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January 5, 2020
Caring For Maryland
Hospitals today face unprecedented challenges, seemingly from all sides. As we aim for better health for Marylanders, we encounter obstacles to building our workforce, upgrading our facilities, and strengthening our bonds with the communities we serve.

We also have others trying to drive the narrative away from our not-for-profit hospitals’ life-saving work. They falsely claim we care more about finances than about patients. They blame hospitals for conduct better associated with profit-seeking insurers and drug companies.

We aim to change this narrative—and to challenge those pushing it—as we enter the 2020 legislative session. To succeed, we’ll need to speak collectively with one voice and with one message.

That is why Wednesday, when the Maryland General Assembly convenes, MHA will launch Caring For Maryland—#Caring4Md—a campaign that speaks to the core mission of your hospitals.

Our message is simple: While Washington politics paralyze health care, Maryland’s hospitals are doing it right. We’re bringing health, hope and healing to every single Marylander.

We’ll tell your staff and patient stories directly to policymakers. We’ll share how you are improving lives and making a difference in your communities. We’ll ask you to like and share #Caring4Md content on social media and to add your own voices to our message. (Email us to join that effort.)

This focus will carry us through the legislative session as we advocate on your behalf to:

  • Enact medical liability reform and protect access to essential services by raising evidentiary standards for life care plans, ensuring patients are compensated fairly
  • Fill critical provider shortages in high-need areas by streamlining and fully funding the state loan repayment program
  • Win promised reductions to the Medicaid Deficit Assessment
  • Ease our behavioral health crisis by removing restrictions to access for appropriate levels of care and fully funding Maryland’s two Institutions for Mental Diseases

Watch this space weekly—and a dedicated web page—for Caring For Maryland updates. We also will update our advocacy website regularly throughout session with written testimony and details about bills we are tracking.

Our hospitals have a great story to tell. Working together that story and our message will resonate in Annapolis and across the state.
Bob Atlas
President & CEO
CMS and Maryland Sign New MOU
Under the Total Cost of Care Model contract, the Centers for Medicare & Medicaid Services (CMS) and the State of Maryland are striving for statewide health care delivery transformation. They hope population-based payments will improve both population health and care outcomes for individuals, while controlling the growth of Medicare total cost of care.

To that end, in late December, CMS executed a memorandum of understanding (MOU) with Governor Larry Hogan, Maryland Department of Health (MDH), and the Health Services Cost Review Commission (HSCRC). The MOU calls on Maryland to focus on three areas—hospital quality, care transformation, and population health—for the remaining performance period of the model contract, through 2026.

MHA engaged with the state agencies in the drafting of the MOU to ensure that it supports the hospital field’s efforts and will not add new burdens.

Per the MOU, Maryland will propose a statewide integrated health improvement strategy (SIHIS), due to CMS by December 31, 2020. HSCRC and MDH will collaborate to outline goals, measures, milestones and targets that were not specified in the contract. HSCRC will focus on hospital quality improvement and health care system transformation while MDH works on population health measures. MHA will work with both agencies on preparation of the SIHIS, relying upon input from members.

The MOU is non-binding and does not amend or modify the model contract. Failure to achieve any of the MOU’s terms cannot trigger a corrective action plan or otherwise alter the contract.

MHA will share more information about the MOU and its implications in upcoming communications with members. 
Webinar to Present Final Evaluation of Maryland All-Payer Model
The CMS Innovation Center and RTI International will present the final results of the independent evaluation of the Maryland All-Payer Model in a webinar January 23 at 9 a.m. During the webinar, participants will learn how Maryland performed on the goals of the model in its agreement with CMMI, the impact of the model on payers, as well as hospitals and the patients they serve, and future goals of the Maryland Total Cost of Care Model. To register for the webinar, click here.
MHA Offers Tools, Resources to Aid Advocacy Efforts
The Maryland General Assembly will convene for the 2020 legislative session this Wednesday, January 8. MHA has several infographics, talking points and other materials to help aid in your Annapolis advocacy efforts. These will be updated regularly during session and will include written testimony of bills we are taking a position on.
 
The priorities MHA will work toward on behalf of the hospital field can be found in the 2020 MHA Advocacy Brochure . An overview of key facts about Maryland’s hospitals are included in this year’s Top 5 Things to Know About Maryland Hospitals card.
 
Also available are talking points on key topics:
 
Other materials:
 
For more information, contact Nicole Stallings .
2020 Session Leadership & Committee Assignments Set
Maryland House Speaker Adrienne Jones and incoming Senate President Bill Ferguson have announced final leadership and committee assignments for the 2020 legislative session. On Friday, Speaker Jones made her final decisions public while Senate President-elect Ferguson announced his decisions before the holidays. For a complete list of Senate announcements, click here and for House announcements, click here.

MHA Contact: Brian Frazee
SAEK Committee Submits 2020 Annual Report
The Maryland Sexual Assault Evidence Kit (SAEK) Policy and Funding Committee submitted its 2020 Annual Report to the General Assembly last week. As part of the committee, MHA and several members developed the recommendations which serve to improve the care provided to survivors of sexual assault and support the forensic nurse examiner workforce that provide their care. A key recommendation was to align discharge and follow-up care with national best practices by recommending that appropriate resources and support are provided to survivors of sexual assault in a timely manner after a forensic exam is performed. Acknowledging the difficulty this can present, the Forensic Nurse Examiner subcommittee agreed to offer guidance to any hospital-based Sexual Assault Forensic Exam program that requests assistance.

The SAEK Committee has been a powerful voice in Annapolis. During the 2019 session, the committee supported several bills focused on improving the care provided to survivors of sexual assault, including legislation that established a statewide pilot program to provide free HIV prophylactic medication. During the 2020 session, the committee will support several initiatives, including a bill that promotes patient confidentiality by removing a provision that requires photographs of a victim be submitted to the state in order for a hospital to receive reimbursement for the sexual assault forensic exam. MHA is proud of the Committee’s work and is committed to supporting the hospital-based SAFE programs so they can continue to care for survivors of sexual assault.
MHA Submits Comment Letter on Proposed Rules for Stark and Anti-Kickback Statute
In early October the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services Office of the Inspector General (OIG) proposed major overhauls to the Stark and Anti-Kickback laws. The proposals are largely positive, as they create new definitions and broad exceptions for value-based models with varying incentive structures and recognize that health care is not limited to the provision of medical items and services. Last week, MHA submitted a comment letter to CMS and OIG on the proposals . The letter highlights the unique facets and goals of the Maryland Model, and urges the agencies to adopt provisions that would maximize flexibility for Maryland’s hospitals and providers to innovate for the Model’s success.
MHA Members Exceed PAC Goal
MHA members exceeded their 2019 Political Action Committee fundraising goal of $130,000—raising $131,051 toward advocacy efforts that support the hospital field’s goals and priorities.

Your PAC dollars advance an ambitious and challenging advocacy agenda that includes:

  • Refinement of Maryland’s Total Cost of Care Model
  • Reduction of the hospital Medicaid tax
  • Tort reform
  • Aid for behavioral health and workforce efforts
  • Support for patient safety and quality of care

Special thanks to Eric Wagner, executive vice president of insurance and diversified operations at MedStar Health and MHAPAC chairman, and board members:

Richard G. Bennett, M.D.
President
Johns Hopkins Bayview Medical Center, Baltimore

John Chessare, M.D.
President & Chief Executive Officer
Greater Baltimore Medical Center, Baltimore

Terry Forde
President & CEO
Adventist HealthCare, Gaithersburg

Neil Meltzer
President & Chief Executive Officer
LifeBridge Health, Baltimore

Dean Teague
President & CEO
CalvertHealth Medical Center, Prince Frederick

Congratulations also to the following hospitals for exceeding their goals:

  • Western Maryland Regional Medical Center 158% of their goal
  • Howard County General Hospital – 150%
  • Johns Hopkins Bayview – 129%
  • Frederick Health – 128%
  • Anne Arundel Medical Center – 125%
  • MedStar Health – 117%
  • Adventist HealthCare – 115%
  • Greater Baltimore Medical Center – 111%
  • The Johns Hopkins Health System – 111%
  • MedStar Montgomery Medical Center – 108%
  • Peninsula Regional Medical Center – 107%
  • Mercy Medical Center – 105%
  • Carroll Hospital – 103%
  • The Johns Hopkins Hospital – 102%
  • Kennedy Krieger Institute – 100%
  • Suburban Hospital – 100%

For questions about MHAPAC, contact Meghan McClelland .
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Maryland Hospital Association | www.mhaonline.org