October 19, 2018
Health Outcomes Challenges
Entering into the new model contract, Maryland's hospitals and health systems are doubling down on the effort to improve health outcomes. Recent reports show where some of the key opportunities lie: maternal health; health care-associated infections; and opioid mortality.
Maternal Health
Last week, the U.S. House Ways and Means Committee announced it will investigate rising death rates among women during and after childbirth. This follows a July USA Today report critical of U.S. health care providers for subpar performance on maternal mortality and last month's introduction of federal legislation aimed at addressing the problem.
MHA foresees this issue coming up during the 2019 state legislative session. We'll be ready to show that achieving zero harm is a priority for the state's 32 birthing hospitals. Data from the Maryland Department of Health's (MDH) Maternal Mortality Review released in May show that of the 12 pregnancy-related deaths in Maryland in 2015 - out of a total 73,544 live births - 10 were considered preventable or potentially preventable. One of those 10 was caused by hemorrhage, the condition USA Today focused on in its story.
When it comes to protecting Maryland's mothers and babies, even a single bad outcome is too many. Our birthing hospitals have worked hard with the Maryland Patient Safety Center and MDH toward the goal of zero harm.
Health Care-Associated Infections
The Centers for Disease Control and Prevention released Friday the latest state-by-state reports on health care-associated infections. Data show Maryland's hospitals - among the first in the nation to voluntarily share data about quality and patient safety - improved in some areas. Ventilator associated events, for example, were 18 percent lower than national rates.
Still, because our hospitals recognize that there is more work to do, a majority are part of a statewide antibiotic stewardship program, the Campaign for Appropriate Antibiotic Use. Many also are involved in Hospital Improvement Innovation Networks - part of the Centers for Medicare & Medicaid Services' Partnership for Patients initiative.
Both programs are focused solely on providing better quality care for our patients and making their stays with us safer.
Opioid-Related Deaths
There were 1,325 unintentional drug and alcohol-related intoxication deaths in Maryland through the first half of 2018 - a 12 percent rise over the same period in 2017. Of these, 1,185 were opioid related, according to data released last week by MDH.
To help lawmakers find better solutions to this public health emergency during the upcoming session, your MHA is preparing a report that will, among other ideas, recommend increasing access to proven interventions such as Naloxone and peer recovery counselors.
We will continue to keep you apprised on progress toward better health outcomes. As always, we want to hear from you about ways our field can reach peak performance.

Bob Atlas
President and CEO

MHA Comments on MPA Policy for Rate Year 2021
MHA has sent a comment letter to the Health Services Cost Review Commission on its Medicare Performance Adjustment policy for rate year 2021. The letter supports the staff's draft recommendations and states that the modifications proposed align the policy with care management relationships hospitals already have with physicians.
Survey Seeks Feedback on GBR Model
All chief financial officers at Maryland's hospitals will receive a survey in early November asking for feedback on Maryland's All-Payer and global budget revenue model. The voluntary survey is being conducted on behalf of the Centers for Medicare & Medicaid Services (CMS), and responses only will be shared with the research team. Feedback collected in the survey will help CMS understand the types of operational strategies, leadership models, and other factors that hospitals perceive as being important to operations under a fixed revenue environment.
State Issues RFP for $5.9M in Grants
The Maryland Community Health Resources Commission is seeking proposals for $5.9 million in new grant funding this fiscal year. Letters of intent are due November 13, and grant proposals are due December 17. Grant recipients are expected to be announced in mid-February. This year's grants are focused on three categories of programs:
  • Promoting delivery of essential health care services: primary/preventative care, dental services, and women's health care 
  • Addressing the heroin and opioid epidemic through integrated behavioral health service delivery
  • Promoting food security and addressing childhood and family obesity
Health Connection Open Enrollment Starts Nov. 1
Marylanders can start exploring 2019 health plan options now at www.MarylandHealthConnection.gov  with open enrollment beginning November 1 and running through December 15. Maryland Health Connection has created an e-toolkit for hospitals to use in promoting open enrollment to the public and their patients. It includes social media graphics, key messages, sample newsletter text, and more.
Equity Speakers Series Offered
Maryland Nonprofits, in partnership with the Maryland Commission on Civil Rights, is hosting an Equity Speaker Series to share tools, tips, and best practices for creating equitable and inclusive organizations. The series begins October 30 with "Unconscious Bias: How Our Minds Lead Us Astray," and continues with events in 2019 in March, June, September and December. Click here for more information and registration details. The events are designed for nonprofits, businesses, and government.
More Value From MHEI
Are you interested in getting more value from your MHEI membership? If so, consider the following possibilities:

Looking for a Cutting Edge Provider for Blood and Associated Services?
For more than 60 years, Blood Bank of Delmarva (BBD) has provided blood and blood components to hospitals throughout the Delmarva region, helping avoid blood shortages and saving thousands of lives with assistance from more than 150,000 current donors.

AHA, NUL Release Community Health Worker Program Resources
The AHA and National Urban League this week released a compendium of resources to help hospitals and health systems implement successful and sustainable community health worker programs.

The Baltimore Sun , By Luke Broadwater, October 13
The Baltimore Sun , By Andrea K. McDaniels, October 12
The Baltimore Sun , By Pamela Wood, October 12
WBAL-TV , By Kai Reed, October 15
Herald-Mail Media , By Janet Heim, October 16
The Daily Record , By Tim Curtis, October 16
U.S. News & World Report , By Gaby Galvin, October 16
The Daily Record , By Tim Curtis, October 17