THA, TMA Outline Legislative Priorities Telehealth, CON, Scope of Practice Lead Concerns By CINDY SANDERS
The Tennessee General Assembly reconvened in January for the second half of the 111th session. Hundreds of bills have been filed that intersect with the broad topic of healthcare. While many will never make it out of committee, two major provider and facility organizations – Tennessee Hospital Association (THA) and Tennessee Medical Association (TMA) – will keep watch for bills impacting their membership while also pursuing action on their own legislative priorities. From consensus items to ones causing consternation, the leadership of two organizations was surveyed to learn their 2020 priorities and key advocacy issues.
The THA has new leadership, but ongoing priority concerns. Wendy Long, MD, MPH, last fall was named president and CEO of the statewide organization, taking the reins from Craig Becker, who retired after more than 25 years at the helm. Among continuing concerns are maintenance of the state’s certificate of need program, the voluntary hospital assessment and support for rural hospitals. Additionally, THA is focused on measures to improve telehealth laws as usage contin-
ues to increase. CON: THA is a strong supporter of Tennessee’s certificate of need program, believing the regulations help level the playing field and dissuade “cherry pickWendy Long ing” the commercially insured patients that keep hospitals financially viable. “We do definitely believe the CON program is absolutely essential,” Dr Long said. “We think it helps in managing healthcare cost, workforce demands and making sure access to quality healthcare services is available throughout Tennessee.” She added the CON program was a hot topic last year and expects legislation to be introduced again this session. “We agree there are some improvements that could be made in the CON process or operation of the program, and we hope that is the focus.” She noted THA is happy to work with the Legislature to improve the efficiency and transparency of the program in a way that isn’t detrimental to the underlying reasons certificates of need were originally implemented. “We certainly worry about rural hospitals if there are changes to the
CON program,” she said. Hospital Assessment: Dr. Long said THA will again voluntarily bring the annual hospital assessment legislation to Tennessee lawmakers. The assessment at the state level draws down matching federal dollars for the TennCare program. She noted the idea of hospitals’ picking up what had traditionally been funded by the state first occurred in 2010 at the height of the recession. “We were looking at substantial changes to services and benefits in TennCare. As a result of that set of dire circumstances, hospitals came forward and voluntarily offered to put up the necessary funding. That assessment today generates $602 million in state funding, which draws down a federal grant for a total of $1.7 billion.” The rate of assessment will remain at the current rate of 4.87 percent of a hospital’s net patient revenue. The funding, Long explained, averts limits on certain benefits, including physical, speech and occupational therapy, for TennCare enrollees. It also avoids a 7 percent reduction in TennCare provider rates. Although hospitals have agreed to the assessment annually for the last decade, Dr. Long said it shouldn’t be considered an automatic conclusion. “It’s something
we discuss each and every year. I would not characterize it as an easy decision,” she noted. “Hospitals continue to hope at some point the state might begin to replace this money with other revenue sources, but that has not happened so each and every year, hospitals have to reassess the issue.” Rural Hospital Support: In 2018, the General Assembly created the Rural Hospital Transformation Program to support work between at-risk rural hospitals and consultants who would assess the facilities and formulate strategies to improve hospital viability and access to care. As a result of this program, Dr. Long said several hospitals have completed the work with consultants and now have a list of recommendations in hand. “Some good suggestions were made . . . but in many, if not all, cases, there was a need for funding resources,” she said. “This was a great first step to do the analysis to come up with these plans. Now we’d like to see funding be directed to help the hospitals be in a position to implement those plans.” Telehealth: THA is working in concert with a number of provider organizations to tweak Tennessee telehealth laws. Long, who previously served as director of (CONTINUED ON PAGE 4)
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