March 10, 2019
Achieving Zero Harm
Maryland’s hospitals are committed to ensuring the safety and well-being of every person in your care.

The advances in patient safety that you are striving for are needed urgently. As has been widely reported , nationally, more than 250,000 deaths each year may be caused by medical errors.

Patient Safety Awareness Week , March 10-16, offers a chance to refocus on eliminating harm. As you review data to uncover potential areas for improvement, you can also learn about other hospitals’ efforts in MHA’s new report on quality, safety, and population health.

Additional activities that you can participate in include:

  • Twitter chat on March 14
  • Free webcast, “Advancing Patient Safety Beyond the Hospital,” on March 13
  • Free Institute for Healthcare Improvement downloadable materials

As you progress on your journey to zero harm, be sure to celebrate your successes. Wins beget more wins.

Thank you for the important, life-saving work you do each day to serve your patients and communities.
Bob Atlas
President & CEO
Updated Medicare Total Cost of Care Data Show Significant Savings in 2018
Updated data from the Centers for Medicare & Medicaid Services (CMS) corrects an error in the way beneficiary data was calculated for 2017. That correction brought the total Medicare Total Cost of Care savings from $138 million to $135 million. Data for 2018 also was released showing that Maryland had a much lower growth rate than the nation. Savings for that year are believed to be between $240 million and $260 million. These savings contribute toward Maryland’s goal of saving $300 million between 2018 and 2023. The state has asked CMS to verify the 2018 figures, and their response is expected in the first week of April. Your Maryland Hospital Association will keep you updated as we learn more.

MHA Contact: Mike Robbins , Senior Vice President, Rate Setting
CMS Explains Hospital Outreach Laboratory Data Reporting Obligations
The Centers for Medicare & Medicaid Services recently released updated resources intended to clarify whether a hospital outreach laboratory qualifies as an "applicable laboratory" under the Medicare Clinical Laboratory Fee Schedule (CLFS). The resources also include related requirements for collecting and reporting private-payer rate clinical laboratory test payment and volume data. The resources, which incorporate recent changes for clinical laboratories made in the Medicare CLFS and Physician Fee Schedule final rule for calendar year 2019, include an updated summary of the private-payer rate-based CLFS, a Medicare Learning Network article , and answers to Frequently Asked Questions .
MHA Supports Facility Fee Billing Regulation
The Maryland Hospital Association (MHA) supports draft regulations that address facility fee billing notifications. In a comment letter to the Health Services Cost Review Commission, MHA supported draft regulations that disclose hospital facility fees for outpatients and inform patients about their right to request and receive a written estimate of charges before non-emergent services.

MHA Contact: Brett McCone , Vice President, Rate Setting
CMS Releases Star Ratings
The Centers for Medicare & Medicaid Services (CMS) released its star ratings February 28. Hospital ratings range from one to five stars with more stars indicating better performance on quality measures. Maryland’s hospitals have a higher percentage of five-star hospitals compared to the nation and 73 percent of Maryland’s hospitals scored a three or better.

MHA Contact: Amanda Thomas , Policy Analyst, Policy & Data Analytics
$6.4M Grant Program Announced For Rural Health Care
Up to $6.4 million in grant funding will be awarded to improve the quality and delivery of rural health care services. The deadline to apply for the Small Health Care Provider Quality Improvement Grant Program is April 22. The grant funding is provided by the Health Resources and Services Administration’s Federal Office of Rural Health Policy.
Kirwan, Budget Take Center Stage in Annapolis
Last week, legislative leadership unveiled the “The Blueprint for Maryland’s Future” legislation, which begins to implement and provide funding for key recommendations of the Kirwan Commission on Education. The bill provides $325 million in fiscal year 2020 and mandates $750 million in funding for fiscal year 2021 for these initiatives. On Thursday, the Maryland Board of Revenue Estimates revealed a $268-million state revenue write-down between fiscal years 2019 and 2020. This news forces the General Assembly to cut funding from Gov. Larry Hogan’s proposed fiscal year 2020 budget to meet the state’s constitutional requirement of a balanced budget. The Department of Legislative Services recommended a list of cuts, including delaying the $40 million Medicaid Deficit Assessment in the governor’s budget and diverting the remaining $10 million from the Maryland Health Insurance Program (MHIP) fund to Medicaid. While the House Appropriations Committee maintained the MHIP diversion, they did include a $20 million reduction in the assessment. To retain the MHIP funding to support administration of the Maryland Primary Care Program (MDPCP), the Health Services Cost Review Commission introduced legislation authorizing the use of MHIP funding through fiscal year 2022. The Senate will begin making their budget decisions this week and a conference committee will be appointed to reconcile differences between the two budgets. Despite a revenue write-down and the legislative leadership’s priority of providing significant funding for the Kirwan Commission recommendations, MHA continues to advocate for a budget that reflects the field’s priorities. 
Md. General Assembly Update
The most important week of the legislative session gets underway tomorrow when legislators will be busy passing bills ahead of next Monday’s “crossover” deadline. Crossover is the day by which each chamber must send to the other chamber bills it intends to pass favorably. Your Maryland Hospital Association team testified on our top three legislative priorities last week, including reducing the Medicaid Deficit Assessment, modernizing the Certificate of Need process, and ensuring objectivity and predictability in the medical liability climate. The General Assembly also began making decisions on Gov. Larry Hogan’s proposed fiscal year 2020 budget. For more information on bills MHA is tracking, click here .
Bond Program Applications Available, Webinar Scheduled
The 2019 Maryland Hospital Association Hospital Bond Program application process will open on March 29. The Hospital Bond Program provides an opportunity to apply for state allocated funding to complete private capital projects. Hospitals applying for funding under this program must request the appropriate approvals/exemptions from both the Maryland Health Care Commission (MHCC) and Health Services Cost Review Commission (HSCRC) no later than April 26. Additional information and application documents will be available soon on MHA’s website. If you have questions, please contact  Brett McCone Jennifer Witten , or  Jane Krienke . MHA will host a webinar that provides an overview of the 2019 Hospital Bond Program on March 25 at 10:30 a.m. Please contact Jane Krienke for more details and to register.
MDH Seeks to Establish Community Health Worker Certification
The Maryland Department of Health (MDH) is asking the state’s community health worker (CHW) training programs to complete a survey by March 18 to help them better understand existing training programs. The results will be used as the state works toward establishing a statewide Community Health Worker Certification Program, which would include the approval of CHW training programs and a process to certify CHWs. MDH aims to develop an approval process for CHW training programs that incorporates best practices along with the guidance of the  Statewide CHW Advisory Committee , and feedback from the community and other critical stakeholders.
Western Maryland Summit Addresses Opioid Crisis
The Western Maryland – Regional Opioid Summit will be held March 21. The summit will focus on how service providers and law enforcement can work together to save lives and impact the overdose crisis. Speakers will include  Donnie Varnell  from North Carolina's LEAD (Law Enforcement Assisted Diversion) program and  Dr. Michael Brumage , who is the Assistant Dean for Public Health Practice and Service at West Virginia University.

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