October 12, 2018
Progress on Two Fronts
This week I have two very different good news items: one related to improving the support for survivors of sexual assault and the other on the Health Services Cost Review Commission's (HSCRC) Medicare Performance Adjustment (MPA) policy.
Last week, the State of Maryland was awarded a $2.6 million Sexual Assault Kit Initiative grant from the Department of Justice. Your MHA advocated for state legislation to allow Maryland to apply for the grant. The funds will be used to test untested and unsubmitted sexual assault evidence kits, develop a kit tracking system, and hire specialized victim advocates.
Last month MHA hosted a statewide forum for forensic nurse examiners, who collect evidence and assist victims of violence seen in your emergency departments. They discussed ideas to improve the way Maryland cares for survivors and how the state can improve reimbursement for these caregivers.
You, as leaders of Maryland's health care community, have dedicated countless resources to care for these individuals during the most traumatic moments of their lives. Now the issue has garnered statewide and national attention. We'll help shape the path forward via MHA's seat on the state's Sexual Assault Evidence Kit Policy & Funding Committee.
I'm also pleased to report that HSCRC staff included all of MHA's recommendations in their draft MPA policy for fiscal 2021 (the performance period is calendar 2019).
MHA submitted two main recommendations to make the policy fairer and give hospitals a better shot at succeeding. The first is to use care management relationships hospitals already have with physicians when attributing beneficiaries to hospitals. Hospitals have invested in ACOs, employment models, and Care Transformation Organizations. Partnering with physicians in these vehicles is key to moving the needle on total cost of care (TCOC). HSCRC staff agreed with our recommendation to expand the types of physician-hospital relationships used in the beneficiary attribution algorithm.
The second is to adjust TCOC targets to reflect the risk profiles of attributed populations. HSCRC staff have agreed that, in 2019, the formula used to set the targets ought to adjust for a person's age, sex, disability status, and living situation (home or long-term care facility). HSCRC staff also acknowledge that, in future, beneficiaries' health status must be factored in as well. Downstream, we intend to advocate further for recognition of differences in socioeconomic factors that affect health status and health care usage.
MHA is here to support you on these and other measures aimed at advancing health care and the health of all Marylanders. As always, we welcome your feedback on the work we do on your behalf. 

Bob Atlas
President and CEO

HSCRC Discusses Potential Changes to Its Volume Policies
This week at the monthly Health Services Cost Review Commission meeting, commissioners discussed work to be undertaken to consider changes to its policies on hospital volume changes, including its market shift and demographic adjustment policies. The commission also addressed a draft update to its MPA policy, and took final action on its policy on the maximum penalty revenue at risk for its quality-based policies. Read about these issues and more in this month's Newsbreak .
Atlas: Transforming Health Care to Meet Tomorrow's Needs
Bob Atlas, President & CEO of the Maryland Hospital Association, offered commentary on WYPR Tuesday. In his remarks, he gave insight on Maryland's new arrangement with the federal government that gives the state more freedom to control how it transforms health care. To listen to the full segment, click here . This is the first in what will be a monthly commentary on WYPR from Atlas on various health care topics.
AHA, Hospital Leaders Announce 340B Good Stewardship Principles
The American Hospital Association (AHA) and individual 340B hospitals announced new principles September 18 for ensuring good stewardship of the 340B program. This new AHA-led initiative will strengthen the 340B program by increasing transparency while helping 340B hospitals better communicate the value of the program for vulnerable patients and communities. Good stewards of the program commit to communicate the value of the 340B program, share estimated savings from the program, and perform rigorous internal oversight. To sign up and commit to the good stewardship principles, click here .
CTOs, Practices Notified About MDPCP Acceptance
The Maryland Primary Care Program (MDPCP) takes effect January 1, and Care Transformation Organizations (CTOs) and practices have been notified of their provisional acceptance into the program. Over the next three months, additional documents related to the program will be provided for review and execution. All of these will require a tight turnaround.

The Program Management Office also is offering a number of educational events related to MDPCP:
Applications Due October 26 for Pharmacy, Therapeutics Committee
The Maryland Department of Health (MDH) is accepting applications and nominations for physicians and pharmacists to serve on the Maryland Medicaid Pharmacy and Therapeutics (P&T) Committee. The 12-member P&T Committee includes five physicians, one psychiatrist, five pharmacists, one member with expertise with mental health drugs, and two consumer representatives. Members serve three-year terms. Additional details on the duties and scope of the board can be found here . Click here to apply by October 26.
AHA to Launch 5th Annual United Against the Flu Campaign
This year's American Hospital Association (AHA) campaign, United Against the Flu, will span four months and peak during the Centers for Disease Control and Prevention's National Influenza Vaccination Week, December 2-8. For the past four years the United Against the Flu campaign has delivered messages on the importance of flu vaccination to millions of Americans through social media and digital outreach. This year's campaign will be aimed at the general public (concentrating on the elderly, young children, pregnant women and caregivers), and hospitals and health systems.
MHEI Connect Offers Programming on Your Campus
For those who know MHEI only by the programs we provide at our offices in Elkridge, you may be interested in knowing that almost anything we produce here can also be brought to your organization, on your campus, at a time that is convenient to you.

Prime Offers Solutions for Market Analyses, Intelligence and Forecasting
Prime, through its affiliation with Vizient, offers solutions through Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services.

CDC Reports Continued Decline in Hospital Infections
Hospitals reduced abdominal hysterectomy surgical site infections by 13 percent and central line-associated bloodstream infections by 11 percent in 2016, according to a report released Thursday by the Centers for Disease Control and Prevention.

Tuesday, October 16
MHA Medicare Performance Adjustment Work Group meeting
Fierce Healthcare , By Paige Minemyer, October 5
Fox Baltimore , By Danielle Jackson, October 7
The Baltimore Sun , By Jon Kelvey, October 9
The Daily Record , By Tim Curtis, October 9
Columbia Patch , October 9
The Baltimore Sun , By Catalina Righter, October 9