November 10, 2017
A Threat to Hospitals'
Charitable Purpose
With the public release last week of a federal tax reform package, and its passage Thursday by the House Ways and Means Committee, Maryland's hospitals face the possibility of losing an important means of raising money for critical infrastructure projects that support their mission of care.
Embedded in the tax proposal is a provision that would eliminate the tax-exemption for private-activity bonds, including 501 (c)(3) hospital bonds. For Maryland's hospitals, all of which are not-for-profit, these bonds represent a significant revenue stream. In the past fiscal year, hospitals floated nearly $2 billion in tax-exempt bonds to support their work.
The tax-exemption enables hospitals to realize lower borrowing costs because investors are willing to accept a lower rate of return in exchange for tax-exempt interest. This furthers the charitable purposes of hospitals in providing care to all in need, including those who receive health care benefits under a federal or state sponsored health plan and those who are unable to pay for the cost of their health care.
Losing the exemption would place vital hospital services at risk, but the greater threat is the long-term fiscal stability of hospitals, whose overall impact on the financial well-being of their communities is far greater than any single infrastructure project.
MHA will share information about the potential impact on Maryland with our state congressional delegation; the American Hospital Association has sent a letter to Kevin Brady, Chairman of the House Ways and Means Committee, and is encouraging hospital leaders to contact their congressional representatives and urge them to oppose this provision.
You know how challenging it can be to manage a hospital in the most stable environments, and today's political climate, with fast-moving and evolving legislation and regulation, makes doing so all the more difficult. That's why vigilance and action against threats like these are so essential: so that the care you provide for your patients and communities will not wane.
Webinar on 3M Grouping Software Available
In a joint MHA-3M webinar this week, 3M previewed updates to the newest version of its grouping software, which will be used to determine occurrences of potentially preventable complications in calendar year 2018. The latest version of 3M's manual, version 35, is available here (User ID: MDHosp, Password: aprdrg401). A recording of the webinar and the accompanying slides are available on MHA's website. These materials will be most relevant for quality leaders and coding managers. Contact Justin Ziombra with questions.
MHA Submits Letter on Medicare Performance Adjustment 
MHA this week submitted a comment letter to the Health Services Cost Review Commission on the commission's Medicare Performance Adjustment (MPA) policy. The letter offers support for the MPA because the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) pathway and alignment of physicians is important to manage the total cost of care. However, if the MPA is not approved for MACRA purposes, the letter asks the commission to scale back the attribution methodology to better align with hospitals' existing efforts to control total cost of care. The commission is expected to consider the MPA for adoption at its monthly meeting on Monday.
Contact: Traci LaValle
Final Webinar in Opioid Crisis Series is
November 14
MHA and the Maryland Department of Health will continue their five-part series: Hospitals' Role in Addressing the Opioid Crisis next week with the fifth and final webinar, "Buprenorphine in the Emergency Department." Materials from the first four webinars are available on MHA's website. The November 14 webinar is at 8:30 a.m. and registration is required.  Contact  Nicole Stallings  with questions. 
MHCC Releases Rural Health Report
The Maryland Health Care Commission has released findings from a year-long assessment of the unique health care delivery challenges in Caroline, Dorchester, Kent, Queen Anne's and Talbot counties on Maryland's Eastern Shore. The report, " Health Matters: Navigating an Enhanced Rural Health Model for Maryland," makes recommendations to improve population health in rural communities within the five-county region and identifies successful initiatives in rural communities throughout the U.S. that can serve as models for Maryland.
MHA and CRISP to Host Image Exchange Webinar
MHA and CRISP next week will host a webinar on CRISP's work to support image exchange. The webinar will cover how hospitals can perform and publish stroke imaging in real time, allowing specialists to make rapid, life-saving decisions for stroke patients. It will also cover the results of a return on investment analysis conducted with five hospitals in Maryland, including reductions in potentially avoidable utilization. Attendees will hear from their colleagues about how image exchange has affected patient care and improved patient and clinician satisfaction. The webinar is November 17, 8:30-9:30 a.m. Click here to register.
Contact: Pat Ross
BHSB Re-releases Stabilization Crisis
Center RFP
The Behavioral Health System Baltimore (BHSB) has re-released its Request for Proposals for a competitive procurement of a Maryland Crisis Stabilization Center. The stabilization center is a new program design in Maryland that will offer a safe place for individuals who are under the influence of drugs and/or alcohol to sober and receive short-term interventions, such as buprenorphine induction and medical screening and monitoring. The center will be a city-wide program that is responsive to local needs, grounded in a public health framework, and integrated into the behavioral health crisis care system. Through this RFP, BHSB is seeking a qualified organization to operate and partner with the Implementation Board to develop and sustain a pilot project. Proposals are due by November 21 with an anticipated contract start date of
December 1.
Webinar on Saline Shortage Available
The Healthcare Association of New York State has made available its webinar on helping hospitals identify practical means to minimize the impact of the current saline shortage on patient care. The webinar was developed with pharmacists from health systems throughout New York State and offers strategies to conserve and bridge gaps during drug shortages. Earlier this week, the American Hospital Association send the Food & Drug Administration a letter about the shortages, and AHA has also sent a letter to House Energy & Commerce Committee's Subcommittee on Oversight and Investigations.
AHA Offers Enrollment Resources
The American Hospital Association has created several resources for hospitals to use to encourage enrollment in the health insurance marketplace, including videos, social media posts, talking points and other resources. 
MCASA Celebrates Forensic Nurses Week
The Maryland Coalition Against Sexual Assault is celebrating Forensic Nurses Week this week to honor the hard work, expertise, and dedication of forensic nurse examiners who care for victims of sexual assault and other trauma. The International Association of Forensic Nurses has created a planning guide hospital staff can use and if you haven't done so already, consider sending a thank-you card or print a certificate of recognition for a forensic nurse to show how much you appreciate their dedication.
Improving Engagement Survey Results
Action Planning for Staff Engagement is a one-day program to help managers and others develop strategies and tactics that will work in their organization.

Prime Offers Solutions for Market Analyses, Intelligence and Forecasting
Prime's through its affiliation with Vizient, offers solutions through Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services. Sg2 delivers an easy access platform of predictive analytics and consulting services that helps more than 1,400 hospitals and health systems - from small community hospitals to large integrated delivery networks - understand current and future market dynamics and capitalize on opportunities for growth and performance.

AHA Webinar November 17 on Improving Transportation Services for Patients
Learn how Taylor Regional Hospital in Kentucky and Denver Health Medical Center improved transportation to health care for rural and urban residents in need during a November 17 AHA webinar on "Transportation and the Role of Hospitals." 

Monday, November 13
Health Services Cost Review Commission meeting

Tuesday, November 14
MHA Executive Committee meeting
MHA and Maryland Department of Health Webinar Series: Hospitals' Role in Addressing the
  Opioid Crisis - Buprenorphine in the Emergency Department

Thursday, November 16
MHA Councils on Clinical & Quality Issues and Financial Policy meeting
The Baltimore Sun, By Juliet Eilperin, November 6
Baltimore Business Journal, By Morgan Eichensehr, November 6
The Baltimore Sun, By Melissa Healy, November 7
Baltimore Business Journal, By Morgan Eichensehr, November 9
Baltimore Business Journal, By Morgan Eichensehr, November 8
Ocean City Today, November 9