February 17, 2019
One Step at a Time
There is a crisis in our state, faced by an estimated one in five Marylanders: mental health and substance use disorders (SUD).

That is why your Maryland Hospital Association (MHA) created the Behavioral Health Task Force . Fifteen months ago, that group – made up of hospital leaders and experts in mental health and SUD — presented the Roadmap to an Essential, Comprehensive System of Behavioral Health Care for Maryland .

Since then we’ve worked fulfill the charge of that report: to identify and address key behavioral health issues affecting Maryland’s hospitals and the communities they serve. Some achievements to date:

  • We are about to launch a second study — this time focused on discharge delays in Maryland’s emergency departments.

  • MDH, in response to MHA-proposed budget language, issued a report detailing that a workforce shortage was hurting Marylanders’ access to behavioral health services.

  • Behavioral health needs also will be taken into consideration when legislation to modernize the Certificate of Need process, championed by the MHA, is considered by lawmakers in Annapolis in March.

MHA will continue to fight to remove all barriers to timely placement, secure investment in needed services, and ensure mental health and SUD patients have access to high quality care in the right setting.
Bob Atlas
President & CEO
MHA Advises HSCRC to Reduce Emphasis on MHAC Policy
The Maryland Hospital Association (MHA) sent a comment letter Friday to the Health Services Cost Review Commission recommending less emphasis on the Maryland Hospital Acquired Conditions policy. The hospital field unanimously supported a “non-linear” payment scale that focuses penalties and rewards on the highest and lowest performance. The MHA recommendation mitigates concerns with the policy’s risk adjustment and reduces distraction so that more resources can be directed to care redesign and alignment activities that support total cost of care management. MHA commented on other aspects of the MHAC policy in January and needed more time to gather hospital field input on how rewards and penalties should be distributed.

To read the full letter, click here .

MHA Contact: Traci La Valle , Vice President, Rate Setting
MHA Releases Report on Quality, Safety, Population Health
Your Maryland Hospital Association has published its annual report on quality and safety in the state’s hospitals. The report includes statistics showing how the state has improved in a number of metrics, as well as examples that showcase quality and safety efforts in hospitals statewide. This year the report also focuses on how the state’s hospitals are addressing population health. To view the full report, click here .
Data Released on HCAHPS Scores
The Maryland Hospital Association’s (MHA) strategic plan calls for MHA to support hospitals in raising performance relative to the nation on key quality metrics. Given the Health Services Cost Review Commission’s continued emphasis on patient satisfaction, or HCAHPS, as part of the Quality-Based Reimbursement program and Maryland’s performance relative to the nation, MHA recently shared hospital-specific improvement data on each domain from 2013 to 2017 with the Council on Clinical & Quality Issues. MHA will use these data along with the council’s guidance to inform a statewide strategy for performance improvement.

MHA Contact: Nora Hoban , Senior Vice President, Policy & Data Analytics
Md. General Assembly Update
The Maryland Hospital Association (MHA) reviewed and processed hundreds of bills this week following the House and Senate introduction deadlines. Bill hearings are now in full swing after the General Assembly’s focus on issue briefings wrapped up last week. In addition to legislative meetings on a range of priorities, MHA attended or testified at several hearings, including the Health Services Cost Review Commission and Maryland Health Care Commission budgets, Prescription Drug Monitoring Program, and liability issues related to discovery, notice of intent, and offers of judgment. For more information on bills MHA is tracking, please click here .
MHA Advocates for Expanded Health Coverage
The Maryland Hospital Association last week announced the hospital field’s support for legislation that works to expand health coverage in the state. Under the bill , those who indicate they do not have insurance when filing their taxes would be screened to determine eligibility for Medicaid or health insurance subsidies to purchase insurance on the state’s health exchange. In addition, a state-levied penalty on people without health insurance could go toward a down payment on a health insurance plan from the state’s health exchange. The bill has the potential of covering approximately an additional 130,000 Marylanders. “Comprehensive coverage is an essential pillar of the state’s unique Total Cost of Care agreement with the federal government which, at its most basic level, requires we advance health care and the health of all Marylanders,” said Bob Atlas, President & CEO of MHA, during a press event announcing broad support for the legislation.
Video Series Highlights Health Care in Rural Maryland
The Maryland Rural Health Association and the Community Health Resources Commission (CHRC) collaborated on a series of videos that highlight collaborative programs funded by CHRC in rural communities. The first video in the series features programs in Calvert, Garrett, and Wicomico counties, including some services that support people with substance use disorders and those who have visited the hospital in high numbers. A second video is expected to be released in the spring, which will feature programs in Carroll, Cecil, and Wicomico counties. The programs demonstrate community and hospital partnerships working together to achieve population health goals.
Health Care Cost Institute Releases Health Care Cost, Utilization Report
The Health Care Cost Institute, an independent, nonprofit research institute, recently released its 2017 Health Care Cost and Utilization Report. The report looks at per person spending across the country, by the four large service categories: inpatient, outpatient, professional, and drugs spending. It also examines growth in spending between 2013-2017. The report is based on four billion claims from roughly 40 million individuals up to age 65 with employer-sponsored coverage. The claims come from Aetna, Humana, Kaiser, and UnitedHealthcare.

The report finds that nationally, 2017 per person spending was at an all-time high of $5,641; 16.7 percent higher than 2013. At the state level, Maryland fares overwhelmingly well in the report, ranking 47 out of 51 (all states and the District of Columbia) on overall per person spending of $4,919. With regards to hospital spending, Maryland ranks 50 out of 51 on both inpatient and outpatient spending in 2017. Between 2013 and 2017, the state’s inpatient costs grew by 3.8 percent, less than the US average of 9.8 percent. Outpatient costs grew by 5.3 percent, significantly less than the US average of 19.3 percent. This report provides yet another analysis confirming the benefits of Maryland’s unique model on health care spending in the state.

To view the full report, click here .

MHA Contact: Maansi Raswant , Vice President, Policy & Data Analytics
Awards Honor Health Care Field
The Daily Record is calling for nominations for its Healthcare Heroes awards. Your Maryland Hospital Association is an event partner for the awards, which honor organizations and individuals who have made an impact on the quality of health care in Maryland. Nominations are due March 5. For more information and to fill out a nomination form or application, click here .
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