Celebrate nurses at nursing leadership conference
The 2023 Iowa Organization for Nursing Leadership Conference will provide an opportunity for nursing leaders to celebrate their profession, collaborate, learn and network. The program will begin with the debut of the 2023 Great Iowa Nurses recognition video, followed by an update about the program’s direction. Mary Greeley Medical Center revived and renamed the recognition program in 2022.

Participants also will learn about the changing roles and responsibilities for nurse leaders and how to be successful in the evolving health care environment. Other topics include:

• Addressing bullying and incivility in the workplace.
• Getting involved with IHA’s advocacy efforts.
• Implementing four phases of quality improvement.
• Investing in the nursing pipeline through recruitment and retention strategies.

The spring conference is scheduled from 8 a.m.-3:45 p.m. Wednesday, May 24. Email Autumn McGill at IHA with questions. The conference is sponsored by CEC and Wellmark.

IHA-supported bill would add 14,000 Medicare-funded residency positions
IHA supports the Resident Physician Shortage Reduction Act of 2023 (H.R.2389), legislation that would add 14,000 Medicare-funded residency positions to help alleviate physician shortages that threaten patients’ access to care.

The bill would add 2,000 positions per year for seven years, targeting a portion of these positions to:

• Hospitals already training over their caps.
• Hospitals in rural areas.
• Hospitals in states with new medical schools or branch campuses.
• Hospitals serving areas designated as health professional shortage areas.

“Your legislation responsibly addresses the nation’s urgent need for additional physicians,” AHA said in a letter to the bill’s sponsors, Reps. Terri Sewell, D-Ala., and Brian Fitzpatrick, R-Pa. “We also applaud you for directing the Government Accountability Office to recommend to Congress strategies for increasing the diversity of the health professional workforce.”

CMS issues IPPS proposed payment rule for FY24
The Centers for Medicare and Medicaid Services has released its hospital inpatient prospective payment system and long-term care hospital IPPS proposed payment rule for fiscal year 2024. The rule proposes a 2.8% rate increase for IPPS payments in FY 2024. Other provisions include:

• Continuing the low wage index hospital policy for FY 2024, treating rural reclassified hospitals as geographically rural for the purposes of calculating the wage index and excluding “dual reclass” hospitals from the rural wage index.
• Adding a new health equity adjustment and a sepsis bundle measure to the Hospital Value-based Purchasing Program.
• Permitting the use of web-based surveys for Hospital Consumer Assessment of Healthcare Providers and Systems.
• Requiring reporting “up to date” vaccination status for the inpatient quality reporting health care personnel COVID-19 vaccination measure.

Webinar keeps boards focused on the ‘main thing’
Spots still are available for the upcoming Foundations of Governance Excellence webinar Keeping the Main Thing ‘the Main Thing’: Focus Your Board on the Right Things. Susan Freed, shareholder with Dentons Davis Brown Law Firm, and former hospital CEO Doug Morse will provide tips and best practices to help governance boards stay focused on their missions.

Discussion topics include:

• Advancing organizational goals.
• Creating ideal board agendas.
• Identifying relevant agenda topics.

The webinar is scheduled from 2-3 p.m. Thursday, April 20.

HIPAA enforcement discretion ending May 11
The Department of Health and Human Services’ Office for Civil Rights announced that HIPAA enforcement discretion will expire with the end of the COVID-19 public health emergency, but covered health care providers will have until Aug. 9 to comply with the HIPAA telehealth rules.

The Office of Civil Rights implemented the enforcement direction policies in 2020 under HIPAA and the Health Information Technology for Economic and Clinical Health Act for:

• Community-based testing sites.
• Online scheduling for COVID-19 vaccinations.
• Telehealth remote communications.

Use and disclosure of protected health information by business associates.

Merritt Hawkins releases latest physician billing report
Physicians bill commercial health care insurance companies an average of $3.8 million a year per provider, according to a new report from AMN Healthcare, parent company of Merritt Hawkins, a ServiShare-endorsed business partner.

The company’s 2023 Physician Billing Report tracks claims submitted by physicians in 18 specialties and claims submitted by nurse practitioners and certified registered nurse anesthetists. On average, providers tracked in the report submit close to $4 million per year in billing to commercial health insurance companies. General surgeons submit the highest average annual claims among physicians included in the report at $11,669,016, while pediatricians submit the lowest average at $1,323,104.

Other report findings:

• Physicians who practice in diagnostic, surgical and internal medicine subspecialties typically generate higher average billing to commercial payers than do primary care physicians.
• The average billing amount to commercial payers generated by specialist physicians is $4,650,750 compared to $1,770,564 for primary care physicians.
• Under health care reimbursement models, surgical, diagnostic and other procedures typically performed by specialists are compensated at higher levels than are the consultative services typically provided by primary care physicians. As a result, claims submitted by specialists are usually higher than those submitted by primary care physicians.
• Certified registered nurse anesthetists submit an average of $1,750,281 in claims to commercial payors while nurse practitioners bill an average of $777,393, underscoring their economic importance.

The report tracks billing only for services provided by physicians, nurse practitioners and certified registered nurse anesthetists directly, and does not include downstream revenue these providers may generate through the tests and hospital admissions they order and other activities. Factoring in this revenue would further underscore their importance as revenue drivers.

Though payment models in health care are evolving, much of health care economics still is driven by the type and volume of services physicians and advanced practice professionals provide. They remain key catalysts of care and revenue.