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Last month, the Kansas budget nightmare hit closer to home when Governor Mark Parkinson announced approximately $260 million in spending cuts for the remainder of fiscal year 2010. Up to that point, health care providers and their patients had been spared cuts aimed at helping the State deal with its continuing fiscal woes. Not any more. Gov. Parkinson took the axe to Medicaid provider rates, cutting them 10 percent.
We all realize the seriousness of the State's financial situation and the need to make adjustments to the budget. It may be that some policymakers hope health care providers simply accept these cuts as part of their "duty" to the State. Kansas hospitals don't see it that way. Our "duty" is to make sure that the State knows how the policies it adopts affect hospitals and the delivery of health care in our state. Our "duty" is to point out to the State when it is and isn't a good business partner. Our "duty" is to object when state policies stretch the fragile health care safety net to the breaking point. As a result, it is incumbent on us to tell policymakers in no uncertain terms that the recent Medicaid decisions are just plain bad health policy.
We have outlined our general concerns about this bad health policy in a letter we sent to the Governor in December. We emphasized that Medicaid payments to providers are already significantly below the costs of providing care; that, given the magnitude of these cuts, access to health care in our State will be impaired; and that the significance of the rate cuts is magnified because of the loss of federal matching funds involved. KHA also has met with a number of other groups representing health care providers who serve Medicaid clients - physicians, nursing homes, safety net clinics, dentists, optometrists, pharmacists and others. It was clear from this meeting that Medicaid providers across the State are extremely concerned about the impact of the State's actions on the people they serve. There was consensus that we need collaboration regarding Medicaid issues to strengthen our voices
In addition to these cuts, the Kansas Health Policy Authority originally announced that it would be eliminating the customer service call center, which normally fields approximately 250,000 provider and beneficiary calls per year. From the start, we criticized these cuts and have continued to have regular communications with KHPA staff. Recently, we learned that a solution may be imminent to save the Medicaid customer service call center. While CMS approval of this plan is required, we are optimistic that it will be granted.
There is no question that the actions taken by the State regarding Medicaid present Kansas health care providers with a difficult advocacy challenge. To meet that challenge, we will need help from hospital leadership in identifying the specific problems created by these cuts and visiting with your legislators about them.
Kansas hospital trustees and CEOs are invited to help us share this story with your state legislators at our 2010 Advocacy Day on Jan. 19 at the Capitol Plaza Hotel in Topeka. This is your opportunity to visit with your elected officials about the issues facing Kansas hospitals. The day will kick off at 9 a.m. with welcoming comments from Gov. Mark Parkinson, followed by remarks from house and senate leadership. All state legislators are invited to join us for lunch.
The Advocacy Day flyer and online registration are available on the KHA Web site. Questions can be directed to the KHA Education Department at (785) 233-7436.
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 The Kansas Hospital Association, in conjunction with The Walker Company Healthcare Consulting, LLC, is now offering dozens of affordable and topical governance education programs that may be easily downloaded from our Web site. This new service was developed in response to member requests for brief governance education programs that may be presented and discussed at board meetings.
Trustee Foundations™, Governance Education On Call 24/7/365, provides you with access to timely and relevant governance education programs when you need them - any time, any day. You simply click on the "Trustee Foundations" link on the Trustee page of our Web site, review the program topics and descriptions, select those you want to purchase, and check out. You'll then be able to immediately download a self-running PowerPoint Show with audio, a detailed BoardBrief handout and other supporting materials, and questions for board discussion following the program.
Individual programs are a very affordable $169 each. In addition, a discount of 10 percent is offered for purchase of five to nine programs in one order, and a discount of 20 percent is offered when 10 or more programs are purchased in one order.
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Congress' consideration of health reform legislation is certainly proving true of the often quoted saying from Otto Von Bismarck: "Laws are like sausages. It's better not to see them being made."
There are many examples of this principle. A fascinating one was the sight of Howard Dean, former Vermont Governor and a physician, calling for the Senate to kill its health reform bill. As you may recall, Dean was formerly the chair of the Democratic National Committee and was widely credited for many of his party's gains during the last election. What was even more fascinating was the White House's response to Dean's criticism, labeling his call to kill the legislation "insane."
However, the real sausage-making occurred as the Senate crafted the final elements of its bill. The proposed 5 percent tax on cosmetic procedures, or the "Botox tax," was removed in favor of a 10 percent tax on tanning services. Vermont Sen. Bernie Sanders took credit for $10 billion in new funding for community health centers. Michigan Sen. Carl Levin carved out an exemption for non-profit insurers in their states from a hefty excise tax. Similar insurers in other states will pay the tax. Three states - Pennsylvania, New York and Florida - all won protections for their Medicare Advantage beneficiaries at a time when the program is facing cuts nationwide. All of this came on top of a $300 million increase for Medicaid in Louisiana, designed to win the vote of Democratic Sen. Mary Landrieu. Another amendment would bump up Medicare payments to doctors and hospitals in state hospitals where at least 50 percent of the counties are defined as "frontier counties." So far, only the Dakotas, Wyoming, Utah and Montana meet the criterion.
Maybe the best and most infamous example is Nebraska Sen. Ben Nelson's "Cornhusker Kickback" - a deal he carved out for Nebraska involving a permanent exemption from the state's share of Medicaid expansion, expected to cost the federal government $100 million over 10 years.
This would almost be comical if we weren't talking about such a serious subject. There are many problems with the Senate bill that deserve the attention of lawmakers - the level of coverage expansion, differences in how the legislation will be paid for, large Medicare reductions for hospitals and a readmissions policy that is punitive rather than thoughtful. But the specter of these "sweetheart deals," which will be paid for by taxpayers in all states, including Kansas, has largely become the focal point of the discussion.
In response to Sen. Nelson's deal, Nebraska Gov. Dave Heineman said, "Nebraskans expect a fair deal not a special deal. Neither Nevada, Vermont, Massachusetts, Louisiana, Nebraska, nor any other state should receive a special Medicaid deal that is not available to other states. It is imperative that every state is treated fairly and equally or all special deals must be removed."
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 It is with great excitement that we kick off our centennial celebration. Kansas hospitals have been working together to improve hospital care through the exchange of knowledge and ideas for 100 years!
It was in 1910 that John Thomas Axtell, MD, met with representatives from privately owed and religiously affiliated hospitals to discuss the formation of what is now the Kansas Hospital Association. Our mission is to be the voice and resource for community-based hospitals by meeting member needs for advocacy and service. Today we consist of 194 members, of which 125 are hospitals, working together to improve access, quality and the affordability of health care for all Kansans.
In celebration of 100 years of working together, KHA has a number of activities planned to inform, engage and educate legislators, media and the public on the history and future of Kansas hospitals. I would like to invite you to participate in any of the 2010 activities that might interest you, as it will be a very special year.
If you have yet to receive a commemorative calendar highlighting the anniversary events we have planned for 2010, just let us know. Click on "Contact KHA," and a calendar will be sent to you.
In addition to a number of special activities, KHA would like your feedback on the branding of your association. We have been using our current logo and branding for a couple of decades and would like you to provide us with your opinion on whether we should retain, update or replace the KHA logo and branding. Between now and March 1, 2010, please go the Vote on the KHA Logo Web page and vote on your choice for your association logo and branding (to begin in 2011). You will need to login to vote.
I encourage you to mark your calendars now for our 100th Anniversary Gala Event on Wednesday, Nov. 10, 2010. This event will be part of our Annual KHA Convention and Trade Show in Topeka, Nov 10-12, 2010. And if you would like to partner with KHA on any activities in conjunction with out 100th anniversary, please contact KHA at (785) 233-7436. On so many levels, 2010 promises to be a year none will soon forget. Your association will continue to work for you on the many critical issues our members face, while striving to unify and amply the voices of Kansas hospitals.
We thank you for your valuable contributions to the communities which you serve, providing care 24 hours a day, seven days a week, 365 days a year, keeping your communities healthy, strong and vibrant. Happy Anniversary to you!
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The Kansas Hospital Association is testing a news clipping feed on the KHA Web site. On the front page of the KHA Web site, you will now find a link to articles of interest from papers across the state and nation that are of specific concern to Kansas hospitals. In addition to this scrolling listing on the KHA home page, the top 20 articles each day can be found on the new Kansas Hospital News section. Once you find an article that interests you, just click on the headline to view the entire article. We will be providing this service temporarily to see if it is of value to KHA members. Please let us know if this service is helpful to you by contacting Cindy Samuelson at (785) 233-7436.
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The Kansas Hospital Association and the Kansas Medical Society, along with support from KaMMCO, are offering a series of Webinars in 2010 outlining legal issues of key importance to hospital and physician leaders. This valuable education series is made possible through a partnership with three leading Kansas law firms; Polsinelli Shughart PC, Lathrop & Gage LLP, and Foulston Siefkin LLP. In six convenient noon-hour sessions, health care law experts will analyze challenges involved in creating, maintaining and modifying constructive hospital-physician relationships.
Jan. 21
Primer: Relationship Chilling Effects
Discussion topics include: Stark, anti-kickback, tax-exempt status
Andrew Ramirez, Lathrop & Gage LLP
Joan Kilgore, Polsinelli Shughart PC
Stan Andeel, Foulston Siefkin LLP
Feb. 24
Planning for Recruitment
Discussion topics include: recruitment policy, immigration issues, board involvement
Doug Anning, Polsinelli Shughart PC
Jay Howard, Polsinelli Shughart PC
March 30
Compensation Models
Discussion topics include: call coverage, malpractice premium subsidies
Andrew Ramirez, Lathrop & Gage LLP
May 25
The Spectrum of Alignment
Discussion topics include: joint ventures, clinical integration, practice acquisition
Scott Palecki, Foulston Siefkin LLP
Oct. 12
Salvaging Difficult Relationships
Discussion topics include: staff investigation/discipline, compliance program integration, covenants not to compete
Mary Beth Blake, Polsinelli Shughart PC
Dec. 1
Synopsis: Pulling It All Together
Jeff Ellis, Lathrop & Gage LLP
Joan Kilgore, Polsinelli Shughart PC
Stan Andeel, Foulston Siefkin LLP
Mark your calendars and plan to participate in these educational offerings. The informational flyer and online registration are available on the KHA Web site. Questions can be directed to the KHA Education Department at (785) 233-7436.
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The American Hospital Association distributed a Call for Nominations for Trustee Leadership Positions on Jan. 5, 2010, to AHA member hospital and health system CEOs. In Region 6, the region for Kansas, AHA is looking for trustees interested in serving 2011-2013 terms in the following roles: Committee on Governance Regional Members, Committee on Governance At-Large, AHA Regional Policy Board Regional Trustee Liaison, AHA Regional Policy Board Trustee Alternate Delegate. Nominations are due on Feb. 16, 2010.
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 In an effort to make the 2009 Annual STAT Report available to as many people as possible, we are now providing this report in two formats. The 2009 Annual STAT Report is available online in a bookmarked PDF. To open the bookmarking feature, once the PDF is open, click on the icon on the left.
In addition to the bookmarked version of the entire 2009 Annual STAT Report, specific sections (with bookmarks) are available. This allows individuals to access just what they are looking for, in smaller file sizes.
The 2009 Annual STAT Report also is available in a print version. If you would like KHA to send you a copy of the 2009 Annual STAT Report, contact Debbie Hall at (785) 233-7436.
The 2009 Annual STAT Report is specific to Kansas, and provides information regarding legislative issues, as well as information on hospital characteristics, workforce, utilization and finances. The 2009 Annual STAT Report is designed to assist health policy decision-makers and business and community leaders in understanding the impact of their decisions regarding access to and the quality of health care in Kansas.
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