MHA's Update newsletter will return January 6, 2017.
December 23, 2016
All in a Year's Work: 2016
Taking stock of all that has happened with health care in Maryland over the past year, it's easy to feel overwhelmed, but instead I am deeply uplifted by all we've accomplished together. Change has been fast, and at times difficult, but the results are undeniable: quality is better, cost trends are lower, and hospitals are engaged with their communities like never before.
I hope you are proud of the work you've done to truly transform health care delivery from a volume-based system to one where value - the quality of care delivered to patients and your communities - has risen to the forefront. And I'm proud of the work that MHA has done to support you in this transformation. Some highlights of how your MHA has made an impact in 2016:  
  • Secured a 2.72 percent increase in total revenue for global budgets for fiscal year 2017; this represents nearly $430 million in additional hospital revenue
  • Helped save Marylanders nearly $70 million by advocating for lower health insurance premiums
  • Developed a framework for funding of capital needs under global budgets
  • Protected the $25 million annual Medicaid tax spend-down
  • Secured $4.3 million in state funding for hospital capital projects
  • Developed an HCAHPS Data Analysis tool to help hospitals understand performance relative to peers and the state as a whole
  • After being the first state to secure 100 percent commitment from Maryland's hospitals, extended work on the national Equity of Care campaign, whose goal is to reduce health care disparities
  • Completed preliminary work with the Behavioral Health Task Force, culminating with the publication of an environmental scan that will help policymakers and others understand the problem
  • Launched Breath of Fresh Care, a statewide public awareness campaign to help consumers understand how hospitals are changing to improve care delivery and empower them to have a greater role in their health care
  • Secured a favorable update to readmissions reduction reimbursement policies that reflect attainment and improvement, as well as socio-demographic factors
  • Launched a public website, Quality Matters Maryland, to share stories of how hospitals throughout the state are improving the quality of care
  • Participated in a series of public forums to share how hospitals have transformed care delivery from reactive, acute care to proactive, whole-person care
Of course there are other accomplishments, and there will be a great deal of work in the coming months and years as we begin to navigate the tectonic changes likely in store for health care in our country. If the past year is instructive in any way, it teaches us that during times of relative stability, hospitals can achieve great strides toward their missions of help, healing and hope. As we move forward together in the coming year, those goals remain the same, as does the simple fact that we are stronger together, no matter what challenges arise.
I hope you and your families - personal and hospital-based - have happy and safe holidays.

MHA Co-Signs Letter Supporting Advanced APM Status
MHA President & CEO Carmela Coyle this week co-signed a letter to the Centers for Medicare & Medicaid Services supporting designation of Maryland's All-Payer Model as an Advanced Alternative Payment Model (APM). The letter was also signed by HSCRC Executive Director Donna Kinzer and MedChi CEO Gene Ransom. The letter details how Maryland's model already meets Certified Electronic Health Records Technology despite a November 4 rule from CMS indicating that it does not. The letter also outlines how the model is creating a path for physicians to become qualifying APM participants. Obtaining Advanced APM status is important because that designation would make Maryland physicians eligible for value-based federal incentives, aligning their business models with those of the hospital field under the All-Payer Model and global budgets.
Contact: Nicole Stallings
Medicaid Outpatient Observation Payments Limited to 24 Hours
Maryland Medicaid this week issued a transmittal to Managed Care Organizations and hospitals, limiting observations payments for all Medicaid recipients to 24 hours effective January 1. The decision comes after Maryland Medicaid learned during negotiations with the Centers for Medicare & Medicaid Services for renewal of the state's 1115 HealthChoice waiver, that federal regulations prohibit federal Medicaid payment for outpatient services beyond 24 hours. MHA has informed Department of Health & Mental Hygiene Deputy Secretary Shannon McMahon and Medicaid staff that this policy change will have significant ramifications, both for individual hospitals and for the all-payer model. Your MHA team is working to identify the implications of this policy notification and will advocate that any changes be implemented in a manner that causes the least disruption to the current system.
Contact: Maansi Raswant
Punitive Damages Report to Offer "No Recommendation"
After holding its final meeting this week, the House of Delegates Punitive Damages Work Group, is expected to issue a report stating that, due to the complexity of the issue, there is no consensus for a recommendation to the legislature on allowing the award of punitive damages based on blood alcohol levels in certain drunk driving personal injury cases. The "no recommendation" helps protect current law's status quo from trial lawyers' attempts to open up Maryland's already challenging liability climate. The work group, which convened following passage of a Senate bill last year that would have allowed for the award of such punitive damages, includes House legislators and stakeholders from the insurance industry, health care industry, plaintiffs' bar, and defense bar.
Hospital CEOs Participate in Rose Dedication Program
Next month, a Polynesian catamaran float will participate in the world-famous Tournament of Roses parade. But this float features more than just an attractive design: the Donate Life Rose Parade Float carries the message of the importance and value of donation and transplantation by honoring organ, eye, and tissue donors and celebrating the gifts they gave to others. Some of those messages will come from CEOs at Maryland's hospitals. Through The Living Legacy Foundation's CEO Rose Dedication Program, 17 CEOs wrote dedications on vials that will hold roses on the float. The messages support the parade's theme, Echoes of Success, bringing to mind the relationship between local hospitals and The Living Legacy Foundation that work together to facilitate the sharing of life-saving gifts. The Donate Life Rose Parade Float inspires viewers to help the more than 1 million people in need of organ, eye, or tissue transplants each year. To save lives by registering as a donor, please visit
Quarterly Financial, Utilization Reports Available
The financial reports for the third quarter of 2016 are now available for MHA members. To access the Accounts Receivable and Combined Financial Trends and Utilization reports, click here. Reports are available only to members. 
Contact: Brian Sims
Registration Open for MHA, CRISP Care Alert Sprint Webinars
A critical step to secure a full fiscal year update in January is to demonstrate to the Health Services Cost Review Commission that hospitals are making use of "care alerts." This can be done by uploading them to the Chesapeake Regional Information System for our Patients (CRISP). To help with this effort, CRISP and MHA have introduced a "Care Alert Sprint," a six-month initiative to help meet this recommendation using existing hospital personnel and resources. The Care Alert Sprint is aimed at population health, readmissions reduction, and emergency department leads. Dr. Amy Boutwell, a national expert on readmissions reduction who has worked with hospitals across the country, including those in Maryland, will support this work. Slides and a link to the introductory webinar (held December 14) are available on our website, along with links to register for all upcoming webinars.
Contact: Nicole Stallings
Mark Your Calendar for Final HSCRC Webinar on All-Payer Model Jan 13
The final in a series of seven webinars with HSCRC staff on the amendment to the All-Payer Model and on care redesign programs is Friday, January 13. The amendment, approved earlier this month:
  • Gives hospitals and their care partners access to comprehensive Medicare data across the care continuum that supports care coordination and a focus on controlling total cost of care
  • Creates the next steps toward total cost of care and delivery system transformation
Under the amendment, the first two care redesign programs are:
  • the Complex and Chronic Care Improvement Program (CCIP)
  • the Hospital Care Improvement Program (HCIP)
Again, the final webinar is:
  • Webinar 7: (9 a.m. Friday, January 13) - Care Partner Agreements
During the webinar, participants can ask questions of HSCRC, the Center for Medicare & Medicaid Innovation, MHA, and CRISP. Click here to find the registration link for the final webinar and the recordings of previous webinars.
Defining Diversity
It seems appropriate that during this season of "good will" and "resolutions" we re-commit ourselves to understanding and caring for others. With that in mind, the Maryland Healthcare Education Institute has designed an approach to assist member organizations with issues of diversity and disparities.

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New PPT Slides Available on the MACRA Physician Payment Final Rule
The AHA this week released an  updated PowerPoint slide deck to help hospital leaders, clinicians and trustees prepare for the new Medicare physician quality payment program, for which performance measurement starts in 2017 under the Medicare Access and CHIP Reauthorization Act. 

The Frederick News-Post, By Nancy Lavin and Sylvia Carignan, December 17
The Baltimore Sun, By Fatimah Waseem, December 20
ABC 2 News, By Catherine Hawley, December 19
Herald-Mail Media, By Valerie Bonk, December 20
My Eastern Shore MD, December 21
The Washington Post, By Dan Morse, December 21
The Frederick News-Post, By Nancy Lavin, December 21