December 2, 2018
Synergies Between Health and Education
A child who misses school due to a parent’s inability to get her to the doctor may fall behind in learning. A hungry child cannot pay full attention in his class. And the effects of insecure housing or at-home trauma most definitely spill over into school performance.

The evidence is clear. There is a direct two-way link between children’s health and educational attainment, from pre-K through high school and beyond.
It’s heartening to learn that Maryland’s Commission on Innovation and Excellence in Education recognizes these connections. Nicole Stallings and I met informally last week with commission chair Brit Kirwan to discuss its recommendations on strengthening schools’ resources for at-risk children’s health and well-being. We also delved into the proposals on career and technical education, which will help prepare students for health care jobs.

From my visits with hospitals across the state, I know you see the clear synergy between these initiatives and our goals as health care leaders. For us to truly improve people’s health, we cannot wait to meet them in the hospital. We must partner with others in our communities and address social factors such as education, housing, and nutrition. Where better to start than in our neighborhood schools?

MHA’s Government Affairs team will closely track movement on the Kirwan commission’s recommendations during the upcoming session of the Maryland General Assembly. We will show support, especially for elements consistent with our mission to advance the health of all Marylanders.
Bob Atlas
President & CEO
HSCRC Total Cost of Care Work Group
At the Health Services Cost Review Commission’s (HSCRC’s) Total Cost of Care Work Group meeting Wednesday, three important topics were discussed:

  • Inclusion of Maryland Primary Care Program (MDPCP) payments in the Medicare Performance Adjustment (MPA): In 2019, the first year of the MDPCP program, the majority of payments to providers and Care Transformation Organizations (CTOs) will not be reflected in the Medicare Performance Adjustment policy. Even though payments will begin in 2019, they will need to be captured in the 2019 base period to fairly compare the year over year change in total cost of care per beneficiary. Only Comprehensive Primary Care Payments (CPCP), applicable to the 10 percent of practices in track two, will be included in the MPA performance calculation in 2019. These up-front care management payments — sometimes called partial capitation — are coupled with reduced fee-for-service payments. Since the 2019 MPA will reflect the reduced fee-for-service payments, the CPCP must be included.
  • Required and optional reporting of provider identifiers for the MPA: The 2019 MPA policy will link provider to hospitals based on Accountable Care Organization (ACO) participation, MDPCP participation through hospital-based Care Transformation Organizations, and employment status. As was done last year, the HSCRC will require hospitals to submit the list of providers in their ACO as of January 2019. The Maryland Department of Health will give a list of providers in the MDPCP program to the HSCRC. Hospitals can voluntarily submit a list of their employed providers for linking in the MPA attribution. The HSCRC will also require to hospitals attest that providers on these lists are in a voluntary care coordination relationship. This is critical to demonstrating a “treatment relationship” that will allow access to a broader range of identifiable data than is currently permitted.
  • Concerns about the accuracy of Medicare monitoring data: The HSCRC has not released Medicare data showing total cost of care performance relative to the nation since the September commission meeting due to concerns regarding its accuracy. HSCRC and CMS contractors have identified questions around beneficiary counts and other areas which will affect performance for the nation and Maryland and are working to resolve the discrepancies. Maryland Hospital Association staff are also working with the HSCRC to target the source of the potential errors. Commissioners and CMMI staff are aware of the issue.

For more details, click here .

MHA Contact: Traci La Valle , Vice President, Rate Setting
Resources Available on Rural Health Care
Presentations from last month’s 2018 Maryland Rural Health Conference are available online. Maryland Hospital Association (MHA) presented on several topics. Nicole Stallings, Senior Vice President of Government Affairs for MHA, gave a presentation on behavioral health, which included recommendations from MHA’s Behavioral Health Task Force. Among them was to provide behavioral health screenings for all patients and grow the behavioral health workforce.
A panel on the impact of the Total Cost of Care Model on Maryland’s health care system, moderated by Jennifer Witten, MHA’s Vice President of Government Affairs, included:
  • Karen L. Twigg, RN, BSN, CMCN, CalvertHealth Medical Center
  • Mark Boucot, MBA, FACHE, Garrett Regional Medical Center & Potomac Valley Hospital
  • Kathryn M. Fiddler, DNP, MS, RN, NE-BC, Peninsula Regional Medical Center
  • Lori Werrell, MedStar St. Mary’s Hospital
  • Nancy Bedell, University of Maryland Shore Regional Health

The American Hospital Association is planning its 2019 Rural Health Care Leadership Conference, which will be February 3 in Phoenix. Additional details are available here .
Care Transformation Organization Meeting Hosted at MHA
The Primary Care Program Management Office hosted the monthly Care Transformation Organization (CTO) meeting at the Maryland Hospital Association November 27. These meetings provide an opportunity for CTO members to give feedback to the program management office, which can be communicated to the Centers for Medicare & Medicaid Services prior to the launch of the Maryland Primary Care Program on January 1, 2019. The final deadline to return all documents including CTO participation agreements, practice participation agreements, and CTO/practice arrangement documents is December 21.

For more information about the program or deadlines click here .
Workplace Violence Prevention Steering Committee Endorses MHA Proposed Survey Effort
The second meeting of the workplace violence prevention steering committee, led jointly by the Maryland Hospital Association (MHA) and the Maryland Nurses Association, was held November 28. The group discussed both short and long term goals, including a subgroup to develop a standard communications tool for health care providers to better understand the legal process after an incident occurs and a strategy to respond to state guidance to ensure patient and provider safety. The committee also endorsed a survey of facilities and front line staff proposed by MHA to learn about their workplace violence prevention programs and experiences with workplace safety. In the coming weeks MHA will reach out to member hospitals and explore the possibility of building this data collection effort.

MHA Contact: Erin Dorrien , Director of Policy & Data Analytics
Want to receive your Toward Better Health
newsletter via text message?
Click here to sign up.
Maryland Hospital Association | www.mhaonline.org