July 28, 2019
Best Foot Forward
Scrutiny in the media and among lawmakers in Annapolis has called into question the soundness of governance of our hospitals and health systems. Those pursuing this line of inquiry are not finished. We expect this matter to gain steam again as the 2020 legislative session approaches.
Your Maryland Hospital Association is working to make the case that our hospitals and health systems not only are already subject to many rules on governance practices but that you adhere to high standards. Key to our efforts is a survey your CEOs will receive Monday related to institutional protections against conflicts of interests.
Full participation in the survey by all hospitals and health systems is crucial for our work product to be credible.
The details shared will be kept confidential and secure by the law firm of Epstein Becker Green (EBG) and MHA. Nothing in our report will be attributed either to individual entities or to those who complete the forms.
Building upon a preliminary review MHA commissioned earlier this year, we expect the survey will demonstrate Maryland hospitals’ and systems’ commitment to best governance practices. In the earlier analysis, EBG noted that a proposal for a House of Delegates bill to adopt new restrictions for the governance of all Maryland hospitals would be unnecessary and may have myriad unintended and potentially significant adverse consequences .
We urge you to complete the survey by August 16. In the meantime, your MHA team continues to impress upon policymakers how seriously we all take our responsibility as institutions of public trust.

Bob Atlas
President & CEO
OIG Report: ACOs’ Strategies for Transitioning to Value-Based Care - Lessons from the Medicare Shared Savings Program
Some Accountable Care Organizations (ACOs) have helped reduce Medicare spending and improved the quality of care, according to a report released by the U.S. Department of Health and Human Services’ Office of Inspector General. MHA believes Maryland’s high-performing hospitals are using essentially the same strategies to fulfill the aims of the Total Cost of Care Model.
The OIG findings show that high-performing ACOs:

  • Work with physicians to lower costs and improve quality
  • Engage beneficiaries to improve their own health
  • Manage beneficiaries with costly or complex care needs
  • Reduce avoidable hospitalizations and improve hospital care
  • Control costs and improve quality in skilled nursing and home health care
  • Address behavioral needs and social determinants of health
  • Use technology to increase information sharing among providers
HSCRC Readmissions Reduction Program Update: HSCRC’s Proposes Inclusion of Oncology Patients in Readmissions Policy
The Health System Cost Review Commission’s (HSCRC) Readmissions Reduction Program (RRIP) Subgroup to the Payments Models Workgroup has been meeting monthly since February to identify and discuss options for revisions to the rate year 2022 Readmissions Reduction Incentive Program (RRIP). As the RRIP policy has matured and corresponding hospital performance has continued to improve, HSCRC staff have acknowledged the need for updating the policy. The workgroup has discussed the impact decreasing hospital discharges has had on readmissions performance (also known as the “shrinking denominator” issue), payer-specific readmissions benchmarks, and options to potentially adjust for socioeconomic status.
Last week, HSCRC staff engaged a small group of hospital representatives to discuss potentially including cancer patients in the RRIP policy in a responsible and sound way. Cancer patients are currently excluded because of the challenges with planned readmissions logic. HSCRC staff stated that by excluding these patients from a readmissions reduction policy, they do not receive the benefit of opportunities for improvement. 

The next meeting of the HSCRC’s RRIP Subgroup is August 27 . Additionally, MHA will continue to assess options and obtain feedback from the field to be considered by the RRIP Subgroup for inclusion in the draft RRIP policy to be presented by HSCRC staff in early 2020.

Materials from last week's meeting are linked below.

For questions or additional information, contact Brian Sims .
HSCRC, MHA Host Care Redesign Program Webinar
The Health Services Cost Review Commission and MHA will host a webinar on a proposed Care Redesign Program (CRP) Track. This CRP track is intended to address "hard-to-place patients" and the possibility of hospitals and post-acute care providers partnering to move those patients to a more appropriate setting of care. The webinar will be August 2 from 11 a.m. to noon.
The first half of the webinar will describe the potential Post-Acute Care for Complex Adults Program Track and the implementation protocol, and the remaining time will allow hospitals to share their thoughts on participation. Registration is open. PACCAP slides are available, as are details about implementation protocol.
MHA Launches Series of Statewide Forums on Workforce
This coming week MHA will host the first in a series of statewide workforce forums. The Aug. 1 forum focuses on workforce development practices and challenges – particularly as they relate to allied health professionals and nursing. It is an opportunity to hear success stories and strategies that are already improving outcomes in our state. The information and feedback shared at the forum will guide the work of the association to further support your future workforce needs. Every member hospital is encouraged to designate a representative from your HR and CNO staff to attend. Registration will remain open until July 31. For details, contact Jane Krienke .
MCASA Hosts Sexual Assault Victim Advocate Training
The Maryland Coalition Against Sexual Assault (MCASA) is hosting free comprehensive training for advocates of victims of sexual assault from Sept. 23-26. The training is designed for advocates who work directly with survivors of sexual assault in any capacity and focuses on the roles of law enforcement and forensic nurse examiners, crisis intervention, professional ethics and more. Registration is open . For details, contact info@mcasa.org or call 301-328-7023.
Plan to Attend Lt. Governor’s Regional Mental
and Behavioral Health Meeting
Lt. Governor Boyd Rutherford’s Commission to Study Mental and Behavioral Health will hold its third regional meeting this Wednesday, July 31. from 4:30-6:30 pm in Globe Hall, High Technology & Science Center at the Germantown Campus of Montgomery College, located at 20200 Observation Drive Germantown, Maryland 20876. The meeting will include public comment and dialogue with commission members. Hospitals should attend to explain your efforts in the behavioral health space and share challenges and recommendations. For more information, please see the commission’s website or contact MHA’s Brian Frazee .
Want to receive your Toward Better Health
newsletter via text message?
Click here to sign up.
Maryland Hospital Association | www.mhaonline.org