December 21, 2018
Happy New Model
As we come to the close of 2018 and take a moment to reflect on the past year, Maryland’s hospitals and health systems are gearing up for the next phase in your efforts to transform health care.
Beginning January 1, Maryland’s hospitals will operate under a new contract with the federal government, the Total Cost of Care Model. The model will test whether successes of the All-Payer Model – cost containment and quality and safety improvements – can grow to embrace all health care providers in the state.
The new model also offers our hospitals and health systems the opportunity to lead in advancing the health of all Marylanders. That’s what really drives you. So, it’s now embedded in MHA’s mission and vision.
This work will consume much of our energy in 2019 and beyond as we help hospitals to partner with physicians, community behavioral care providers, post-acute care providers, and others to keep people healthy and, when they need care, to make it efficient and of the highest quality.
We, at your Maryland Hospital Association, are grateful for your continued support and engagement in these collective efforts.
We wish you and yours a happy, restful, and safe holiday and a happy New (Model) Year.
Bob Atlas
President & CEO
MHA Provides Resources to Help Communicate CMS Price Transparency Requirement
The Centers for Medicare and Medicaid Services (CMS) requires all U.S. hospitals, including those in Maryland, to “make public, via the internet, a list of the hospital’s standard charges for all items and services provided by the hospital.” This requirement was reinforced in the recently released Inpatient Prospective Payment System (IPPS) Fiscal Year 2019 Final Rule, which clarifies that the information must be provided in a “machine readable” format. The Maryland Hospital Association has a website with resources to help hospital leaders understand and communicate this mandate, including a sample posting and talking points.

MHA Contact: Brett McCone , Vice President, Rate Setting
MHA Seeks Changes to Draft Policy on Sequester Adjustment
The Maryland Hospital Association asked the Health Services Cost Review Commission (HSCRC) to reconsider portions of its draft policy recommendation to provide the Medicare sequestration adjustment of 2 percent to the Medicare Advantage plans in Maryland. In a comment letter to the HSCRC Thursday, MHA recommended changes to the effective date — July 1, 2019 rather than January 1, 2019 — as well as suggesting the HSCRC consider the impact on hospital rates as part of the Update process, and asked that further analysis be conducted in finalizing its policy recommendation.

To read the full letter, click here .

MHA Contact: Mike Robbins , Senior Vice President, Rate Setting
Hospitals Provide Input on All-Payer Model
As part of the annual evaluation of the Maryland All-Payer Model on behalf of CMS, RTI International recently reached out to Maryland hospitals for completion of an online survey as part of its evaluation. MHA wants to thank members for the 100 percent participation rate that RTI reported to us earlier this week, as we complete the current model and start the new year under the Total Cost of Care model.
MHA Seeks Changes to HSCRC’s Readmissions Recommendations
The Maryland Hospital Association (MHA) is asking the Health Services Cost Review Commission to reconsider portions of its Draft Recommendation for the Readmissions Reduction Incentive Program for Rate Year 2021. In a comment letter, MHA writes that it supports the recommendation to continue measuring attainment and improvement in the readmissions policy. However, MHA asks that the commission reconsider the inclusion of specialty hospital admissions until those visits are included in the monitoring data.

To read the full letter, click here .

MHA Contact: Traci La Valle , Vice President, Financial Policy & Advocacy
Kirwan Commission Extended Another Year
This week, Senate President Thomas V. Mike Miller, Jr. and House Speaker Mike Busch announced that the Kirwan Commission will continue its work through fall 2019 and that the commission’s major recommendations will not be considered until the 2020 legislative session. A top campaign issue during the 2018 elections, the Kirwan Commission is charged with studying and recommending appropriate funding levels for Maryland’s public education system. This announcement came on the heels of the General Assembly’s Spending Affordability Committee decisions, which include the recommended spending parameters for the state’s fiscal year 2020 budget that will be considered in the upcoming session.

For more information on the Kirwan Commission, click here .

For more information on the Spending Affordability Committee decisions, click here .
AHA Offers Insight on ACA Court Decision 
To help answer questions the field could anticipate receiving from members of the community, the media, and hospital employees, the American Hospital Association (AHA) released a summary document addressing key aspects of the recent ruling by a district court in Texas to strike down the Affordable Care Act (ACA) as unconstitutional. The messaging emphasizes that this decision does not have an immediate impact on any ACA program, including waivers like Maryland’s, administered by the Centers for Medicare & Medicaid Innovation. During a member call Monday, AHA said the decision is expected to be reversed by the United States Court of Appeals for the Fifth Circuit, an expected next step which has bipartisan support in Congress.

To listen to a replay of the AHA member call, click here .

MHA Contact: Maansi Raswant , Vice President, Policy & Data Analytics
Atlas: Hospitals Work to Curb Opioid-Related Deaths
Between 2013 and 2016, hospital emergency department visits related to opioids jumped 82 percent. And in 2017, there were more than 2,000 opioid-related deaths in Maryland. In a WYPR commentary that aired December 18, Bob Atlas, President & CEO of the Maryland Hospital Association, shares how hospitals are working to address the opioid crisis. That includes championing the passage of a state law to ensure that every hospital has a discharge protocol for patients identified as having a substance use disorder – to help make sure they get the right follow-up care – and screening all emergency department patients for signs of substance use disorders. Hospitals also are working to prevent opioid misuse before it begins by reducing quantities of opioids prescribed and promoting non-opioid options, where appropriate, for pain management.

Click here to listen to the full segment.
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