May 25, 2018
Another Case for Health Equity
Earlier this week, MHA hosted the latest in our series of conversations about how to reduce health disparities in Maryland. For the two dozen attendees charged with this task at hospitals across the state, the focus was how to elevate the pursuit of health equity in the face of budget limitations. MHA presented a framework to begin thinking about how to capture the financial benefit of reducing health disparities in our communities.
 
In an example that used statewide data applied to a hypothetical hospital, we discovered that by bringing all racial groups to the same level as the best-performing group on readmissions, a hospital could see as much as a 1.5 percent gain ($3 million for a hospital with $200 million in inpatient revenue) via the quality-based incentive program.
 
Reducing health disparities is of course more important and worthwhile than just improved finances. It is central to our mission of care as we refashion hospital work to address not only somatic and behavioral care for individuals, but also the social determinants that affect the health of whole communities.
 
Because hospitals do not have limitless resources, you as a leader are often faced with choosing between several worthy approaches, any of which could mean that something else may not get done. Tools like this framework, as well as a potential template that will allow hospitals to plug in their own data to generate estimates of the financial impact of reducing health disparities, can help you make sure these are well-informed choices.
 
If you need any assistance on health disparities, please don't hesitate to reach out to me directly, or contact Mark Rulle at mrulle@mhei.org .
 
One more brief housekeeping item for this week: regular readers of MHA's Update newsletter are accustomed to seeing the President & CEO's message in this space. In the coming weeks, we'll be expanding the use of Update to add more voices to the mix. Keep an eye out for messages from other senior MHA leaders who will offer ideas and insight on a variety of timely topics.

Bob Atlas
President & CEO

Maryland Model Presentation Materials Available
In the wake of the agreement between the state and the federal government on the next phase of Maryland's unique hospital payment model, MHA has prepared several documents for your use as needed when talking to boards, the public, the media and others. You can access them by clicking on these links:  
 
Each of these documents can be tailored to your own needs.  
 
Contact: David Simon
MHA's Annual Meeting Is Fast Approaching
In just a couple of weeks, hospital CEOs and other leaders will gather at the Four Seasons Hotel in Baltimore to discuss the latest national issues in health care and how a new agreement with the federal government will affect the future of Maryland's hospitals. An evening reception on Monday, June 11, will offer time to connect with one another, and we'll recognize some special award winners. On Tuesday, June 12, our program runs through lunch and features several prominent speakers:  
  • This year's Davidson Lecture will be delivered by Atul Gawande, M.D., one of Time's 100 Most Influential Thinkers, a renowned surgeon and researcher, and author of Being Mortal: Medicine and what Matters in the End. Gawande will share his bold vision for improving performance by focusing on the needs of real people, the values that make for a healthy society, the science and technologies waiting over the horizon, and how to reform systems to make it all work. Dr. Gawande will remain after his lecture for a book-signing.
  • Ben Nemtin's inspirational message has its roots in a cross-country trip with three friends, when they began to check items off of the "world's greatest" bucket list. Every time they accomplished a dream, they helped a complete stranger cross something off their bucket list. From playing basketball with President Obama to streaking a soccer field, from raising over $400,000 for charity to placing a record-breaking $250,000 bet on roulette-the bucket list quest has inspired millions to chase their dreams. Nemtin's message of radical possibility has been featured in major media including The Today Show, The Oprah Winfrey Show, CNN, FOX, ABC, CBS, NBC News, and more.
  • Dr. Omar Manejwala, Addiction psychiatrist and Chief Medical Officer at Catasys, a national health services management company; Author of Craving: Why We Can't Seem to Get Enough; and former Hazelden Foundation Medical Director.in his talk, he will present a futurist's perspective, detailing the changes needed to foster improved addiction outcomes and how innovation will play a key role in the work to turn the tide on substance use disorders.
 
There's still time to register . You can check the full brochure here .
 
Contact: Kathy Gotwalt
Register Now for Workplace Violence Summit
MHA and the Maryland Nurses Association will hold a Workplace Violence Summit June 28 from 9 a.m. to 4 p.m. at the Marriott BWI Airport. The summit will feature national experts who will discuss promising strategies on violence prevention programs in health care facilities. It also will offer facilitated discussions of workplace safety issues like employee resiliency, security protocols, and creating a culture of safety. The keynote speaker is Ann Scott Blouin, RN, PhD, FACHE, President and CEO, PSQ Advisory. A nationally recognized health care leader with more than 30 years of strategic planning, health care administration, consulting, and clinical experience, Dr. Blouin has worked with health systems across the country to address operations efficiency and effectiveness, improve revenue management, address competitive challenges and minimize reputational risk by enhancing quality and patient safety. Registration is free but space is limited. The meeting is aimed at health care practitioners (nurses, physicians, etc.), health care facility, security, and administrative staff, law enforcement, and state officials.
 
Contact: Erin Dorrien
MHA Submits Letter on Annual Update Recommendation
MHA has submitted a comment letter on behalf of the hospital field to the Health Services Cost Review Commission on the Rate Year 2019 Annual Payment Update Draft Recommendation. Collectively, hospitals are seeking a 0.5 percent increase to the recommended overall annual payment update. This request is supported by several arguments, including expected cushion in the national payment projections, savings shared with payers that exceed the previous infrastructure adjustments, and others. If you have any questions, contact Brett McCone .
Long-Term Providers to Receive 3 Percent Rate Increase
Governor Larry Hogan this week announced that the administration will provide a 3 percent increase to the Maryland Medicaid Long-Term Services and Supports provider rates. The increase will benefit nursing home and home and community-based providers who deliver services to individuals enrolled in Maryland Medicaid.
Synthetic Marijuana Still Causing Concerns
Maryland's hospitals, EMS, and other health care providers were notified last week by the Maryland Poison Center that 21 people in the state with exposure to synthetic cannabinoids had significant elevations in International Normalized Ratio (INR) and bleeding. All nine of those people who had their blood tested for the presence of brodifacoum tested positive. Brodifacoum is a long acting vitamin K-mediated anticoagulant that is used as rodenticide. The notice asks that, for patients who present with any signs of bleeding, providers check an INR. All patients who present with symptoms consistent with anticoagulation and elevated INR should be evaluated for cannabinoid associated coagulopathy. Hospitals that encounter a patient with significant bleeding and an elevated INR without a definitive etiology (e.g., taking warfarin or overdose of rat poison) should promptly report the case to the Maryland Poison Center at 800-222-1222.
IHI Seeking Participants for Age-Friendly Action Community Program
The Institute for Healthcare Improvement is providing an opportunity for up to 150 health systems across the country to participate in an action community program. These health systems will have seven months to implement changes to improve how care is delivered to older adults and to learn more about operating an " Age-Friendly Health System ." This care model is currently being piloted by five health systems in the country, one of which is Anne Arundel Medical Center. It is funded by the Institute for Healthcare Improvement and the John A. Hartford Foundation. Started in 2017, this model focuses on reflecting evidence-based geriatric best practice interventions. An informational call will be held on May 30 from 4 p.m. to 5 p.m. Registration information can be found here .
Grant Available for Vulnerable Rural Hospitals
The Vulnerable Rural Hospitals Assistance Program is a new program from the Health Resources and Services Administration's Federal Office of Rural Health Policy. This initiative will fund one entity up to $800,000 to provide targeted in-depth assistance to vulnerable rural hospitals struggling to maintain health care services, with the goal for residents in those rural communities to maintain access to services. The awardee will work with individual hospitals and their communities on ways to understand community health needs and resources and find ways to ensure communities can keep needed care locally. Applications are due July 16. If you have any questions about this program, contact Suzanne Stack .
Leadership Resources for Physicians
 
Most competent leaders would agree that learning to lead takes a lifetime of experience and is a never-ending quest filled with mistakes and missed opportunities.

Prime Offers Solutions for Market Analyses, Intelligence and Forecasting
 
Prime, through its affiliation with Vizient, offers solutions through Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services.

AHA Voices Support for FDA Plan to Improve Medical Device Security
 
The American Hospital Association this week submitted comments on the Food and Drug Administration's Medical Device Safety Action Plan.

THE WEEK AHEAD
Tuesday, May 29
MHA Certificate of Need (CON) and State Health Plan Work Group meeting

Friday, June 1
Executive Assistant Conference
TOP NEWS FROM THE WEEK
The Baltimore Sun , By Andrea K. McDaniels, May 18
 
The Daily Record , By Tim Curtis, May 18
 
Baltimore Business Journal , By Reed Abelson, et al., May 21
 
Capital-Gazette , By E.B. Furgurson III, May 21
 
Southern Maryland Chronicle , By Staff, May 21
 
Baltimore Business Journal , By Morgan Eichensehr, May 22
 
The Baltimore Sun , By Erin Cox, May 23
 
The Baltimore Sun , By Andrea K. McDaniels, May 23
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