January 12, 2018
What Does the New Model Delay Mean?
Earlier this week, the state announced a one-year extension for Maryland's All-Payer Model contract, through December 31, 2019. The extension provides the U.S. Department of Health and Human Services more time to understand the model and its next phase, as well as additional time for a new health secretary to be installed prior to approval.
While the delay may carry some risks, CMS Administrator Seema Verma is a strong proponent of our system and is pushing for HHS to have its review and approval completed in the first quarter of this year. If approval comes before the end of 2018, the hospital field will have an opportunity to weigh in on the start date for the new model.
The strong support from CMS is demonstrated by anticipated actions in the coming months, including a determination that the Maryland model is an Advanced Alternative Payment Model - a designation that will facilitate physician eligibility under MACRA for hospitals participating in Maryland's care redesign programs. This suggests that for now, hospitals should keep doing what they are doing.
There are outstanding questions around the timing of HHS's review, and the development of the savings target for the sixth year of the current model. Answers to those questions should emerge over the next few weeks, as your MHA team meets with HSCRC and federal staff.
As it stands now, the process remains on track for Maryland's hospitals to continue to build on the successes they've realized over the first four years of the All-Payer Model: lower cost growth, better outcomes for patients, and healthier communities. These improvements are a prime reason why CMS supports our new model, and that support will be the driving force behind HHS approval of the model's next iteration.

At Work in Annapolis
The Maryland General Assembly opened its 438th session on Wednesday. The combination of election year politics and uncertainty at the federal level will be sure to play a role in legislative deliberations in 2018. Next week, Governor Hogan will introduce his fiscal year 2019 budget proposal, and the hospital field will be looking for a reduction in Maryland's $364 million sick tax on hospital care. Also, MHA will share findings and recommendations from a recent report compiled by MHA's Behavioral Health Task Force with the Senate Finance and House Health and Government Operations committees. Several hospital leaders will be testifying against three bills that, if passed into law, would exacerbate Maryland's already litigious medical malpractice environment. Details of the status of legislation, upcoming hearings and links to position papers will be updated weekly in MHA's Advocacy Dashboard
HSCRC Hears Reports on Emerging Treatments
The Health Services Cost Review Commission this week heard presentations from the Johns Hopkins Health System and the University of Maryland Medical System on the unique role played by academic medical centers in evaluating emerging new technologies and treatments. Commissioners also received the staff draft recommendations on the MHAC program for fiscal year 2020. Read more in this month's Newsbreak .
Health Disparities Data Provided to Hospitals
MHA this week provided all acute-care hospital CEOs and designated Equity of Care leads with detailed and updated data on hospital-specific rates of readmissions, mortality, and a select group of in-hospital infections, by race, ethnicity, language, age and gender. The data are intended to help hospitals achieve their health disparities reduction goals. If you have questions about the data, contact Justin Ziombra. If your organization has not designated an Equity of Care lead, please email the name, title and email address of your lead to David Simon.
State to Hold Meeting on Primary Care Program
The Maryland Department of Health anticipates that the Maryland Primary Care Program will begin next summer, pending federal approval. The state has already held several regional meetings to enhance understanding of the program and will hold another January 25 in Southern Maryland. The meetings address questions specific to each area of the state. Hospitals are asked to share invitation and registration details with their primary care providers and leaders interested in advanced primary care. This activity has been planned and implemented through MedChi, The Maryland State Medical Society, and The Maryland Department of Health. MedChi will provide continuing medical education credits for physicians.
CDC Reports 50 Percent Drop in CLABSIs
Hospitals nationally reduced central line-associated bloodstream infections by 50 percent between 2008 and 2016, according to a new progress summary by the Centers for Disease Control and Prevention. The report also shows progress by hospitals in reducing other healthcare-associated infections, including catheter-associated urinary tract, surgical site, methicillin-resistant staphylococcus aureus and Clostridium difficile infections. The American Hospital Association's Health Research & Educational Trust affiliate has been working with CDC to reduce CLABSI, CAUTI, C. difficile and MRSA infections in targeted acute care hospitals. HRET also has worked with the Agency for Healthcare Research and Quality's Comprehensive Unit Based Safety Program to prevent CLABSI and CAUTI infections, and with the Centers for Medicare & Medicaid Services' Hospital Improvement Innovation Networks to continue to reduce hospital-acquired conditions in the Medicare program. 
When Understanding "Finance and Budgeting" is Not Your Manager's Strength
Great clinical staff are often promoted to management positions because of the respect they garner - not because they have a solid understanding of finance and budgets.

Looking for a Cutting Edge Provider for Blood and Associated Services?
For more than 60 years, Blood Bank of Delmarva (BBD) has provided blood and blood components to hospitals throughout the Delmarva region, helping avoid blood shortages and saving thousands of lives with assistance from more than 150,000 current donors.

AHA Webcast Jan. 17 to Feature CMS Administrator
Register today for a January 17 AHA Town Hall Webcast in which AHA President and CEO Rick Pollack will be joined by Centers for Medicare & Medicaid Services Administrator Seema Verma to discuss the current regulatory landscape. 

Tuesday, January 16
MHA Council on Financial Policy meeting
MHA Medicare Performance Adjustment Work Group meeting
The Baltimore Sun, By Erin Cox and Michael Dresser, January 7
The Daily Record, By Staff, January 5
The Baltimore Sun, By Sarah Gantz, January 8
Baltimore Business Journal, By Morgan Eichensehr, January 8
The Baltimore Sun, By Erin Cox, January 9
WMDT, By Dani Bozzini, January 9
The Star Democrat, By Daniel Divilio, January 11