, critical deadlines are approaching. Bills must be heard and pass out of committee by Feb.19. The surviving bills then must be amended and voted on by the full House and Senate by Feb. 24 and 25, respectively. Bills that don't make it through this process will be considered "dead." Of course, to keep things interesting, there are always opportunities to revive dead legislation, but these instances are limited.

Various bills addressing workforce issues are moving forward this session. Legislation includes:

Professional Licensing Matters: HB 1573, authored by Peggy Welch (D-Bloomington), addresses various professional licensing matters. The bill currently contains language that will grant physician assistants (PAs) more autonomy and somewhat expand their scope of practice. Among other changes, it would add PAs to the list of providers that can refer patients to occupational and physical therapists. It would also eliminate the current limit on the number of PAs that a physician may supervise and significantly changes the supervisory agreement. The bill is set for a hearing during next weeks' House Public Health Committee.

Home Health Care Wages and Benefits: HB 1028, authored by Rep. John Day (D-Indianapolis), would require home health care agencies to report annually wages, benefits, travel time and mileage, and other detailed information. This legislation is backed by the SEIU, which is concerned about the level of compensation for certain home health care workers. However, IHA’s government relations team has communicated to lawmakers that hospital-employed home health care workers are generally more highly-compensated than their non-hospital employed counterparts. Hospitals have been exempted from any new requirements.

Attracting Primary Care Physicians for Shortage Areas: HB 1138, authored by Rep. Scott Reske (D-Pendleton), passed out of the Public Health Committee this week. It defines primary care as family practice, obstetrics and gynecology, pediatrics, and internal medicine. The bill creates a loan forgiveness program for Indiana physicians who practice in these areas. A similar loan forgiveness program is included in HB 1210 (Public Psychiatry Development Program) authored by Rep. Charlie Brown (D-Gary). This bill is designed to increase the number of psychiatrists, psychologists, and psychiatric nurses practicing in Indiana, especially in the public sector.

Surgical Technologists and Nurse Circulators: HB 1593, authored by Rep. Chuck Moseley (D-Portage), presents some concerns for hospitals. The bill would require hospitals to employ only surgical technicians certified by a private, national accrediting agency (with some exceptions and a provision “grandfathering” those currently working as surgical technicians). This requirement would also extend to surgery centers and other health facilities.

Language in the legislation would also require nurse circulators to be present for the “duration” of surgical procedures. There are other issues that need clarification if this bill moves forward. The bill has passed out of the Public Health Committee, but Chairman Charlie Brown has asked IHA to work with the surgical technicians’ representatives to resolve other outstanding issues.

Trauma Funding Bill Passes First Test
This week, HB 1215, authored by Rep. Charlie Brown (D-Gary), was endorsed by the House Ways and Means Committee by a vote of 21-3. Before the vote, an amendment was approved that would reduce the amount of projected funding. The Legislative Services Agency had estimated that the introduced version of the bill would generate $16 million annually based on increased fees for motor vehicle violations, registrations, and driver's licenses. In its current form, the bill would only generate dollars for trauma centers through increased penalties for motor vehicle violations. HB 1215 could move to the House floor as early as next week for purposes of amendment by the full body.

FSSA Halts Welfare Modernization Rollout
FSSA Secretary Anne Murphy has halted any further rollout of the state's privatized, automated welfare intake system until agency officials are sure it can handle the additional volume. This decision comes at a time when lawmakers have introduced bills to slow down the initiative and fine-tune the new system which has met criticism. Since the rollout began 15 months ago, some have complained of lost documents, revoked benefits, lengthy hold times, and other problems.

State Revenue Falls Short; FSSA Asked to Make Cuts
The State Budget Agency has published the most recent monthly revenue report which can be viewed here: http://www.in.gov/sba/2485.htm.

Total tax collections for January were $142.2 million, well below a forecast that was made just a few weeks ago. The "Big Three"-- sales tax, individual income tax, and corporate income tax all fell below projected levels. For the first time in recent memory, this revenue report was posted along with a special commentary written by State Budget Director Chris Ruhl. His memo raises the very real possibility of additional state cost containment measures, and FSSA is specifically mentioned:

"Given the possibility of further revenue shortfalls, the Governor has directed us to assemble options for additional contingency measures. These generally include additional reductions in base spending, transferring unused balances in dedicated funds to the general fund, and renegotiating contracts and leases to generate cost savings. The Family and Social Services Administration has been asked to continue to generate other cost savings ideas in both Medicaid and other welfare programs they operate while preserving services."

IHA Update - Jan 30, 2009

The IHA issued a legislative update on Jan 30. Of note is a proposed bill to limit insurance carriers from demanding that members accept care outside of the US as a condition of coverage. The entire IHA Legislative Update is copied below:


IHA Examines FSSA HIP Expansion Proposal
On Wednesday, FSSA Secretary Anne Murphy appeared before the House Ways and Means Committee to address the agency’s funding levels in the 2009-2011 state budget. Two elements of her presentation were of particular importance to Indiana hospitals: 1) the status of the existing Healthy Indiana Plan (HIP); and 2) a new proposal to expand HIP.

FSSA has put forth the Indiana Check-Up Plan II, which would allow more Hoosiers to be covered under the current HIP program, expand coverage for the disabled, and increase Medicaid reimbursement for hospitals closer to Medicare levels. The funding would come from a redirection of state appropriations made to replace the HCI property tax levies and a new provider tax paid by hospitals. In addition, FSSA has proposed to phase out all allotments under the Disproportionate Share Hospital (DSH) program in exchange for federal approval of covering more non-parental adults under HIP.

There are multiple reasons why FSSA is pursuing the Check-Up Plan II. For one, the majority of the 43,000 HIP enrollees are non-parental adults. Since this population is not normally covered by Medicaid, agencies that approved the HIP waiver required Indiana to give up $50 million annually in federal DSH dollars. In addition, a cap of 34,000 enrollees was placed on the number of non-parental adults that could be covered.

In her testimony, Secretary Murphy told the Committee that this cap of 34,000 will be reached early this year. FSSA says that in order for CMS and OMB to increase this limit, Indiana would likely have to forgo additional DSH funding to offset the federal government’s future costs (referred to as ‘budget neutrality’). Under the Indiana Check-Up Plan II, all remaining DSH dollars would be phased out by 2013.

BACKGROUND: The total amount of DSH dollars available to hospitals in Indiana (after the diversion of $50 million for the first HIP program) is roughly $130 million. While this number is significant, FSSA believes that the overall benefit of the Check-Up Plan II would offset this loss to Indiana’s hospitals as a whole.

Another motivator is that many disabled Hoosiers are signing up for HIP. Although they may be partially Medicaid-eligible, they are seeking to avoid the cumbersome “spend down” system imposed in Indiana. It is believed that this will drive expenses for the HIP program upward faster than expected. A chart produced by FSSA during Wednesday’s budget presentation showed annual expenses for the HIP program meeting revenues by 2011. FSSA proposes that a provider assessment levied on hospitals (in addition to the tobacco tax already dedicated for HIP) would then help stabilize funding for the entire program.

IHA is engaged with FSSA to better understand these and many other components of the Check-Up Plan II. To properly evaluate any proposed expansion of HIP, we are working with Secretary Murphy and her staff to better understand the magnitude and distribution of dollars returned to hospitals under HIP since its inception. We firmly support expanding coverage and leveraging more federal dollars back to the State of Indiana.

There are elements in the plan that generated reservations. The Federal Leveraging Task Force, convened by the IHA Board to explore the redesign of DSH and other supplemental payment programs, has been studying the proposal. Concerns have been raised about a hospital assessment that could return less than 100 percent to hospitals. In addition, members feel that the impact of the first HIP program must be better understood before Indiana surrenders its entire DSH allotment.

Legislation has been introduced to serve as a “placeholder” for FSSA’s proposal, but the bill’s author and Secretary Murphy have assured us that unless IHA supports a hospital provider tax, the major components of the Indiana Check-Up Plan II described above will not move forward this session.

This week IHA's Federal Leveraging Task Force recommended that a provider tax not be pursued at this time. This has been communicated to key policymakers. The task force did direct IHA to continue working with FSSA on many elements of the plan including: improving the current HIP program, expanding coverage for more Hoosiers, and creating a transparent and equitable supplemental payment structure.

Statewide Smoke-Free Air Bill to Be Heard Next Week
Broad smoke-free air legislation authored by Rep. Charlie Brown (D-Gary) has been scheduled for a hearing next week in the House Public Policy Committee. HB 1213 would ban smoking in public places and all enclosed workplaces. If it is successful, Indiana would join 23 other states that have enacted comprehensive smoke-free air legislation. The hearing will be held in the House Chamber on Feb. 4 at 9 a.m. and will be available online through the General Assembly's Web page.

IHA is supporting this legislation along with many other groups including the Coalition of Advanced Practice Nurses, the Indiana Academy of Family Physicians, the Indiana Minority Health Coalition, the Indiana Rural Health Association, and many more.

HB 1084: Medical Tourism Bill
A bill heard this week in the Indiana House would ban insurers from requiring health care treatment outside the U.S. as a condition of coverage. Rep. Craig Fry (D-Mishawaka), chairman of the House Insurance Committee, has authored a bill that would prevent some health insurers from forcing or encouraging customers to receive treatment overseas. HB 1084 was heard this week in the Committee, but a vote was not taken. It will be back on the agenda on Feb. 4 when the Insurance Committee meets at 10:30 a.m.

Last November, Indianapolis-based WellPoint launched a pilot program with a Wisconsin employer to cover certain elective procedures performed in India. This program was featured in an article published last month by Inside Indiana Business. Read the article.

Register Now for Hospital Day at the Statehouse
Registration is now open for Hospital Day at the Statehouse. The event is set for March 10. This year, Hospital Day will follow a new format. The luncheon will be members-only and hospital leaders should instead invite their legislators to attend an evening reception from 4:30-6:30 p.m. at the Eiteljorg Museum. To register or to view a copy of the brochure, visit www.regonline.com/iha2009hospday.