June 16, 2019
Global Budget Update
The Health Services Cost Review Commission (HSCRC) granted Maryland’s hospitals their largest global budget increase in recent memory last week — a 3.59% increase in total revenue (3.28% per capita) for fiscal year 2020.

The average hospital is expected to receive about 3.3% growth in total regulated revenue — or 3% per capita.

I and MHA colleagues Brett McCone and Mike Robbins advocated with HSCRC for an additional 0.33% for global budgets to aid the expansion of your care transformation efforts.

We underscored the hospital field’s success in the All-Payer Model — which resulted in $273 million in Medicare total cost of care savings in 2018 alone — and asked that hospitals receive additional funding to augment your investments in communities intended to advance the health of all Marylanders.

We also noted, as featured in MHA Insight , that commercial payers are benefiting from hospitals’ successes but do not appear to be passing the savings through to consumers.

The approved update offers a measure of stability for fiscal year 2020. Yet, hospitals must continue to build upon the progress you’ve made so far, all while limiting growth in statewide total cost of care and curbing avoidable utilization.

We were very pleased to receive kudos on our success at our annual meeting last week from Adam Boehler , head of the Center for Medicare and Medicaid Innovation. We need a concerted effort not just by hospitals but with non-hospital providers, payers, policy-makers and others to ensure the Maryland Model stays strong and endures.
Bob Atlas
President & CEO
Commission Adopts Staff Update Recommendation
A s reported in this month’s edition of Newsbreak  commissioners unanimously adopted the staff request for an increase of 3.59% in total revenues for fiscal year 2020, rejecting the Maryland Hospital Association's request for an additional 0.33% in funding. Commissioners also adopted changes to the Emergency Department RVU scale and changes to its market shift policy as part of this month’s public meeting.
Capital Bond Program Application Reminder
The 2019 Maryland Hospital Association Hospital Capital Bond Program provides an opportunity for hospitals to apply for state allocated funding to complete private capital projects. Hospitals applying for funding under this program must submit their applications via the hospital-specific SharePoint site by Friday, June 21. Additional information and application documents are available on MHA’s website . If you have questions, please contact  Brett McCone Jennifer Witten , or  Jane Krienke
Share Innovative Ideas For New Payment Models
The provider-led Stakeholder Innovation Group (SIG) is accepting innovative ideas for new payment models through the newly launched section of the Innovations for Better Health Website . New payment modes are ideas — outside of traditional payment structures — that require approval from the Centers for Medicare and Medicaid Services (CMS) and/or the state of Maryland. Based on these ideas the SIG will make recommendations to the Secretary’s Vision Group for approval and eventual application to CMS. Please submit your innovative idea by September 30 for consideration for 2021 program launch date.

Please also continue to share your innovative programs already occurring in Maryland that are not new payment models here .
Md. Hospitals Achieve Goal For New Registered Nurses To Complete Residency Program
Maryland achieves the goal set by the American Academy of Nursing that all acute care hospitals have newly licensed registered nurses (RNs) complete a residency program. The requirement is part of the hospital’s hiring practices for newly hired licensed registered nurses (RN’s), as a condition of their employment to complete a 12-month nurse residency program. The residency program provides newly licensed nurses with a structured transition into clinical practice. The Maryland Action Coalition worked with 40 of Maryland’s acute care hospitals and the Health Services Cost Review Commission to fund and implement the program developed by Vizient and the American Association of Colleges of Nursing. The second phase of the program will seek to include other health care facilities.
Surveys, Focus Groups Focused on Workforce Supply, Violence
Hospital leaders have alerted us to the pervasive workforce supply challenges statewide. That’s why last week we launched several efforts to better understand and address these issues through data collection and by hearing directly from you.

  • Standard vacancy data for certain employee categories: Please complete this Excel spreadsheet and email to Jane Krienke by June 28. Individual survey results will be kept anonymous, but aggregate data and blinded responses will be shared.
  • Web-based Focus Groups: Join us July 9 for the first in a series of web-based focus groups. Through a roundtable discussion, we hope to learn about the challenges you experience each day. Additional details and registration information will be shared soon.
  • Workplace Violence Prevention Survey: MHA also launched a workplace violence prevention survey, which your CEOs will receive. The survey aims to assess incidents of workplace violence, prevention efforts and reporting practices. Please share the survey with the appropriate individuals. Individual survey results will be kept anonymous, but aggregate data and blinded responses will be shared.
MHA Executive Committee Approves Health Equity Task Force
On June 10, MHA’s Executive Committee approved the formation of a Health Equity Task Force. This task force will guide MHA’s work in advancing health equity, particularly related to supporting hospitals in addressing the social determinants of health in their surrounding communities and reducing health disparities. The task force will also inform MHA’s Health in All Policies strategy in considering the health-related impacts to Marylanders of public policies. MHA staff will invite members to join this task force over the next month.
At the same Executive Committee Meeting, MHA staff also shared the organization’s goals to advance health equity:
  • Support hospitals in addressing the social determinants of health in their surrounding communities with the goal of eventually reducing disparities in health outcomes.
  • Influence public policy development to consider the health-related impacts to Marylanders by building partnerships with relevant state agencies and educating legislators on the health implications of all policies.
  • Improve workforce diversity, inclusion, and advancement opportunities for underrepresented minorities, particularly in leadership and governance positions in Maryland’s hospitals and health systems.
Atlas: Hospitals Finding a Remedy For Food Insecurity
Most of us would eat more healthfully if given the choice. But many Marylanders lack easy access to fresh, affordable food, especially fruits and vegetables. That makes it hard to maintain a healthy diet, Bob Atlas, President & CEO of the Maryland Hospital Association, says in this WYPR commentary. “It’s a growing problem – one that Maryland’s health care leaders and public officials are working to remedy,” he says. “Just the other day, a leader of one of Baltimore’s hospital systems told me that 58% of patients it screened faced food insecurity. And the chief health officer of a nearby county said that food insecurity is their greatest challenge – more so even than housing.”
MHA Annual Membership Meeting
MHA’s Annual Membership Meeting was held last week, and we thank all of those who attended. Attendees should have received a survey asking for feedback to help us shape next year’s event as we celebrate MHA’s 50 th anniversary. For details, contact Kathy Gotwalt .

For a recap of the event, read our Annual Meeting Highlight coverage here . And view our Annual Report to learn more about how MHA is working to help you advance health care and the health of all Marylanders.
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