October 27, 2017
Empowering Communities
On Wednesday in Baltimore County, MHA joined with many of Maryland's hospital and health care officials, state and federal legislators, and community leaders for a far-reaching conversation on how our nation's and state's health care system is evolving.
The forum, spearheaded by the Maryland Citizens' Health Initiative, covered legislative and political developments around the Affordable Care Act, prescription drug prices, Maryland's opioid crisis, the state's unique hospital payment model, and more.
For the dozens who attended, the forum offered a peek into the complex world of health care during a volatile time, when policymakers are racing to keep pace with changing political winds and public expectations. Forums like these are valuable opportunities for hospital leaders to engage with residents, to let them know about the critical role hospitals play - both in keeping people healthy and supporting the economic vitality of their communities.
As we look forward to the next phase of the All-Payer Model, public forums like these will take on even greater importance, because under the new iteration of the model hospitals will rely even more on patients to act as equal partners in their health care. And the more your communities are engaged and empowered, the more successful you will be in supporting their health care goals.

MHA Holds Clinical Conversation Forum on ED Protocols for SUD and Overdose Patients
At the first MHA Clinical Conversations forum last week, representatives from about 30 of MHA's member hospitals began an insightful and informative discussion of emergency department discharge protocols for patients with a substance use disorder or overdose. Members shared their experiences and challenges with naloxone prescriptions and dispensing, screening, and brief intervention for these patients. The next two forums, to be held November 8 and 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 see where hospitals may develop a consensus on best practices for this patient population. This will 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. 
Fatal Overdose Data Released
Overdose-related deaths in Maryland continue to increase with 1,172 reported between January and June of this year. Of those, 799 were fentanyl-related deaths. The largest increases continue to be fentanyl-related, carfentanil-related, and from cocaine use combined with opioids. Heroin overdose deaths increased by seven when compared to the same time frame last year, and overdose deaths from prescription opioids fell by seven. The 2nd quarter report from the state can be found here.
As the nation's hospitals and health systems continue to address the opioid crisis, the American Hospital Association has developed a new toolkit to provide guidance and information on how to work with patients, clinicians and communities to stem this epidemic. 
Open Enrollment Tool Kits Available
Open enrollment for plans sold on the Maryland Health Benefit Exchange begins November 1. In preparation, the exchange has shared open enrollment tool kits in both English and Spanish, and plans to distribute open enrollment brochures to hospitals next week. Please contact Jenny Mancha if you have any questions. 
Leapfrog Grades Available to Public Next Week
The Leapfrog Hospital Safety Grades fall release will be made available to the public Tuesday, October 31, and for the first time Maryland's hospitals will be included. The report card assigns a single letter grade to each hospital to indicate overall performance in keeping patients safe from harm. In prior years, data reported under Maryland's unique hospital rate setting system was not comparable to the national CMS data used by Leapfrog to develop its scores. This year, the Maryland Health Care Commission provided Leapfrog with quality metrics directly generated from the Health Services Cost Review Commission's claims database, which has made the inclusion of Maryland's hospitals possible. Hospitals can preview their own grades here. Talking points have been provided to your communications leads. For questions about your hospital's scores, contact Leapfrog.
CHRC Issues Call for Proposals 
The Maryland Community Health Resources Commission (CHRC) has issued its Fiscal Year 2018 Call for Proposals to support programs that preserve or enhance the state's ability to serve vulnerable populations regardless of insurance status; promote health equity by reducing health disparities and addressing the social determinants of health; and support community-based projects that are innovative, sustainable, and replicable. CHRC anticipates awarding approximately $2.2 million in new grant funding this fiscal year. Letters of Intent are due by noon November 14, and full grant proposals are due by noon December 18. Grants are expected to be made in mid-February. A public information call will be held for potential applicants Monday, November 6 at 10 a.m (Dial in number: 1.866.247.6034, Access code: 4102607046). Click here to download a copy of the request.
Shortages of IV Fluids Reported Nationwide
The American Hospital Association has sent a notice to hospitals about a nationwide shortage of intravenous (IV) fluids, shortages that have worsened as a result of Hurricane Maria's impact on manufacturing plants in Puerto Rico. The most significant and severe shortage is for small-volume parenteral solutions, such as the 50 and 100 milliliter "minibags" of sodium chloride 0.9%, dextrose 5% and IV nutritional products made by Baxter. The American Society of Health-System Pharmacists  in collaboration with the University of Utah Drug Information Service, has compiled a document, " Small-Volume Parenteral Solutions Shortages, Suggestions for Management and Conservation," to assist hospitals and health systems seeking ways to manage these shortages by conserving existing supplies of these IV fluids. AHA encourages hospitals to share the document with your pharmacy, medical and nursing leaders, materials managers and others involved in addressing the current shortages.
New Ransomware Outbreak Reported
A new ransomware campaign, dubbed Bad Rabbit, hit several targets in Russia and Eastern Europe this week and hospitals in the U.S. were alerted by the Florida Hospital Association to be aware of how they could be impacted. Computers can be infected when users download Adobe Flash from an infected site. It is recommended that if a site asks you to download Flash, go directly to the Adobe website to download it instead of using the link that site asks you to use. More from the Wall Street Journal.
Patients Want "Peace of Mind"
At the MHEI annual leadership conference last week Dr. Thomas Lee, chief medical officer for Press-Ganey, indicated that the number one thing patients were interested in receiving from their health care providers (practitioners as well as organizations) was "peace of mind."

Prime's Value to Member Hospitals
Prime is the shared service/group purchasing subsidiary of the Maryland Hospital Association. Its goal is to help our member hospitals reduce the cost of care.

AHA Shares Regulatory Relief Priorities With CMS
AHA participated yesterday in a stakeholder listening session hosted by Centers for Medicare & Medicaid Services Administrator Seema Verma to formally launch the agency's regulatory relief effort. Katie Boston-Leary, Senior Vice President, Patient Care Services at Union Hospital of Cecil County and a member of MHA's Council on Clinical and Quality Issues, also participated.

The Baltimore Sun, By Jacques Kelly, October 22
Baltimore Business Journal, By Morgan Eichensehr, October 24
The Baltimore Sun, By Meredith Cohn, October 24
The Baltimore Sun, By Andrea K. McDaniels, October 25
The Baltimore Sun, By Andrew Michaels, October 24
The Baltimore Sun, Andrea K. McDaniels, October 25
The Washington Post, By Sudhin Thanawala, October 25
The Washington Post, By Georgia Slater, October 25