July 7, 2017
The Dog Days ...
With the July 4 holiday just past and the dog days of summer approaching, the temperature may be heating up but nothing slows down in the world of health care. Here is a midsummer list of the important activities MHA is undertaking on your behalf that the heat cannot wilt:  
  • In Washington DC, we are working with our congressional delegation and the American Hospital Association to make sure our senators have everything they need to fight the bad health care bill that is working its way through the process - if process is still the correct word for what is going on. We're working to send senators the latest information on the bill's impact on Marylanders and Maryland's hospitals, and bolster their case for "no." 
  • We continue to work with state negotiators to improve the specifications of an enhanced All-Payer Model for Maryland. We shared with Health Secretary Schrader the letter that MHA crafted with your help, listing our serious concerns with the current term sheet. We expect a written response soon. The work to get to a feasible, achievable set of goals for Maryland's hospitals continues, and my thanks go to the hard-working and committed team of hospital negotiators representing you in this historic effort: Bob Chrencik, Peggy Naleppa, Ron Peterson, Joe Ross, Kevin Sexton, and Eric Wagner.   
  • While the legislature does not re-convene until January 10, we continue to work with legislators during the interim to set the stage for a reduction in the Medicaid hospital "sick" tax, including reminding them of the agreement last year to chip away at the tax by $25 million a year, and that the tax artificially erodes the state's ability to meet the requirements of the All-Payer Model. 
  • MHA's Behavioral Health Task Force is continuing its important work, including a report that will lay out specific recommendations for the state to consider to address the substance abuse and mental health crisis that is affecting so many lives. That report is expected to be ready in August or September. 
  • We are working with the state Forensic Work Group to improve the availability of behavioral health services especially for forensic (criminal) patients. We are convening a discussion to check interest among our community hospitals in providing beds for certain of these patients in a public-private partnership; watch for more on this interesting work. 
  • The issue of patients' rights in Maryland's hospitals is ongoing, but must be addressed in a manner that actually helps patients rather than adds red tape for both them and their hospitals. Our success in the last legislative session to fend off bad and prescriptive legislation cannot be celebrated; such legislation will arise again in the next session, and hospitals need to work on our collective consistency in providing information on patients' rights and the content of our patients' rights statements in hospitals across the state. 
  • Last week we convened dozens of hospital emergency department clinicians, along with state regulators and emergency medical services specialists, to discuss concerns about recent upward trends in the number of ED diversions and ED wait times. The Maryland Institute for Emergency Medical Services Systems (MIEMSS) reported the extent of the problem, MHA staff provided a root cause analysis, and several ED clinicians presented best practices to improve ED throughput and avoid diversions. MHA will continue to work with MIEMSS and other stakeholders on this issue. 

While there are of course many other issues being attended to on a day-to-day basis, these are among the ones that promise to have a broad yet direct impact on you and those you serve. I hope that your July and August will include some time away with family and friends, to cool off and gear up for the activities of the coming months.

Coyle to Lead California Hospital Association
MHA announced yesterday that President & CEO Carmela Coyle will leave the association in the fall to head the California Hospital Association. She will succeed C. Duane Dauner, who is retiring after leading CHA for 32 years. In a  press release, MHA Executive Committee Chair Mary Pat Seurkamp said, "Carmela's service to Maryland's hospitals, and to the patients and communities we all serve, has been marked by intelligence, integrity, and compassion," adding that, "we are confident the talented and dedicated MHA team will continue our good work as we search for her replacement." Ms. Coyle, who has led MHA since 2008, said "It has been my great privilege to work with our state's hospital leaders in blazing the trail to advance care delivery in Maryland and, indeed, to serve as a possible model for the nation. The work of Maryland's hospitals has been extraordinary."
Contact: Jim Reiter
Next Webinar in Series on Opioid Crisis July 11
Materials are available on MHA's website from the first webinar in a five-part series titled Hospitals' Role in Addressing the Opioid Crisis. That webinar topic was "New Opioid-Related Requirements Impacting Hospital-based Providers." The next webinar, on Naloxone prescribing and dispensing, is July 11 at 8:30. The series of webinars will feature emergency department interventions that can be implemented to help address the opioid crisis. Participants will hear from Maryland hospitals using specific interventions and their experience to date. Registration is required for each webinar. Click each title below for the registration link. Contact Nicole Stallings with questions. The remaining webinars and their topics are:
September 12 at 8:30 a.m.
Alcohol and Drug Use Screening
October 11 at 8:30 a.m.
Overdose Survivors Outreach Project
Quarterly Financial, Utilization Reports Available
The financial reports for the first quarter of 2017 are now available for MHA members. To access the Accounts Receivable and Combined Financial Trends and Utilization reports, click here. Reports are available only to members.
Contact: Brian Sims
AHA Hosts Webinar on MACRA Updates
The American Hospital Association will host a webinar Friday, July 14 at 1 p.m. to review the highlights of proposed changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Centers for Medicare & Medicaid Services in June released a proposed rule with updates to the quality payment program (QPP) for physicians and other clinicians required by MACRA. The rule proposes changes that would impact reporting requirements starting in 2018. Whether your clinicians are employed, under contract, or independent, the rule will have implications for how you work together to deliver safe, high-quality care. Click here to register for the July 14 webinar.
Cybersecurity Report Released
Maryland Attorney General Brian E. Frosh, Chair of the Maryland Cybersecurity Council, this week announced the release of its Biennial Report, outlining the Council's activities and updated recommendations based on its findings over the last 12 months. The report follows up on its  Preliminary Report issued in July 2016, in which several of the Council's recommendations have been implemented. The recommendations include enactment of several bills that expand protections for consumers, the creation of a portal to house best practices and additional resources to protect Maryland's critical infrastructure.
Leadership Begins
With Attitude
Edgar Schein, scholar and well-known organizational culture guru, indicates in his book on communication that having the right "attitude" regarding asking for and seeking information from others is as important as the actual technique we use.

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CDC: Opioid Prescribing Down Since 2010, But Varies Widely
The amount of opioids prescribed in the United States decreased each year between 2010 and 2015, according to a Vital Signs report released yesterday by the Centers for Disease Control and Prevention.

Wednesday, July 12
Health Services Cost Review Commission meeting

Thursday, July 13
MHA Statewide CEO, COO, CFO and CMO meeting with Health Secretary Dennis Schrader
  and the state team leading the development of the new Maryland Primary Care Model
  known as the Maryland Comprehensive Primary Care Model (MCPC)
MHA Financial Technical Work Group meeting
The Washington Post, By Associated Press, July 2
Baltimore Business Journal, By Morgan Eichensehr and Jonathan Munshaw, July 3
The Frederick News-Post, By Kate Masters, July 3
The Baltimore Sun, By Andrea K. McDaniels, July 5
The Washington Post, By Arelis R. Hernandez, July 5
Fierce Healthcare, By Annette Boyle, July 5