June 30, 2019
Finding a Remedy for Food Insecurity
We talk a lot these days about the social determinants of health – those things other than genetics, personal choices, and health care that affect how healthy each of us will be. In discussions I’ve had recently, it’s striking how often food insecurity is mentioned as a top challenge – especially given Maryland’s high per capita income. For instance:

  • Fifty-eight percent of patients screened for a community health program run by one of our Baltimore city hospitals faced food insecurity.
  • The chief health officer of Howard County recently described food access as their greatest challenge – more so even than housing.

It’s clear that if Marylanders cannot access nutritious, fresh food regularly, they will be less healthy – and require more care.

In a recent WYPR commentary, I shared with the public how your hospitals are working to solve Maryland’s food insecurity challenges. Hospitals not only offer healthy meal choices for inpatients. Some of you work with community food banks to connect people in need to sources of available food. Some of you sponsor community gardens and pop-up produce markets in places where there are no stores that sell fresh produce. And some teach cooking classes for people eager to learn how to prepare healthy meals.

As you strive for success under the Total Cost of Care Model, these initiatives are vital.

At MHA we’re seeking to understand what public policy is needed to bolster your efforts. We’re also in pursuit of state and local agencies and community partners to help you truly prevent or lessen the effects of chronic conditions and help all Marylanders to be healthy.
Bob Atlas
President & CEO
HSCRC Payments Models Readmissions Subgroup Considers Policy Changes
The Readmissions Subgroup of the Health Services Cost Review Commission’s Performance Measurement Work Group met this past Tuesday to further discuss potential revisions to the fiscal year 2022 Readmissions Reduction Incentive Program (calendar 2020 performance year). The staff will likely continue to set statewide readmission improvement and attainment targets. However, they are interested in monitoring and reporting on disparities in readmission of different populations by hospital. Although the work group discussed the possibility of creating an attainment only policy, which would require a more robust risk adjustment, potentially including an adjustment for disadvantaged populations, staff appear to favor a monitoring approach for now. Staff provided analyses demonstrating the impact of an attainment-only policy and concluded that many hospitals still have room for improvement and an attainment-only policy would be overly punitive statewide. Staff also addressed the concern about worsening readmission rates as the acuity of inpatients increases — what they call the “shrinking denominator.” According to their analysis, this is not currently associated with worsening performance under the policy, most likely due to the case-mix adjustment. The work group is scheduled to meet again in July provided staff has additional analyses to share. The draft policy is expected to be presented in February 2020.
General Assembly's 2019 Interim Activities
The Department of Legislative Services recently released the annual proposed interim committee activities report from the Legislative Policy Committee. The report outlines each General Assembly committee’s proposed 2019 interim activities, including briefings, work groups, site visits, and issues of interest. Your Maryland Hospital Association team is working with your government affairs liaisons and other staff on issues related to hospitals and health care in preparation for the 2020 legislative session.
More Federal Activity on Surprise Billing, Price Transparency
Last week saw increased federal activity related to surprise billing and price transparency. The Senate Committee on Health, Education, Labor and Pensions passed the Lower Health Care Costs Act (S.1895) . As mentioned last week, the bill would hold patients harmless from surprise medical bills and use a benchmark rate to resolve payment disputes between plans and out-of-network providers. The American Hospital Association, Maryland Hospital Association (MHA), and hospital members support the intent in protecting patients from surprise medical bills, and support several other provisions in the legislation. Hospitals do remain concerned, however, with the benchmark payment rate for providers and provisions that may result in limiting access to care. While several protections outlined in the legislation already exist in Maryland under state law, these protections only apply to individuals with insurance plans that are regulated by the state. The Lower Health Care Costs Act applies to Employee Retirement Income Security Act, or ERISA, plans, therefore expanding the scope of plans to which protections apply. MHA will continue to monitor the legislation and analyze impacts to Maryland.
Also last week, the President issued an Executive Order focused on price and quality transparency. Key provisions of the Executive Order direct federal agencies to promulgate rules around disclosures of hospital charges, rates negotiated with insurers, and consumer out-of-pocket costs. The Executive Order also requires federal agencies to report on barriers to sharing price and quality transparency with consumers, and how the agencies will implement the surprise billing principles outlined by the President last month. MHA is working with members to explore how the hospital field may advance and implement transparency initiatives, including working with other health care stakeholders across the state. MHA will continue to review federal proposals on this topic and share impact with members.

Workforce Focus Groups
MHA will be hosting a series of focus group to discuss workforce-related challenges. The first of the series will be held via webinar July 9 from 1 p.m. to 2:30 p.m. Human resource professionals and others engaged in workforce development planning are encouraged to participate. This interactive discussion will cover topics such as workforce development practices, top challenges to maintaining an optimal workforce and identifying successful development strategies. For more information and to register, click here .
MHA Contact: Jennifer Witten , Vice President, Government Affairs; Erin Dorrien , Director, Policy
Grants Aimed At Integrating SBIRT in Mother-Baby Units
The Mosaic Group is seeking hospitals for an opportunity to receive grant funding to integrate SBIRT in mother-baby units and select OB/GYN practices in targeted high-needs communities. The program will help hospitals develop a protocol.

Mosaic Group, the Maryland Department of Health and the Behavioral Health Administration’s technical assistance expert for SBIRT implementation will bring the model of SBIRT implementation that has led to practice adoption in over 100 primary care practices and 24 hospitals in Maryland to the expansion to these maternal child health settings. Selected hospitals will receive a year of seed funding to hire a full-time peer recovery coach that will work as an integral member of the labor and delivery/ mother baby unit team to address patient’s that screen positive for high risk alcohol or substance use. Nurses or technicians will be trained to screen women as part of the initial assessment to the unit using evidence-based screening tools. For details, contact Marla Oros , president of The Mosaic Group.
ASAM Releases Guide For Patients, Families Affected by Opioids
The American Society of Addiction Medicine is offering a free patient guide that hospitals can give to their patients affected by opioid abuse or substance use disorder. The guides include information about initial assessment, treatment (including treatment plans, patient participation, and counseling) and all of the medications available to treat opioid use and overdose. It also provides resources to find providers and support groups for patients and families. For details, contact Jade Winfrey .
MHA Welcomes New Executive Committee, Council Members
The Maryland Hospital Association is pleased to welcome a number of new Executive Committee and council members. Thank you to all of our Executive Committee and council members for your valuable guidance, contributions and insight.

MHA Executive Committee 2019-2020
  • Chair, Council on Clinical & Quality Issues: Mitchell Schwartz, M.D., Chief Medical Officer, Anne Arundel Medical Center
  • Chair, Council on Legislative & Regulatory Policy: Jonathan Ringo, M.D., President, Sinai Hospital of Baltimore
  • CEO Councillor-at-Large: Thomas Kleinhanzl, President & CEO, Frederick Regional Health System
  • CEO Councillor-at-Large: Kevin Sowers, President, Johns Hopkins Health System
  • CEO Councillor-at-Large: Mohan Suntha, M.D., President & CEO, University of Maryland Medical Center & Midtown Campus
  • CEO Councillor-at-Large: Erik Wangsness, President, Adventist Healthcare Washington Adventist Hospital

Council on Legislative & Regulatory Policy (Fiscal Year 2020)
  • Louis Damiano, M.D., President, Holy Cross Hospital, Silver Spring
  • Joseph Meyers, Chief Strategy Officer, Saint Agnes Healthcare, Baltimore
  • Thomas J. Senker, President, MedStar Montgomery Medical Center, Olney, and Senior Vice President, MedStar Health
  • Jennifer Wilkerson, Vice President & Chief Strategy Officer, Sheppard Pratt Health System, Towson

Council on Clinical & Quality Issues (Fiscal Year 2020)
  • Carrie Adams, Pharm.D, Vice President & Chief Quality/ Transformation Officer, Meritus Health, Hagerstown
  • Griffin Davis, M.D., Senior Vice President & Chief Medical Officer, Fort Washington Medical Center, Oxon Hill
  • Terry Fairbanks, M.D., Vice President Quality and Safety, MedStar Health, Columbia
  • Kathryn Fiddler, DNP, Vice President of Population Health, Peninsula Regional Health System, Salisbury
  • Michelle A. Gourdine, M.D., Interim Chief Medical Officer & Senior Vice President, Population Health & Primary Care, University of Maryland Medical System
  • Susan Mani, M.D., Vice President Clinical Transformation & Ambulatory Quality, LifeBridge Health, Baltimore
  • Marta Brito Pérez, Senior Vice President of Population Health & Post-Acute Care Services Adventist HealthCare, Gaithersburg
  • Rahul Shah, M.D., Vice President, Chief Quality & Safety Officer, Children’s National Health System, Washington, D.C.
Congratulations Health Care Heroes
Congratulations to our members who were recognized by  The Daily Record  as Maryland’s Health Care Heroes. We are proud to support you as you make an impact on the quality of health care in our state. Read more about all of these impressive professionals and organizations in the event’s special publication .
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. 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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