June 22, 2018
A Rare Gem
As you know, the federal authority for the Maryland health care financing model runs through the Center for Medicare & Medicaid Innovation (CMMI). So, recent criticism of CMMI from federal budgeteers for producing "underwhelming" results, along with a proposed $800 million decrease to its $10 billion budget, would seem concerning. Instead, let's view this as a cause for optimism in Maryland.
The pressure on CMMI to show solid savings suggests, according to an article in Politico , that volume-to-value programs are not moving fast enough. The piece does acknowledge, via a quote from an ACO executive, that the center is "an incubator ... the whole model is to learn."
Yes, some of the center's future work across the nation will change. Yet CMMI is right now putting the finishing touches on a new 10-year agreement with the State of Maryland, effectively doubling down on the Maryland model. The very fact that the new Maryland model has moved relatively smoothly through federal red tape means it is an example of what is working right, and that CMMI is invested in that work. Maryland has saved Medicare nearly a billion dollars since 2014. Plus, we're doing the right thing in shifting the perspective to the total cost of care: aligning incentives to keep people healthy, which saves money and focuses on whole-person care.
In other words, Maryland's four decades of innovation as the only state with an all-payer model have laid the foundation for the future. Multiple challenges were solved over those decades, year by year, by the field and the state, and CMMI knows it. And we will continue to deal with challenges as we work through the new model. Expanding incentives to physicians and nursing homes and so many others, while hospitals bear the entire risk of achieving results, is a challenge. Working with the state to make sure insurers, who have benefitted so greatly from the system, pull in the same direction - another challenge. Working with HSCRC on effective and appropriate implementation will be a challenge. Saving money for Medicaid as well as for Medicare will be a challenge.
So, while CMMI's purpose and budget may be nudged in a different direction by federal overseers, be proud that Maryland's way of doing things is a rare gem. That's a testament to you and the state leaders who have persevered over four decades to do the right thing for those we serve.

Bob Atlas
President and CEO

Waiver Amendment, Medicare Differential Comment Letters Submitted
MHA submitted two comment letters this week. The first was sent to Tricia Roddy, Director of Planning for Maryland Medicaid, in support of the state's ยง1115 demonstration waiver amendments submission. The second was sent to HSCRC Chairman Nelson Sabatini, in support of a small adjustment to the public payer differential, from 6 percent to 7.7 percent.
Registration Still Open for Second High-Utilizer Webinar
The second in a two-part webinar, Improving Care for High Utilizers: The MAX Method, is Wednesday, June 27 at 9 a.m. and it isn't too late to register. This webinar is designed for hospital teams focused on reducing potentially avoidable utilization, specifically addressing high utilizers of the emergency department or inpatient settings. The webinar, hosted by MHA and Amy Boutwell, MD, MPP, the developer of the MAX Method, will explain core concepts and key operational aspects as well as the impact it has on patients, teams, cross-setting partnerships, and outcomes. You can view the first webinar, which was held June 13, on our website . To register for the June 27 webinar, click here .
Office Hours Webinar to be Held on Md. Primary Care Program
Care Transformation Organization (CTO) applicants interested in the Maryland Primary Care Program (MDPCP) are invited to a CTO Office-Hours Webinar Tuesday, June 26, from 1:30 to 2:30 p.m. hosted by the Center for Medicare and Medicaid Innovation. The webinar will be structured as a question and answer session for interested CTO applicants on the application process and program requirements. Click here to register.
HHS ASPR Releases Disaster Health Response Funding Opportunity
The Office of the Assistant Secretary for Preparedness and Response (ASPR) within the Department of Health and Human Services has announced the release of a new funding opportunity announcement, the Partnership for Disaster Health Response Cooperative Agreement. ASPR invites applicants to develop demonstration projects that address health care preparedness challenges, establish best practices for improving disaster readiness across the health care delivery system, and show the potential effectiveness and viability of a Regional Disaster Health Response System. This is among the first steps in ASPR's broader efforts to develop a Regional Disaster Health Response System that leverages and enhances existing programs - such as the Hospital Preparedness Program and the National Disaster Medical System - to create a more coherent, comprehensive, and capable health care system integrated into daily care delivery. For details on this opportunity, please see the Partnership for Disaster Health Response Cooperative Agreement Funding Opportunity Announcement .
HRSA Releases Funding Opportunity for Rural Opioid Response
The Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy has released a Notice of Funding Opportunity for the new Rural Communities Opioid Response Planning initiative for fiscal year 2018. All eligible high-risk rural communities are encouraged to apply. Successful awardees will receive up to $200,000 for one year to develop plans to implement opioid use disorder prevention, treatment, and recovery interventions designed to reduce opioid overdoses among rural populations. The lead applicant must be part of a group including at least three other partners that have committed to forming a consortium or are part of an established consortium This initiative is part of a multi-year Rural Communities Opioid Response initiative by HRSA aimed at supporting treatment for and prevention of substance use disorder. Click here to review the funding opportunity.
When You Can't Do It All Yourself
Tom Peters, in his book "In Search of Excellence," identified the ability of an organization to "stick to the knitting" as one concept that will assist organizations in achieving excellence in the marketplace.

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Atul Gawande to Lead Amazon, Berkshire Hathaway and JPMorgan Chase Health Care Venture
Amazon, Berkshire Hathaway and JPMorgan Chase have  selected  Harvard Medical School professor and New Yorker staff writer Atul Gawande as the CEO of their still unnamed company.

Wednesday, June 27
Webinar: Improving Care for High Utilizers: the MAX Method

Thursday, June 28
MHA Workplace Violence Summit
Fox Baltimore , By Bryna Zumer, June 15  

The Daily Record , By Tim Curtis, June 18
WMAR , By Staff, June 18
The Baltimore Sun , By Talia Richman, June 20
Healthcare IT News , By Mike Miliard, June 19
Cumberland Times-News , June 21