July 28, 2017
At the Table to Preserve Coverage
For hospital leaders fighting to protect coverage for their patients and communities, it's been another week of Capitol Hill consternation. Fifty senators, with Vice President Mike Pence breaking a tie, voted to allow debate to proceed on several bills aimed at repealing and possibly replacing the Affordable Care Act.
Each of the measures by themselves - a repeal-and-replace bill that would have cut coverage for 20 million people, a full repeal without any concrete replacement, and a "skinny" repeal which would have eliminated a few key components of the ACA - failed to garner enough votes to pass.
Still, through regulatory changes or a defunding of certain ACA provisions through the federal budget process, millions across the country could yet lose their coverage. In Maryland, health care for the estimated 450,000 people who gained coverage as a result of the Affordable Care Act remains in question.
Recognizing the threat, Maryland lawmakers during this year's General Assembly session passed a bill establishing the Maryland Health Insurance Coverage Protection Commission. The commission, whose first meeting is Tuesday, will help the state address coverage issues, including the impact of federal changes on the All-Payer Model. You, through your MHA, will have a seat at the table.
The first meeting will be largely informational, with presentations on the impact of the ACA on Maryland, how states are responding to proposed federal legislation, Medicaid expansion, and more. The commission must submit its initial report to the Governor and General Assembly by December 31.
While all of this is going on, a dedicated and hard-working team of hospital executives continues to work with the state to try to design the best way to extend the All-Payer Model demonstration, so that Maryland's 40-year-old unique health care system can continue to succeed. As we have discussed with you during our Thursday morning member calls and in-person meetings over the past months, we still have questions about the next phase of Maryland's model and we are working hard to secure the answers.
All these ingredients add up to challenging times for hospital leaders. You must make strategic planning and budgetary decisions that help your organization continue to take care of people despite uncertain conditions on the horizon. We will continue to make sure our state and national leaders hear loudly and clearly what's at stake for their constituents in Maryland, and for the hospitals that are entrusted with providing their care.

Health Coverage Commission Meets Next Week
The Maryland Health Insurance Coverage Protection Commission, established by the General Assembly earlier this year, will have its first meeting on Tuesday. This commission will submit a report to the governor and lawmakers by the end of the year on issues such as the impact of federal efforts to repeal/replace the Affordable Care Act and what the state can do in response. Invited presenters include:  
  • Karen McManus, Deputy State Director, Office of Senator Chris Van Hollen
  • Haley Nicholson, National Conference of State Legislatures
  • Bradley Herring, Associate Professor and Deputy Chair for Academic Affairs, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
  • Cynthia Woodcock, Executive Director, Hilltop Institute, UMBC
  • Ben Orr, Executive Director, Maryland Center on Economic Policy
  • Leighton Ku, Professor, Department of Health Policy and Management, and Director, Center for Health Policy Research, Milken Institute School of Public Health, George Washington University
MIA Offers Training
The Maryland Insurance Administration (MIA) is offering training sessions at hospitals and other facilities to groups of providers and/or their staff to explain the MIA's role. The administration helps providers assist families and individuals in understanding their rights when it comes to getting treatment; navigate the process of getting proper coverage through health insurance; and understand the laws that protect their benefits. Several teams are available to assist with appeals from denial of coverage, issues related to mental health parity, and more. Hospitals can file claims on a patient's behalf and the MIA website has links to complaint and authorization forms.  For more details about the appeals process, contact Joyce Peach at joyce.peach@maryland.gov or 410-468-2360.
Brian Gragnolati Named Future AHA Chair
The American Hospital Association's board of trustees has selected Brian Gragnolati, president and CEO of Atlantic Health System, as its chair-elect designate. Gragnolati will assume the chairmanship in 2019, becoming the top-elected official of the national organization that represents America's hospitals and health systems. Before arriving at Atlantic Health System in 2015, Gragnolati was senior vice president, community division, at Johns Hopkins Medicine. Previously, Gragnaloti served as president and CEO of Suburban Hospital in Bethesda, for 12 years, and served four years as president and CEO of WellSpan Health in York, Pa. Currently a member of the AHA board of trustees' Executive Committee and chair of its Operations Committee, Gragnolati also serves on the AHA's Investment Committee, Committee on Health Strategy & Innovation and Next Generation Physician Engagement Task Force.
OHCQ Clarifies Outpatient Behavioral Health Requirements
The Office of Health Care Quality has released a memo to clarify new licensure requirements for hospitals that operate outpatient behavioral health programs. Effective January 1, 2018, community-based behavioral health programs, including all off-campus hospital owned and operated programs, will be required to be surveyed under the Joint Commission's behavioral health standards in order to be licensed. For programs operated on a hospital campus and accredited under the Joint Commission's Hospital standards, the memo details several criteria that should be used to rule out whether a behavioral health program requires an additional license and survey. All questions should be directed to Renee Webster at the Office of Health Care Quality, renee.webster@maryland.gov
Collaborative Health Care Leadership Program Opens
The Maryland Healthcare Education Institute has opened registration for a program on collaborative leadership. This session, to be held November 9 from 8:30 a.m. to 3:30 p.m., will explore The Center for Creative Leadership model, which health care leaders can adapt for their own use. Attendees will learn how to identify collaborative strategies designed to achieve departmental and organizational goals. Click here for more information and details on how to register.
Team Building as an
Informal Activity
All leaders are interested in building their teams into units that produce high quality and efficient care/service. As leaders become more sophisticated, they learn two things about team building. The first is that team building (or deconstructing) occurs all the time, whether or not there is any formal or direct attention being paid toward it.

Prime Offers Solutions for Market Analyses, Intelligence and Forecasting
Prime's affiliate, MedAssets, has acquired 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 Releases Community Conversations Resource
AHA this week released a toolkit to help hospitals and health systems in vulnerable rural and urban communities engage their communities in discussions on how to ensure continued access to essential health care services.

Capital Gazette, By Phil Davis, July 22
Herald-Mail Media, By Julie E. Greene, July 24
Baltimore Business Journal, By Tina Reed, July 24
Capital Gazette, By Amanda Yeager, July 25
The Frederick News-Post, By Danielle E. Gaines, July 26
Modern Healthcare, By Virgil Dickson, July 27
The Baltimore Sun, By Sarah Gantz, July 27