December 8, 2019
Evaluation of the All-Payer Model
Without fanfare, the Center for Medicare and Medicaid Innovation (CMMI) posted the final evaluation of the Maryland All-Payer Model. Overall the findings suggest the Model works. One good sign: CMMI’s project leader for Maryland praised the Model on social media last week, saying, “What I’m most impressed with is the decrease in potentially avoidable hospitalizations.”

The evaluator, RTI International, notes that Maryland reduced hospital costs without shifting costs to other parts of the health care system outside the global budgets. Though it wonders if the Model produced the broad ranging effects that CMMI seeks.
CMMI and our regulator, the Health Services Cost Review Commission, will use the evaluation to press us to improve on areas where we could do better.

There are, in fact, many areas to celebrate including driving down cost and utilization for beneficiaries with multiple chronic conditions and dual eligibles, slowing growth in total cost of care for Medicare beneficiaries and all-payer hospital expenditures, and reduced spending on outpatient hospital services.
The report also reveals opportunities for improvement. RTI found the All-Payer Model did not have an impact on the percentage of Medicare beneficiary or commercial plan member discharges with a follow-up visit within 14 days.

Other areas for renewed focus include patient experience, population health, unplanned readmissions, and ED visits for avoidable conditions.

We’ve prepared a concise summary of the 278-page report. For those inclined to delve deeper, the full report is available on the CMS website .

Just as with our full attainment of the goals of the model contract, this evaluation adds to the case for the Maryland Model to continue. It also invites us to raise our game. Working together, we will do that.
Bob Atlas
President & CEO
Two Senate Leaders Resign
Last week, two long-time Senators announced their retirements ahead of the 2020 legislative session. Senate Judicial Proceedings Committee Chairman Bobby Zirkin will resign from the Senate prior to the first day of session and Senate Education, Health, and Environmental Affairs Committee Vice Chair Shirley Nathan-Pulliam resigned from the Senate effective December 1. MHA thanks outgoing Chairman Zirkin and Vice Chair Nathan-Pulliam for their service to our state.
Incoming Senate President Bill Ferguson named Montgomery County Senator Will Smith as the next chair of the Judicial Proceedings Committee. Senator Smith currently serves as Vice Chair of that committee. Local Democratic Central Committees will be charged with recommending the two new Senators who will serve out the remainder of this four-year term to Governor Larry Hogan. Delegates Charles Sydnor and Keith Haynes have expressed interest in outgoing Senator Nathan-Pulliam’s seat and Delegates Shelly Hettleman and Jon Cardin have expressed interest in outgoing Senator Zirkin’s seat.

These most recent announcements mean that all four of the Senate standing committee leaders have changed since the start of this four-year term of office.

MHA Contact: Brian Frazee
Emergency Medical Services (EMS) Innovation Stakeholder Group to Hold First Meeting
The Stakeholder Innovation Group (SIG) meeting scheduled December 16 has been canceled. The EMS Innovation Stakeholder group, requested by the SIG, will meet December 16 at 9 a.m. at MHA. The group will begin to discuss the potential to expand certain EMS innovations statewide and include all payers. For information about this group please contact Erin Dorrien .
Hospital Care Redesign Program Approved for Commercial Expansion
The Maryland Insurance Administration (MIA) recently reviewed the governing documents submitted by three hospitals on their Hospital Care Improvement Program (HCIP). MIA quickly concluded that the HCIP program at these hospitals do not “constitute the business of insurance.” This will enable these hospitals to increase physician engagement by expanding the program to their non-Medicare population. The process to expand care redesign programs was authorized by MHA-supported legislation in 2017. There is still time for current HCIP participating hospitals to submit documents to MIA for approval for a January 1 start date. Interested hospitals should contact Erin Dorrien to discuss the process for expansion.
Registration Open for Primary Care Office Regional Meetings
The Primary Care Office (PCO) was awarded a five-year grant by the Health Resources and Services Administration (HRSA) to improve access to health care. The first year of the grant began in April. It requires that the Maryland Department of Health hold regional meetings to meet specific federal requirements. The overall purpose in having reoccurring regional meetings is to improve access to health care and how to coordinate efforts among all providers, including hospitals. Specifically, the meetings will help meet federal guidelines pertaining to Statewide Primary Care Needs Assessment, coordination of shortage designation, workforce needs, and to provide technical assistance to communities.

For more information about upcoming meetings in your region and registration process, please visit The Primary Care Office Regional Meeting resource page.
Affordable Care Act Open Enrollment Ends December 15
Open enrollment for the health insurance exchange marketplaces for 2020 ends December 15. Maryland Health Connection offers a variety of resources, including fact sheets , videos and  social posts . Information on where individuals can receive in-person assistance is also available.

Please share these resources within your organization. MHA is happy to assist with connecting staff to the state’s health benefit exchange for hospital staff who may have any questions. 
Behavioral Health System Baltimore Hosting a Seminar on the Outpatient Civil Commitment Pilot Program
Behavioral Health Systems Baltimore will be hosting a seminar December 17 from 9 a.m.-11 a.m. at the Maryland Hospital Association to discuss the Outpatient Civil Commitment Pilot Program available to residents of Baltimore City. The goals of the program are to assist individuals with mental illness, who have not been well connected to care, connect to services in the community and reduce visits to hospital emergency departments and inpatient psychiatric units. Currently, the program is available to residents of Baltimore City of who have had two or more inpatient stays in the last year.

To learn more about the OCC pilot program contact Erin Dorrien and register here for the seminar. 
National Group Buys Program Offers Savings for MHA Members
Maryland Hospital Association (MHA) members are eligible for Vizient’s National Group Buys through MHA Prime. The program offers opportunities for members to realize substantial savings and enhanced contract value on select products and services. To date, Vizient’s capital equipment group buys have saved members more than $421 million. Group buys are available in 45 major categories, including biomedical engineering, imaging, business office, cardiology, laboratory, central supply, emergency room, medical records, and surgery. Here is a list of group buys on offer through December. For more information contact your MHA Prime Client Executives: Joy Money at 240-856-3303 or Diane Bruno at 410-790-8031.
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