November 4, 2016
Hospital Care Is Never Partisan
In four days, millions of Americans will head to schools, libraries, churches and other sites to cast a ballot for our country's next president. You don't have to be an expert in national political history to know that this election season has been one for the books.
Amid the mudslinging, attack ads, personal attacks and partisanship, a few kernels of serious health policy discussion have emerged. One has been a discussion of how each candidate would approach the future of the Affordable Care Act, the most sweeping and historic health care legislation in generations.
The Clinton camp says it would build on and improve Obamacare by requiring enrollees to pay no more than 8.5 percent of their income in premiums, compared with the current 9.66 percent. They also support a public option (either a government-run plan as an alternative to private plans offered under the ACA, or a backup option in markets where insurers have pulled out), and a broader push to enroll healthier individuals.
The Trump camp would repeal Obamacare altogether, allow insurers to sell policies across state lines, and convert Medicaid into a state-run block grant. They say they would retain some of the ACA's provisions, such as requiring insurers to cover people with pre-existing conditions.
Health care policymakers and analysts are watching closely, because the outcome of the election, including which party controls the Senate, will have a direct impact on payers, providers and patients.
Even so, with the race so tight and with emotions running high on both sides, it's important to remember that at its core, the delivery of health care is truly a nonpartisan endeavor. The goal of providing high-quality, efficient care for all those in need is the mission of every hospital, and that doesn't change when a new president takes up residence in the Oval Office, nor when the Senate or House change hands. That's one reason why the Maryland Hospital Association, as well as the American Hospital Association, do not endorse presidential candidates.
With everyone's eyes on the polls Tuesday, we already know it will be an historic outcome. But it's in the aftermath that we will continue to serve, never losing sight of what's most important: the patients and communities who come to our hospitals seeking top-notch care from compassionate professionals, with no thought about how we voted as individuals.

Hospitals Contribute to MHCC Cybersecurity Report 
The Maryland Health Care Commission (MHCC) has released an information brief, Hospital Cybersecurity:  Evolving Threats Require New Approaches, using information submitted by all acute care hospitals in the state. MHCC's assessment asked how hospitals are preparing for and managing cyber risks.  A copy of the brief is available here
Networks Offer Support to Reduce Infections, Readmissions
Health Quality Innovators (HQI) - formerly VHQC - invites hospitals to continue their quality improvement work by joining a Hospital Improvement Innovation Network. These networks will build on the good work started by the Hospital Engagement Networks (HENs) under the Partnership for Patients initiative. Over the last four years, hospitals that participated in HENs have contributed to an unprecedented decline in preventable patient harm, saving 87,000 lives and nearly $20 billion in health care costs. As a partner to both the Health Research & Educational Trust and Premier, HQI will offer participating hospitals support and assistance as they implement infection prevention and quality improvement processes. Participants will pursue ambitious new goals of reducing all-cause inpatient harm by 20 percent and readmissions by 12 percent by 2019. By committing to this initiative, hospitals will benefit from on-site and virtual technical assistance and coaching, best practices from high-performing hospitals, peer-to-peer networking opportunities and clinical, topic-specific resources. All hospitals are eligible to join. Please contact Sheila McLean with any questions or call 301-744-8472.
MHA, CRISP Host Webinar on Care Alerts, Care Plans
The HSCRC's recommendations for achieving a full rate year 2017 global budget update include a suggestion that hospitals work with the Chesapeake Regional Information System for our Patients (CRISP) to "... exchange information regarding care coordination resources aimed at reducing duplication of resources, ensuring more person-centered approaches, and bringing additional information to bear at the point of care for the benefit of patients." One way to do that is to upload and share Care Alerts and Care Plans for high-risk Medicare patients. Care alerts are targeted, direct messages intended to assist clinicians in acute-care settings like emergency departments. Several hospitals already create and share such alerts internally, and others have begun to share them more broadly. On November 1, MHA and CRISP hosted a webinar on care alerts and care plans, highlighting three hospital pilots' experience with these tools to reduce potentially avoidable utilization. The webinar kicked off the first of a series of steps hospitals can undertake to fulfill the HSCRC's recommendation. Click here for a recording of the webinar and additional information.
Next steps:
  1. Meet with CRISP to determine how your hospital's information system can interface with CRISP's. Chief information officers, chief medical officers and/or population health leads should meet with CRISP to identify the members of a patient's care team, including the primary care provider and care manager, and how existing IT systems can be used to populate care alerts. To schedule a meeting, contact Craig Behm at CRISP.
  2. Participate in a dedicated Care Alert and Care Planning Learning Network. The network, for chief medical information officers, clinical integration leads, and emergency department leads, will be convened by MHA and CRISP to will share content, benefits, and resources for hospitals that are ready to develop and share care management data to reduce potentially avoidable utilization and improve care coordination. Click here for details.
If you have questions, email Nicole Stallings or call her at 410-379-6200
Sample Letter of Intent Available for Care Redesign Programs
Hospital participation in the HSCRC's Care Redesign Amendment webinars is instrumental to advance the goals of the All-Payer Model and help demonstrate to the HSCRC the hospital field's commitment to care redesign efforts. For many hospitals, attending these webinars will culminate with the signing of a letter of intent - a nonbinding agreement submitted to the HSCRC that indicates interest in participating in one or both of the care redesign programs (Hospital Care Improvement Program and Complex and Chronic Care Improvement Program; details at the top of this page). Please note that the deadline to submit the letter of intent is November 18. Click here for the letter of intent template. In addition, should you submit a letter of intent to the HSCRC, please copy Pat Ross at so we can tabulate the field's participation in the care redesign programs. If you have any questions, contact Nicole Stallings.
HSCRC Webinars Continue
The third of seven webinars with HSCRC staff to provide hospitals with detailed information on the amendment to the All-Payer Model and on care redesign programs was this week; the schedule for the remain webinars is below. The amendment, approved earlier this month:
  • Gives hospitals and their care partners access to comprehensive Medicare data across the care continuum that supports care coordination and a focus on controlling total cost of care
  • Creates the next steps toward total cost of care and delivery system transformation
Under the amendment, the first two care redesign programs are:
  • the Complex and Chronic Care Improvement Program (CCIP)
  • the Hospital Care Improvement Program (HCIP)
The remaining webinars are:
  • Webinar 4: (9 a.m. Friday, November 18) - HCIP Program Template and Implementation Protocol
  • Webinar 5: (9 a.m. Wednesday, November 30) - Comprehensive Medicare Data Process and Use
  • Webinar 6: (9 a.m. Wednesday, December 7) - Care Redesign Program Monitoring
  • Webinar 7: (9 a.m. Friday, January 13) - Care Partner Agreements
During each webinar, participants can ask questions of HSCRC, the Center for Medicare & Medicaid Innovation, MHA, and CRISP. Click here to find the registration links for each webinar and the recordings of previous webinars.
CRISP Reports Help Meet HSCRC Update Recommendations
MHA, HSCRC, and CRISP are working together to provide Medicare data that will help hospitals and partner organizations meet two of the HSCRC's global budget update recommendations:
  1. Monitor the growth in Medicare's total cost of care and total hospital cost of care for its service area
  2. Work with CRISP, HSCRC, and MHA to obtain available information to support monitoring and implementation efforts
The two types of reports available are: total cost of care by geography and a limited data set with non-identifiable patient-level analytics. There will be a webinar on Thursday, November 10 from noon-1 demonstrate the data set reports, show the information available through these data, describe the differences between these and other CRISP reports, and discuss the key definitions and calculations used in the associated analytics. The reports also will be released on the CRISP site on November 10. Click here for more information from CRISP. Any questions about these reports and the webinar should be directed to Craig Behm at CRISP or Nora Hoban at MHA.
Hospital-based Peer Recovery Specialists Invited to Forum
The Maryland Behavioral Health Administration's Office of Overdose Prevention is holding a Peer Recovery Specialists in Hospitals Forum on November 30 from 8:30 a.m. to 4 p.m. at the Vocational Rehab Building at Spring Grove Hospital Center in Catonsville. The goals of the forum include identifying successes, barriers, and resources that could assist peers in hospitals and similar clinical settings, as well as providing a way for peer recovery specialists to develop a network of colleagues for professional and personal support. Those interested in attending should register by emailing Brian Holler
AHA Hosting Hospitals Against Violence Webinar
The American Hospital Association's Hospitals Against Violence initiative is a web-based resource to help hospitals and health systems address violence and the toll it takes on their communities and colleagues. The web page provides information on national, state and local efforts to help end violence in communities, and to help hospital employees cope with the impact of violence, whether at home, on the job or in their neighborhoods. On November 15 at 4 p.m., the Hospitals Against Violence initiative will host its first monthly members-only webinar, which will focus on a Kansas City partnership to prevent the long-term health impacts of childhood trauma. Click here to register for the webinar, which will include opportunities for Q&A and to share experiences from similar projects.
Helping Physicians Solve Leadership and Management Problems
MHEI is launching four new programs beginning in January to help physicians with their leadership responsibilities.

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.

CMS: More Than 15.7 Million Enroll in Medicaid/CHIP Since October 2013
More than 15.7 million people enrolled in Medicaid or the Children's Health Insurance Program between Oct. 1, 2013 and Aug. 31, 2016, increasing total enrollment in the programs by 28 percent since the start of the first open enrollment period for the Health Insurance Marketplace, according to a report released this week by the Centers for Medicare & Medicaid Services.

Monday, November 7
Carmela Coyle presents to Trivergent senior leadership teams in Hagerstown

Tuesday, November 8
MHA Executive Committee meeting

Wednesday, November 9
MHA Joint Quality-Finance Work Group
Health Services Cost Review Commission meeting

Thursday, November 10
MHA Financial Technical Work Group meeting
The Washington Post, By Sarah Vander Schaaff, October 30
The Baltimore Sun, By Meredith Cohn, November 1
The Baltimore Sun, By Andrea K. McDaniels, October 31
Baltimore Business Journal, By Morgan Eichensehr, November 2
Washington Business Journal, By Tina Reed, November 2
The Baltimore Sun, By Andrea K. McDaniels, November 2
Baltimore Business Journal, By Morgan Eichensehr, November 2
The Daily Record, By Staff, November 2