August 25, 2017
Opioid Crisis Demands Action
The Maryland Department of Health has reported that drug- and alcohol-related deaths continued to climb in 2017 - the 550 deaths in the first quarter of 2017 represent a 44 percent increase from the same period last year. The need for effective measures to mitigate the crisis is becoming even more pressing.
Of the 550 deaths, 372 (a 137 percent increase from the same period last year) were related to fentanyl, a potent opioid that is often mixed with heroin.
Already, hospitals are taking steps to combat these tragedies, from linking nonfatal overdose patients to community-based treatment, to enhanced screenings for substance abuse, to the expansion of the use of naloxone. But more needs to be done.
That's why improving Maryland's behavioral health treatment system remains one of the hospital field's primary legislative goals for the upcoming 2018 General Assembly session. Among the issues that need to be addressed: a shortage of qualified behavioral health practitioners, limited community-based resources, unstable funding, and crowded hospital emergency departments.
Ahead of the legislative session, MHA's Behavioral Health Task Force, composed of hospital leaders and behavioral health experts, expects to release its report containing concrete, actionable recommendations that can lead to a comprehensive, integrated behavioral health treatment system. This report, the result of more than two years of work by the task force, could serve as the foundation for legislation that will have a meaningful impact on the behavioral health crisis.
In releasing the overdose death data, Clay Stamp, executive director of the state's Opioid Operational Command Center offered these thoughts: "The number of Marylanders impacted by this crisis continues to drive our resolve to manage this epidemic as a statewide emergency. In order for us to be successful, we must be united in this fight and steadfast in our commitment to partner with others in efforts to prevent, protect, and treat those in need."
Maryland's hospitals stand ready.

Hogan Unveils Draft Terms of All-Payer Model Progression
Gov. Larry Hogan on Thursday announced in a press release the draft terms for Maryland's All-Payer Model progression. In the release, Hogan referred to the completion of these terms as a "milestone reflecting the state's continual commitment to improving residents' health care quality while reducing costs." MHA provided a quote in the release supporting a long-term, sustainable system and noting that hospitals look forward to working with the state so that the arrangement is successful. There will not be a press conference for the announcement of the terms; the governor expects that a press conference will be held in January after an agreement with CMS is finalized.
Comment Letters Submitted to MHCC, CMS
MHA submitted two comment letters this week to state and federal regulators.
The first, sent August 21, was to the Centers for Medicare & Medicaid Services on a proposed rule updating the physician quality payment program to continue most calendar year 2017 policies governing advanced alternative payment models into calendar year 2018. In the letter, MHA requests that CMS waive lower financial risk thresholds for practices that are part of organizations with 50 or more qualified clinicians that participate in medical home models authorized under Section 111A. The letter also requests that nominal risk standards apply to practices in the Maryland Primary Care Program, and that special consideration be given to hospitals and physician providers in Maryland due to the amount of risk they are taking on under the All-Payer Model.
The second letter, sent August 23, was to the Maryland Health Care Commission on revisions to the State Health Plan for General Surgical Services. The letter states that several significant changes have been made to the current revision of the plan from earlier drafts, particularly regarding ambulatory surgical facilities and Certificate of Need review. The letter notes several questions that Maryland's hospitals would like answered as MHCC continues revising the plan.
OHCQ to Accept Input on Regulatory Proposals
The Office of Health Care Quality will host a public meeting on from 10 a.m. to noon on September 8at its offices in Catonsville to hear input on proposed regulatory changes. The proposed regulations touch on three areas: lay caregivers, patient rights and observation status notice. The lay caregiver regulations effectuate recently passed legislation and largely mirror the text of that legislation. Patient rights regulations reflect practices that most hospitals already have in place and were prompted by failed legislation to require a standard, comprehensive patient bill of rights to be distributed at all hospitals. Observation notice provisions would modify existing regulations and are meant to smooth discrepancies between Maryland law and recently enacted national legislation and associated Centers for Medicare & Medicaid Services' regulations. MHA has already submitted an informal comment letter on these regulations with input from the field. Those interested in attending the meeting should register here (details and driving directions provided on the registration page). Contact Renee Webster at the Office of Health Care Quality with questions,
Hospitals Invited to Join AHRQ Antibiotics Program
The Johns Hopkins Armstrong Institute for Patient Safety and Quality is seeking hospitals to join a national project to reduce inappropriate antibiotic use while preserving antibiotic effectiveness for future generations. The free 12-month program begins this December and is funded and guided by the Agency for Healthcare Research and Quality. Participants will receive antibiotic-use guidelines for several infectious diseases, expert coaching, online education, improvement tools, patient education materials and other resources to help run an effective antibiotic stewardship program. One hour informational webinars to learn about project goals, interventions and expectations of participants are scheduled for August 29 at 1 p.m., September 12 at 1 p.m., September 26 at 1 p.m., and October 10 at 1 p.m. Registration is required. Please click each date above to register. Visit the project website for additional information.
A Prerequisite for Success
It's called a "Culture of Collaboration." And it's working.

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. 

CMS Updating QualityNet to Reflect Reduced 2017 eCQM Requirements
The QualityNet system has not yet been updated to reflect changes to electronic clinical quality measure reporting requirements for calendar year 2017 under the fiscal year 2018 inpatient prospective payment system final rule, the Centers for Medicare & Medicaid Services reports. 

Thursday, August 31
Meeting with hospital representatives of MHA and Health Services Cost Review Commission
  work groups participating in the Medicare Performance Adjustment

The Baltimore Sun, By Talia Richman, August 18
The Washington Post, By Mark Beckford, August 20
The Baltimore Sun, By Mina Haq and Jon Kelvey, August 21
Washington Business Journal, By Tina Reed, August 21
Delmarva Now, By Reed Shelton, August 19
Baltimore Business Journal, By Morgan Eichensehr, August 24
Capital Gazette, By Amanda Yeager, August 24