June 30, 2017
Senate Bill Would Hurt Maryland
While a vote on the Senate's health care bill - the Better Care Reconciliation Act - has been delayed, the fight to protect patients and communities is far from over. Analyses this week from the nonpartisan Congressional Budget Office and the American Hospital Association show that the bill would significantly impair the way Maryland's hospitals care for their patients and communities, jeopardizing the All-Payer Model and the seismic care delivery transformation it has cultivated.
According to AHA's state-by-state analysis, an estimated 215,000 Marylanders would lose coverage in 2018, increasing to more than 256,000 by 2026. The coverage losses alone are deeply concerning, but they also represent a very real threat to the viability of the All-Payer Model.
The All-Payer Model encourages hospitals to direct patients to the right care, at the right time, in the right setting: doctor's offices, pharmacies, home health, nursing homes and more. But without coverage to access these services, more Marylanders will turn to hospital emergency departments - health care's highest-cost setting - for care. The increased costs and increased hospital utilization would make it difficult if not impossible to meet the stringent metrics of the All-Payer Model.
This week, The Baltimore Sun published a joint op-ed from MHA and AARP that details our concerns with the Senate bill. At its core, the bill would make Maryland's health care system less secure and less affordable, and it would foist a financial burden on every Marylander as the state struggles with reduced Medicaid funding and the costs of caring for hundreds of thousands more uninsured. The good news is that because Senate leaders don't have the votes to pass it, a vote on that bill has been delayed until after the July 4 recess. Meanwhile, hospitals and others across the country are gearing up to ensure that the vote tallies don't add up for a bill that would hurt so many people.
There are many complex politics at play as Senate Majority Leader Mitch McConnell tries to thread the needle to gain support among the conservative and moderate wings of his party. For our part, MHA is supporting AHA's strategy to advocate with a select group of U.S. senators to fend off this bill - so that the tremendous potential to improve quality, control costs, and make people's lives better that you have demonstrated over the past four years will not be struck by a bad bill whose purpose seems to be achieving a victory rather than actually doing good. 

Media Resources Available on Senate Better Care Reconciliation Act
Following the release of the Congressional Budget Office analysis of the Senate Better Care Reconciliation Act, MHA and the American Hospital Association have compiled several resources for your organizations to draw from should you need to respond to media inquiries. They are:  

AHA is encouraging the hospital community to urge senators to oppose the BCRA and a special web page has been created by AHA to make it easier for you to contact your senators. Additional resources are available on the Coalition to Protect America's Health Care website. Please take a moment to send a message, and please share these links with your employees, trustees and other members of your hospital community.
Contact: Jim Reiter
Dozens Gather for ED Diversion Discussion
Dozens of hospital emergency department clinicians, along with state regulators and EMS specialists, convened at MHA's Elkridge offices on Thursday to discuss concerns about recent upward trends through 2016 in the number of ED diversions and ED wait times. Maryland Institute for Emergency Medical Services Systems (MIEMSS) Acting Co-Executive Director Patricia Gainer provided an overview of the problem: Maryland has seen a steady increase in the number of diversions since 2013, and the state's ranking for ED wait times is among the worst in the nation. Nora Hoban, Senior Vice President, Policy & Data Analytics for MHA, provided a root cause analysis for the problem, and several ED clinicians presented methods their hospitals are using to improve ED throughput and avoid diversions. MHA will continue to work with MIEMSS and other stakeholders on this issue.
Contact: Nora Hoban
New HHS Resources on Ongoing Ransomware Attack
An evolving cyberattack using a variant of Ransomware this week hit businesses worldwide, with particular impacts in transportation and health care. According to press reports, Nuance Communications, a provider of voice and language solutions including transcription services, was among those impacted in the health care sector.
The Department of Health and Human Services (HHS) is advising vigilance and following general cyber hygiene practices, such as ensuring that all your systems' patches and anti-virus definitions are up to date and educating users on common Phishing tactics. Please click here to see the latest guidance from HHS, including information on a "vaccine" to help protect uncompromised systems. Making sure your systems are patched remains your best defense.
The American Hospital Association will be updating members as more information becomes available. For additional AHA resources, visit www.aha.org/cybersecurity.
PDMP Registration Mandate Deadline is Tomorrow
A new law requires that all controlled dangerous substance prescribers and pharmacists be registered with the Maryland Prescription Drug Monitoring Program (PDMP) by tomorrow, July 1. The PDMP is administered by the Maryland Department of Health and Mental Hygiene's Behavioral Health Administration to support health care providers and their patients in the safe and effective use of prescription drugs. The PDMP is a core component of the state's and many local jurisdictions' strategies for reducing drug-related overdoses. It collects and securely stores information on drugs that contain controlled substances and are dispensed to patients in Maryland; these data are made available to health care practitioners exclusively through the state-designated health information exchange, Chesapeake Regional Information System for our Patients. PDMP registration must be completed through CRISP's website
DHMH Name Change
Effective tomorrow July 1, the state health department is changing its name from the Maryland Department of Health and Mental Hygiene to the Maryland Health Department.
Why Change Efforts Fail
If you've been in a leadership position, you have undoubtedly experienced organizational change efforts meant to alter the culture of your organization, with the goal of improving everything from customer service to quality results to the organization's business model itself.

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.

CBO: Senate Health Bill Would Reduce Medicaid Spending 35% in 2036
Federal Medicaid spending under the Better Care Reconciliation Act would be 35% lower in 2036, according to a new analysis released this week by the Congressional Budget Office. 

MHA's offices will be closed Tuesday, July 4 for Independence Day.

Baltimore Business Journal, By Morgan Eichensehr, June 23
The Daily Record, By Tim Curtis, June 25
WTOP, By Jack Moore, June 27
Baltimore Business Journal, By Morgan Eichensehr, June 26
The Baltimore Sun, By Ian Duncan, June 27
WBAL-TV, By Kim Dacey, June 27
The Daily Record, By Bryan P. Sears, June 28