December 9, 2016
Safe Places to Heal, and to Work
Hospitals - the very special places to which people turn in their times of need - are supposed to be places of refuge, but frequently that isn't the case.
Far too many of America's nurses, doctors, and other hospital staff end up as patients rather than providers due to a national wave of abuse toward health care workers. In 2014, 75 percent of hospital nurses experienced verbal or physical abuse from patients and visitors, and three in 10 reported physical abuse, according to a study in the Journal of Emergency Nursing.
These numbers are cause for alarm - and for action.
That's why MHA is partnering with the Maryland Nurses Association on several efforts to address this issue, including a statewide forum early next year that will bring together those on the front lines of care to share best practices for keeping hospital workers safe from violence. Many Maryland hospitals are tackling this issue with systematic efforts, and several of them will be highlighted at this forum. We're gathering information on those efforts and will be sharing them with you via our website. (If you have best practices you'd like to share, please email Brian Frazee at
Nationally, the American Hospital Association has begun work to address not only hospital-based violence, but also how violence that occurs in communities affects hospital workers who treat its victims. Because it's not just the physical effects, but also the psychological strain of caring for victims of violence and trying to shield one another from becoming victims themselves that are taking a toll.
On December 15, AHA will host the next webinar in its "Hospitals Against Violence" educational series. The hour-long webinar features leaders from Ashville, N.C.-based Mission Health, who will discuss their efforts to decrease and prevent workplace injuries and review steps hospitals and health systems can take to mitigate violence within their organizations. (It begins at 2 p.m.; you can register by clicking here.)
The AHA webinar series and January's forum represent the seeds of what will become a long-term fight to stem the wave of violence in our communities and in our hospitals. And it will take the collective strength of hospital leaders throughout America to turn the tide, so that hospital caregivers can do what they do best without fearing for their own safety.

MHA, CRISP Launch "Sprint" on Key HSCRC Recommendation
A critical step to secure a full fiscal year update in January is to demonstrate to the Health Services Cost Review Commission that hospitals are making use of "care alerts." This can be done by uploading them to the Chesapeake Regional Information System for our Patients (CRISP). To help with this effort, CRISP and MHA have introduced a "Care Alert Sprint," a six-month initiative to help meet this recommendation using existing hospital personnel and resources. The first in a series of webinars and meetings will be December 14 from 9 a.m. - 10 a.m. The Care Alert Sprint is aimed at population health, readmissions reduction, and emergency department leads. Dr. Amy Boutwell, a national expert on readmissions reduction who has worked with hospitals across the country, including those in Maryland, will support this work. Hospital teams should register here for the December 14 kickoff webinar. Additional information is available here or by contacting Nicole Stallings at 410-540-5069 or
AHA Launches Federal Transition Site
As the Trump Administration begins to take shape, the American Hospital Association has launched a website (you must be a member to log in) with resources that provide guidance on many questions that hospital executives may have. Transition 2017 provides information on what the changes will mean for hospitals' mission, outlines the key players, and shares AHA's advocacy agenda and messages moving forward. In addition, the site links to proposals for the future of health care. Resources will be updated regularly as new information is available.
AHA Releases Report on Impact of ACA Repeal
The America Hospital Association and the Federation of American Hospitals this week released a new report, commissioned from a health care economics consulting firm, detailing how hospitals could be financially impacted by a repeal of the Affordable Care Act. The report finds that under the most recent repeal-without-replacement bill, H.R. 3762, hospitals would face a net negative impact of $165.8 billion from 2018-2026 from the loss of health care coverage. The report also found that hospitals would suffer a loss of $289.5 billion in Medicare inflation updates if the payment reductions in the ACA are not restored. Finally, the study states that the impact of retaining the Medicare and Medicaid Disproportionate Share Hospital reductions would amount to an additional $102.9 billion. Click here for several documents from AHA, including a press release, an executive summary of the report, a letter to President-elect Trump and congressional leaders, an infographic and a fact sheet.
Submit Your Successes for MHA's "Quality Matters" Website
Earlier this year, MHA launched a public-facing website dedicate to shining a spotlight on the great work Maryland's hospitals are dong to improve quality. Quality Matters is updated once a month with stories MHA receives from our member hospitals - brief examples on everything from improved data analytics to refined patient interaction protocols to innovative care coordination, and more. We would like to continue to share your stories as you continue to improve the delivery of care. If your hospital would to share a quality improvement story, please email Justin Ziombra.
MHA Executive Committee Minutes Available
The minutes from the November MHA Executive Committee meeting are available on the Governance page on our website. Members must be logged in to download the minutes.
HSCRC Webinars on All-Payer Model Continue
The final in a series of seven webinars with HSCRC staff on the amendment to the All-Payer Model and on care redesign programs is Friday, January 13. 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)
Again, the final webinar is:
  • Webinar 7: (9 a.m. Friday, January 13) - Care Partner Agreements
During the webinar, participants can ask questions of HSCRC, the Center for Medicare & Medicaid Innovation, MHA, and CRISP. Click here to find the registration link for the final webinar and the recordings of previous webinars.
Diversity & Disparities: Where to Begin?
There are certain subjects that appear so overwhelming, difficult, and sensitive that our tendency is to tip-toe around them. While we are prepared to acknowledge that this topic, Diversity & Disparities, fits all of those categories, we are not willing to simply recognize the difficulty and then quietly ignore such an important conversation. 

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CMS Posts Final Hospital MOON for Implementation by March 8
The Centers for Medicare & Medicaid Services this week posted its updated version of the Medicare Outpatient Observation Notice, a standard notice that all hospitals and critical access hospitals must provide effective March 8, 2017, to all Medicare beneficiaries who receive outpatient observation services for more than 24 hours.

Tuesday, December 13
MHA Council on Clinical & Quality Issues meeting
Maryland Healthcare Education Institute Board meeting

Wednesday, December 14
Health Services Cost Review Commission meeting

Thursday, December 15
MHA Financial Technical Work Group meeting
Capital Gazette, By Ben Weathers, December 3
The Washington Post, By Christine Vestal, December 3
Baltimore Patch, By Isatou Simaga, December 5
The Daily Record, By Staff, December 5
Baltimore Business Journal, By Morgan Eichensehr, December 7
The Baltimore Sun, By Erika Butler and David Anderson, December 6
The Baltimore Sun, By Andrea K. McDaniels, December 7
WBAL-TV, By Omar Jimenez, December 7