June 15, 2018
The Power Within Us
If there's a common theme that the three featured speakers at this week's annual MHA membership meeting shared, it's this: each of us, both professionally and personally, has immense power to change people's lives for the better.
Ben Nemtin showed us a path to achieve one's lifelong goals and to receive joy by helping other people along the way.
Dr. Omar Manejwala shared how our professional roles and our systems of care must evolve to meet people's changing needs, especially in the addiction arena.
Dr. Atul Gawande reminded us of the special role health care providers play throughout people's lives. He focused on the period toward the end of life but emphasized that, at all of life's stages, individuals' own goals ought to be elicited and guide clinicians in their treatment plans. Clinicians must avoid performing services that may be ineffective in achieving patients' goals or simply unwanted.
It's these personal connections - between health care provider and patient or simply between a giver and a recipient of any kind of help - that enable those around us to live as good a life as possible, all the way to the end.
Each of our speakers pointed out how each of us is uniquely empowered in this way.
Take a moment to think about how many people's lives you touch each day through the decisions that you make as a leader. The patients to whom you provide comfort by employing a dedicated, compassionate staff; the staff who feel trusted and empowered by their managers; the people you serve, who know that their hospital is there for them.
These lessons prompt a thought: The power you have as an individual grows exponentially when we work together.
Consider how much you've accomplished under the All-Payer Model. Gains made on readmissions reductions and Medicare savings translate into very meaningful changes for real people: less time in the hospital; the ability to go directly home after a hospital stay; preventive/primary care and, when appropriate, palliative care - all of which give people the chance to spend more time with their families, to do more of what makes their lives valuable.
These are just a few of the benefits that your hard work has produced. Now, as we unite under the new Enhanced Total Cost of Care model, your power, and the power of your hospital, to improve the lives of all Marylanders, will fulfill, as Nemtin quoted poet Matthew Arnold: "...a thirst to spend our fire and restless force in tracking out our true, original course..."

Bob Atlas
President and CEO

Guzzone Receives MHA Outstanding Legislator Award
At MHA's Annual Membership Meeting this week, Maryland State Senator Guy Guzzone (right) received MHA's Outstanding Legislator Award.  The award recognizes an individual for his or her work within the General Assembly to support hospitals' legislative agenda and, as a result, hospitals' work to take care of people and transform care. (Pictured at left is Brian Frazee, Director, MHA Government Relations.)

Signed Agreements for Final Care Redesign Agreement Due June 26
Hospitals currently in a care redesign program as well as new entrants have been sent via email the final Care Redesign Program Participation Agreements for their review. The final Care Redesign Program Participation Agreements for signature are expected to be emailed by June 20. Hospitals must have a signed version submitted and returned by June 26. Separate emails are being sent to hospitals with instructions on submitting implementation protocols by the June 29 deadline. In addition, hospitals must have their CMS-vetted care partners signed onto the hospital's care partner arrangement and submitted for certification by July 13 in order for those partners to be MACRA-eligible for 2018.
Contact: Nicole Stallings
Value Report Posted to Website
MHA's 2018 Value Report to Members has been posted on our website. It details a few of the ways MHA brought value to Maryland's hospitals over the past year, from a $30 million reduction in the Medicaid sick tax to $5.5 million for six hospital capital projects.
HSCRC Reduces Hospital Global Budget Update
During this month's Health Services Cost Review Commission meeting, based on concerns regarding non-hospital and total Medicare spending growth, commissioners voted to increase global budget revenues by 1.83 percent for next year, 0.25 percentage points below the staff recommendation. Commissioners also approved a resolution regarding the impact of the Maryland Primary Care Model fees on the all-payer update in future years, as well as a proposal to increase the Medicare/Medicaid differential by 1.7 percentage points. Details are available in this month's edition of Newsbreak .
Draft Comprehensive Care Facility Chapter Posted
The Maryland Health Care Commission has posted the draft Comprehensive Care Facility (Skilled Nursing Facility) Chapter of the State Health Plan on the its website for informal public comment. The State Health Plan sets the parameters for Certificate of Need decisions. Proposed changes include exceptions to consider projects in areas without bed need that expand a limited number of quality providers, or are intended to reduce total cost of care through hospital collaboration. The draft also reflects a revised bed need methodology. Informal comments are due by July 9 at 4:30 p.m.
Deadline Approaching for 2018 Bond Program
The deadline to submit applications for the 2018 MHA Bond Program is Friday, June 22. Application forms and other supporting documentation must be submitted via the hospital-specific SharePoint site. If you have questions regarding the application or submission through the SharePoint site, please contact Jane Krienke . All application materials are available on our website www.mhaonline.org/bond .
Health Connection to Hold Regional Forums
The Maryland Health Connection will hold two regional forums next week with state and community leaders to explore ideas to strengthen the marketplace for 2019 enrollment. The first is Tuesday, June 19 from 11 a.m. to 12:30 p.m. at the University of Maryland Adele H. Stamp Student Union, Nanticoke Room 1238, 3972 Campus Drive, in College Park. The second is Thursday, June 21 from 1 p.m. to 2:30 p.m. at the Enoch Pratt Free Library, Waverly Branch in Baltimore. Health care leaders will also review upcoming state and federal actions. Please RSVP to Jenny Mancha at jenny.mancha@maryland.gov or 410-547-6323.
Overall Hospital Star Ratings Will Not Be Updated in July
The Centers for Medicare & Medicaid Services this week announced it will not update its overall hospital quality star ratings on Hospital Compare in July. The decision was made to give time for additional analysis of the impact of changes to some of the measures on the star ratings and to address stakeholder concerns. As part of this process, CMS said it will seek feedback from a multi-disciplinary technical expert panel, a provider leadership workgroup, and a public comment period.

In a related development, Modern Healthcare reports today that a new study by Rush University Medical Center in Chicago has found that CMS has been miscalculating hospital star ratings since they were first released in 2016.
The "Valued" Conference
MHEI has been hosting a fall leadership conference for over 40 years. Two years ago, we decided to change our approach to more closely match the needs of you, our MHEI members.

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.

Apply to Participate in High-Value Care Collaborative
The AHA, in partnership with the American Board of Internal Medicine's Choosing Wisely campaign and the Costs of Care organization, is enrolling clinical teams in a 12-month virtual High-Value Care Collaborative.

Tuesday, June 19
MHA Medicare Performance Adjustment Work Group meeting
The Baltimore Sun , By Libby Solomon, June 13
WCBC , June 12
The Star Democrat , June 13
The Baltimore Sun , By Jeff Barker, June 13
Baltimore Business Journal , By Morgan Eichensehr, June 13
The Baltimore Sun , By Andrea K. McDaniels, June 14
The Baltimore Sun , By Andrea K. McDaniels, June 13