November 3, 2017
Coverage Remains Key
For the millions of Americans who have health coverage through the Affordable Care Act, and the millions more who still need coverage, the past six months have felt a bit like a yo-yo. First, Congress was going to repeal Obamacare, then it was going to replace it, then it was going to fix it.
In the end, it did nothing at all - for now.
Still, as the debate in Congress has shifted to tax cuts, the uncertainty over health care policy remains. The federal budget could cut billions of dollars from Medicare and Medicaid, posing a significant risk to hospitals and other providers and, more importantly, the lives of the patients you serve. And some lawmakers are promising to revisit ACA repeal in the future.
Amid this turmoil, on Wednesday, the annual open enrollment period for 2018 for health plans sold via ACA exchanges opened. And although this period is truncated - just six weeks compared to 12 weeks in previous years - its opening signifies something important: that the coverage so critical to hospitals and their patients is still here.
That's no small feat, and ensuring broad-based coverage has been a focus of the hospital field nationally and here in Maryland since repeal efforts began. Without broad-based coverage, we simply cannot do what is needed to take care of communities and meet the requirements of a new all payer model. This week's start of open enrollment offers a clear message: the exchange is still here, and it is still a necessity for those who would find themselves either uncovered or under-covered without it.

We know the fight to protect coverage isn't over. And as the national conversation about health care continues, for hospitals, politics will always take a back seat to patients.

AHA Global Budget Webinar Available
MHA's Mike Robbins, Senior Vice President, Rate Setting, was a featured presenter during this week's American Hospital Association webinar "Global Budgets as a Pathway to Ensuring Access," viewed by more than 150. Global budgets are one of nine strategies recommended by AHA's Task Force on Ensuring Access in Vulnerable Communities. Dr. Joshua Sharfstein, Associate Dean for Public Health Practice and Training and Professor of the Practice in Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, also presented, along with GBMC President & CEO John Chessare. Slides from the webinar are available here. More information on the task force's work is available on AHA's Ensuring Access web page.
Forum to Address ED Protocols for Substance Abuse, Overdose Patients
The second of three Clinical Conversations forums will be held Wednesday, November 8, at MHA. At the first forum last month, representatives from about 30 hospitals began an insightful discussion about emergency department discharge protocols for patients with substance use disorders and those experiencing an overdose. Attendees shared their experiences and challenges with naloxone prescriptions and dispensing, screening, and brief interventions for these patients. The forum next week and the final forum on November 29 will focus on referrals to treatment, the role of non-clinical personnel, and medication assisted treatment, among other topics. MHA's goal is to help identify a consensus on best practices for this patient population and help those that are developing their emergency department discharge protocols in order to comply with the state's HOPE (Heroin and Opioid Prevention Effort) Act of 2017.

State to Hold Regional Meetings on Primary Care Program
The Maryland Department of Health anticipates that the Maryland Primary Care Program will begin next summer, pending federal approval. Meanwhile, the state is holding four regional meetings to enhance understanding of the program. The meetings will provide in-depth discussion and address questions specific to each area of the state.  
Please contact with questions.
CMS Issues Final Rule on CY2018 MACRA
The Centers for Medicare & Medicaid Services this week issued a final rule updating the requirements of the quality payment program for physicians and eligible clinicians mandated by the Medicare Access and CHIP Reauthorization Act of 2015. Two tracks are included: the default Merit-based Incentive Payment System, and the advanced alternative payment models. The rule adopts key policies for the program's 2018 performance period, which will affect clinician payment in 2020. Among other policies, CMS will increase the low-volume threshold in MIPS, thereby excluding more than 540,000 eligible clinicians from the program. CMS also will implement an incentive payment measurement option that allows hospital-based clinicians to use their hospital's value-based purchasing results for the cost and quality categories. However, the agency will delay the availability of the option until the calendar year 2019 reporting period. Read more at AHA News.
"Mindfulness" Can Be Strategic
The topic of "mindfulness" has emerged front-and-center this year as a strategy to attain one's personal and leadership goals.

Prime Offers Guaranteed Savings on Biomedical and Diagnostic Imaging Service Costs
Are you looking for an approach to technology that fixes not just medical equipment, but the workflow and inventory management challenges health care organizations face?

CMS Releases Final 2018 Physician Payment Rule
The Centers for Medicare & Medicaid Services late Thursday issued its final rule for the physician fee schedule for calendar year 2018. 

Wednesday, November 8
MHA Clinical Conversation Series (second of three): Hospital Emergency Department
  Discharge Protocols for Drug Overdose and Substance Use Disorder Patients
MHA Certificate of Need/State Health Plan Work Group meeting

Thursday, November 9
MHA Technical Work Group conference call

Friday, November 10
MHA Hospital Care Improvement Program Technical Work Group meeting
The Baltimore Sun, By Pamela Wood, October 27
NPR, By Allison Aubrey, October 27
Maryland Independent, By Paul Lagasse, November 1
The Washington Post, By Ovetta Wiggins, October 31
The Washington Post, By Ovetta Wiggins, October 31
Baltimore Business Journal, By Jonathan Munshaw, November 1
The Daily Record, By Adam Bednar, November 1
Washington Business Journal, By Carolyn M. Proctor, November 3