July 14, 2019
Promoting Health Equity
All Marylanders deserve an equal opportunity to achieve optimal health — regardless of social, economic, or demographic differences. Though we all share this goal, health disparities persist stubbornly.

As your hospitals work to address social needs of individual patients and social challenges in your communities, it’s clear that access to better housing, food and transportation is crucial to people’s ability to become healthier. It helps that the Maryland Model has incentives, both explicit and tacit, to improve population health and to fix the problems that lead to disparities. But the hospital field cannot do this alone.

Your Maryland Hospital Association’s strategic plan promotes health equity. Last month, our Executive Committee approved the formation of two member-driven groups to guide our work: Health Equity Task Force, to address social determinants of health, and Diversity and Inclusion Advisory Group, to focus on hospital and health system workforce diversity and inclusion .

Active participation on these groups will advance health equity by:

  • Supporting hospitals in addressing social influencers of health and reducing disparities in health outcomes.
  • Influencing public policy development across all domains that can affect health outcomes.
  • Bolstering workforce diversity, inclusion, and advancement opportunities for underrepresented groups in Maryland’s hospitals and health systems – not just among associates but also in leadership and governance roles.

We urge you to nominate committed organizational leaders who have expertise in social determinants and workforce diversity to help us drive these important initiatives. Please submit nominations to equity@mhaonline.org by July 19.

Thank you!
Bob Atlas
President & CEO
HSCRC Staff Present Draft Integrated Efficiency Policy Recommendation
At Wednesday’s Health Services Cost Review Commission (HSCRC) meeting, HSCRC staff presented a draft integrated efficiency policy recommendation to bring high-cost outlier hospitals closer to the peer group average. The proposed policy ranks hospitals based on all-payer, adjusted cost per case, and Medicare total cost of care growth. Hospitals in the least favorable quintile would not receive an inflation adjustment for the Medicare portion of all-payer revenues. Certain hospitals would be excluded from revenue adjustments if they have existing agreements with the HSCRC or if their adjusted cost per case is less than one standard deviation above the peer group. Hospitals in the lowest cost quintile would be eligible for a potential increase to their annual global budgets. Read more in this month’s Newsbreak .
House Subcommittee Passes Surprise Billing
The U.S. House Energy and Commerce Subcommittee on Health passed the No Surprises Act ( H.R. 3630 ) that would prohibit balance billing for out-of-network emergency services and certain out-of-network ancillary and post-stabilization services, and set a benchmark or reference rate for out-of-network payments to providers. The legislation approved by a voice vote would set a federal benchmark rate to settle payment disputes between insurers and providers, similar to an approach approved by the Senate HELP Committee last month . Committee leaders said they would work with lawmakers on  H.R. 3630 (116) , to try and address concerns in the coming days, with a possible vote by the full panel next week.

MHA drafted talking points that can be used to share the field’s position and concerns with the current legislation. In addition, staff have developed a crosswalk of all the current federal surprise billing legislation with a comparison to Maryland’s state law. Staff are actively engaged with Maryland’s delegation on this issue and are coordinating advocacy outreach with the American Hospital Association.

MHA Comments on MDH Plan to Alter Reimbursement for Telehealth
The Maryland Department of Health (MDH) is considering taking steps to remove current restrictions on the types of providers who may seek reimbursement from Medicaid for telehealth services. In a letter to MDH July 8, the Maryland Hospital Association expressed support for the intent of the efforts but raised concerns with two provisions that have been included in the initial draft of the regulations.
Registration Open for Maryland Rural Health Care Conference
Registration is open for the Maryland Rural Health Care Conference in October. Your Maryland Hospital Association is proud to partner with the state’s Rural Health Association on this event and year-round efforts to educate and advocate for the optimal health of our rural communities and their residents. MHA staff also will be presenting during the conference on the state’s Total Cost of Care Model and emergency department overcrowding.
SIG Discusses Potential New Payment Models
The Stakeholder Innovation Group (SIG), convened by the Maryland Hospital Association at the request of Health Secretary Robert Neall, met July 12. The SIG, modeling its role after the federal Payment Model Technical Advisory Committee, discussed two potential new payment models proposed by provider groups to assist the state in achieving the goals of the Total Cost of Care Model. The first is a model aimed to enhance emergency medicine, and the second is a model to improve post acute care for complex patients at risk for delayed discharges from acute care hospitals. Proposed new payment models will be vetted by the SIG before the state considers taking the proposal to the Centers for Medicare & Medicaid Services. Proposed new payment models should be submitted through the Innovations for Better Health website . All SIG materials can be found here . For questions contact Erin Dorrien .
MHA to Host Series of Statewide Forums on Workforce
Your Maryland Hospital Association (MHA) is hosting the first in a series of statewide workforce forums August 1. The forum will focus on workforce development practices and challenges – particularly as they relate to allied health professionals and nursing. It is also 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. We encourage every member hospital to designate a representative from your HR and CNO staff to attend.
Registration is open . For details, contact Jane Krienke .
New Medicaid System of Care Task Force Begins Work
Last month, your Maryland Hospital Association’s Executive Committee approved the creation of the Medicaid System of Care Task Force. This task force will discuss and develop policy proposals specific to the state’s Medicaid population. The first topic the group will address is behavioral health service delivery. The group met for the first time last week and will continue its deliberations on the topic through the end of the year. Recommendations from the task force will go to Executive Committee for approval.

MHA Contact: Maansi Raswant
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