September 8, 2017
National Issues, Local Voices
Next week in Washington, D.C., the American Hospital Association will host its annual National Regional Policy Board meeting, bringing together hospital and health care leaders from across the country to discuss some of the most pressing issues our field will face in the coming years. You may remember that for governance purposes the AHA breaks the nation up into nine regions (we're in Region 3), each of which meets three times a year to foster communication between the AHA and its members and state hospital associations. The RPBs provide input on public policy issues considered by the AHA board and identify needs unique to each region.
Maryland is well represented on Regional Policy Board 3 by health care leaders you know well, including Anne Arundel Health System President & CEO Tori Bayless, Garrett County Memorial Hospital President & CEO Mark Boucot, Holy Cross Health President & CEO Dr. Van Coots, Fort Washington Medical Center trustee Kim Robertson, and Children's National Medical Center trustee Schonay Barnett-Jones, all of whom will join me for next week's meeting. On the agenda:  
  • Medicaid reform, with a focus on financing for long-term care and support services
  • Infrastructure investment, including systems to support broadband telehealth, prescription drug monitoring programs, and cyber security
  • Marketplace stability, especially the steps that Congress and the Trump administration should take to shore up insurance markets 
This national conference comes in the wake of Congress's return this week from its August recess. They have a long list of goals: tax reform, hurricane disaster relief, a looming debt limit battle, and funding for the Children's Health Insurance Program, which expires September 30. That last item, for which funding renewal could provide a vehicle for change to insurance markets under the Affordable Care Act, will also be discussed at our meeting next week.
The meeting will conclude with an AHA Advocacy Day, during which policy board members and other hospital leaders will head to Capitol Hill to meet with their senators and representatives to deliver several key messages:  
  • Fully fund reductions in cost sharing that help low-income consumers afford coverage through the health insurance marketplaces, and that in turn stabilize those marketplaces.
  • Fully fund the CHIP program. It is authorized until October 1, 2019, but legislative action is required to fund the program beyond September 30 of this year.
  • Stop the Medicaid Disproportionate Share cuts slated to go into effect on October 1.
  • Oppose cuts that the Centers for Medicare & Medicaid Services has proposed to the 340B drug-pricing program. 
While Maryland is unique in the way we pay for hospital care, we and the other states share a passion for local advocacy that helps you care for people every day. The National Regional Policy Board meeting is our opportunity to bring that passion and our message of caring to our national leaders, and just one of the many ways AHA and MHA are making sure your voice is heard on Capitol Hill and beyond.

Leapfrog Exec Helps Hospitals Prepare for Grading
Missy Danforth, Vice President of Health Care Ratings from the Leapfrog Group this week led an education session at MHA's offices (attended by roughly two dozen hospital staff from all levels) to help Maryland's hospitals prepare for their upcoming inclusion in Leapfrog's Hospital Safety Grades. The safety grades, which are available online, assign a single letter grade to each hospital to indicate overall performance in keeping patients safe. Staff at the Maryland Health Care Commission provided Leapfrog with inpatient claims data from the Health Services Cost Review Commission to generate several hospital-specific quality measures for Medicare patients (the hospital-specific data are available here). Grades will be released in October following a September preview period for hospitals. A recording of the education session can be seen here; you can also access slides, a timeline sheet, and a calculation sheet. Contact the Leapfrog help desk with questions. 
Novitas Offers Annual Medicare Symposium
The Medicare Administrative Contractor for Maryland's hospitals, Novitas, will host its annual symposium on September 21 at the Radisson Hotel in Rockville. The symposium will provide hospital billing and compliance professionals with the opportunity to engage with the Medicare Provider Outreach and Education team. The event is free, but attendees must register here.
Hospital Leaders Discuss Obstacles to Reduce Health Disparities
At a meeting this week hosted by the Maryland Healthcare Education Institute, hospital leaders specializing in reducing health disparities learned about forthcoming data from MHA on readmissions and hospital-acquired conditions stratified by race, ethnicity, language, age and gender. Eloiza Domingo-Snyder, chief diversity officer for Johns Hopkins Medicine, discussed how her organization is approaching some of the culture and data-collection challenges related to equitable care, and Jo Wilson, vice president for population health at Western Maryland Health System, presented how that hospital is addressing the social determinants of health to reduce avoidable utilization. The meeting was part of a series organized by MHEI and MHA to assist with the national Equity of Care initiative. For more information, email Mark Rulle at
HSCRC Seeks Comments for Regulatory Review
The Health Services Cost Review Commission is seeking comments by October 1 for the mandatory Regulatory Review for years 2012 - 2020. MHA, at a minimum, will be commenting on COMAR 10.37.03 dealing with rate compliance, 10.37.08 dealing with conduct of public meetings, and 10.37.10 dealing with rate application and approval procedures. Hospitals should review the document and provide any comments to Mike Robbins , who will be coordinating comments on behalf of MHA member hospitals.
Next Webinar on Opioid Crisis Is September 12
The next webinar in MHA's and the Maryland Department of Health's five-part series Hospitals' Role in Addressing the Opioid Crisis is September 12 at 8:30 a.m. The topic is "Alcohol and Drug Use Screening." Materials from the first two webinars in the series, which will feature emergency department interventions, are available on MHA's website. Participants will hear from Maryland's hospitals that are using specific interventions and their experience to date. Registration is required for each webinar. Click each title below for the registration link. The remaining webinars and their topics are:
September 12 at 8:30 a.m.
October 18 at 8:30 a.m.
November 14 at 8:30 a.m.
Contact Nicole Stallings with questions.
Quarterly Financial, Utilization Reports Available
The financial reports for the second quarter of 2017 are now available for MHA members. To access the Accounts Receivable and Combined Financial Trends and Utilization reports, click here. Reports are available only to members.
Contact: Brian Sims
Direct-Entry Midwives Have New Form Requirement 
The Maryland Board of Nursing has a new form that licensed direct-entry midwives must sign upon admitting their patients to a Maryland hospital. The General Written Care Plan for Direct-Entry Midwives ( download here) will have to be signed and presented to the hospital when the patient is admitted. Contact Ann Tyminski with the Maryland Board of Nursing with questions.
Health Care Without Walls: A Future of More Distributed Care?
New technologies, advances in science, the focus on population health, and demands for consumer convenience are among the trends that are driving much of health care outside of conventional institutional settings and into homes and communities.

Physician Survey Available to Prime Members
It's that time of year again. Now in its 24th year, the most comprehensive report on physician recruiting incentives in the field - Merritt Hawkins' annual Review of Physician and Advanced Practitioner Recruiting Incentives - is available for Prime members. 

AHA Releases Resource for Vulnerable Communities
Last year, the American Hospital Association's Task Force on Ensuring Access in Vulnerable Communities identified nine innovative strategies to help hospital and health system board members address the underlying social conditions preventing individuals from accessing health care.

Wednesday, September 13
Health Services Cost Review Commission meeting

Thursday, September 14
MHA and Maryland Nurses Association host Workplace Violence Forum at Sheppard Pratt
MHA Financial Technical Work Group meeting