June 16, 2017
Commanders of Chaos
That's how I referred to Maryland's hospital leaders in my remarks Tuesday at MHA's Annual Membership Meeting. The reference came after we showed a very effective and touching American Hospital Association video featuring hospital employees talking about their "superpowers" on the front lines of care. The behavioral health crisis, questions surrounding coverage at the national level, and as many questions about the next phase of Maryland's All-Payer Model, among other things, are making you Commanders of Chaos, and it is almost superhuman the way you are continuing to take care of people and communities in the face of such turmoil.
I mentioned that commanders need armies around them to get the job done, and one such supporter for us is Senator Thomas M. (Mac) Middleton, to whom I was very proud and happy to present MHA's highest honor: The Distinguished Service Award. This is not an award we give annually, but one we give only when someone is deemed deserving. And Senator Middleton's support for and championing of the mission of hospitals has certainly been exactly that. His work in Annapolis has been marked not just by effectiveness, but also by grace and class - not something that can always be said about the often rough-and-tumble politicking that goes on from January into April each year. Senator Middleton understands why you do what you do, and fights for what you need to do it. His gracious and touching acceptance remarks Tuesday displayed a real knowledge of and deep appreciation for the work that you do and the chaos that surrounds it.
Our speakers, David Brooks, Rick Pollack, and Dr. David Wolf, gave us unique insights from the world of journalism, from Capitol Hill, and from outer space respectively, but each, as Pollack told us, "connected the dots" to help us understand where our chaos fits in this uncertain, challenging, but ultimately promising national and local transformation. And we changed leadership, passing the gavel - literally - from Mark T. Jensen to Mary Pat Seurkamp as MHA's Executive Committee chair. We thank Mark for his diligent service and thank Mary Pat for agreeing to be at the helm as we navigate the chaos that lies ahead.
And thank you for your continued support of your MHA, and for continuing to make better the lives of the people who rely on you during their own times of chaos. 

Pictured left to right: Carmela Coyle, State Senator Thomas M. (Mac) Middleton, and outgoing MHA Chairman Mark T. Jensen
HSCRC Approves 3.12 Percent Global Budget Update
After a lengthy debate, the Health Services Cost Review Commission this week approved a 3.12 percent (2.75 percent per capita) update to hospitals' global budgets for the year beginning July 1, and a 2.28 percent increase for psychiatric hospitals and Mt. Washington Pediatric Hospital. Commissioners expressed concern regarding the potential for the Medicare Total Cost of Care guardrail that could be violated in calendar year 2017 if hospitals fail to continue to reduce hospital avoidable utilization to offset growth in non-hospital spending. Additional details on the monthly commission meeting can be found in this month's edition of Newsbreak .
Medicare Hospital Wage Index Data Released
MHA staff recently sent hospitals the preliminary Medicare wage index data from the fiscal years 2015 and 2016 cost reports. These data are made available for review, and, if needed, revision, by September 1, 2017. The Health Services Cost Review Commission intends to use the Medicare wage index data to adjust for labor market differences in future policies. This data is also used to adjust Medicare prospective payments for skilled nursing facilities, home health, and inpatient rehab facilities that may be part of your health system. MHA will analyze the data, calculating year-over-year changes and determining the impact on wage index reporting over time. MHA plans to host a Hospital Wage Index Reporting session in July or August. Please contact Brian Sims for more details. 
Naloxone Now Available without Prescription
A new statewide standing order issued by Dr. Howard Haft, Deputy Secretary for Public Health Services at the Department of Health and Mental Hygiene, has made Naloxone available in Maryland without a prescription. The order, effective June 1, 2017, replaces a December 2015 order from Dr. Haft that authorized pharmacists to dispense Naloxone to individuals who had been trained and certified under the Maryland Overdose Response Program. As authorized by the recently signed Heroin and Opioid Prevention Effort and Treatment Act of 2017, the new order allows pharmacists to dispense Naloxone to anyone, whether or not the person has been certified under the response program or received any training. Maryland-licensed pharmacists are allowed to dispense Naloxone to anyone who may be at risk for opioid overdose or in a position to assist someone believed to be experiencing opioid overdose. A person-specific prescription is not required for a pharmacist to dispense Naloxone under the standing order.
AHRQ Offers Webinars on TeamSTEPPS Journey
The Agency for Healthcare Research and Quality invites hospitals to a three-part webinar series that will detail one organization's journey through TeamSTEPPS implementation and how it was sustained. The webinars are July 12, August 9, and September 13, and are meant to build on one another but can also be listened to independently. The webinars will feature the University of Washington Medicine and will describe how breaking down the tools and concepts into different skill levels helps an organization transform its culture to one with improved communication and teamwork, leading to improved patient outcomes. The webinars are free. Click here to register.
Physicians Learning to Collaborate
If you saw Hospitals & Health Network's article last week on Physician Engagement and Clinical Variation , you might remember the call for "engaging physicians" in a more collaborative approach.

Reduce Lighting Energy Costs Up to 50 Percent
Lighting accounts for 30 to 60 percent of annual electric costs for many facilities, and many new advances in lighting technology can help your organization conserve energy and save money.

MACPAC Issues June Report To Congress
The Medicaid and CHIP Payment and Access Commission this week released its June report to Congress, which includes a chapter examining how Medicaid programs are responding to the opioid epidemic. 

Tuesday, June 20
MHA Council on Financial Policy meeting
The Baltimore Sun, By Andrea K. McDaniels, June 9
Baltimore Business Journal, By Morgan Eichensehr, June 9
The Frederick News-Post, By Kate Masters, June 10
The Baltimore Sun, By Andrea K. McDaniels, June 13
CBS Baltimore, By Ava-joye Burnett, June 11
The Baltimore Sun, By Sarah Gantz, June 14
Baltimore Business Journal, By Tina Reed, June 15