November 11, 2016
What's Next?
Every new administration brings change. As the nation's health care field watches to see what that change means for the transformation of care nationally, Maryland's hospitals will be watching for the local impact. And of course your MHA will be vigilant as we track the potential implications of the new administration's policies on our state's All-Payer Model demonstration.
Remember that the authority for our model comes directly from the Center for Medicare and Medicaid Innovation (CMMI), which was created by the Affordable Care Act (ACA). So we'll be watching very carefully how the details of "repeal and replace" might develop. At the same time, remember that a previous Republican-led bill making changes to the ACA and vetoed by President Obama actually retained CMMI, as it did the Accountable Care Organizations that are a part of the ACA. Will both continue to be retained, but changed? We'll watch along with the rest of the country.
It's also important to remember that, no matter what changes are made, making sure people have coverage is critical to the success of any model. Getting people the right care, at the right time, in the right setting is a lot harder when people don't have an insurance card. Coverage has always been and is likely to remain the goal - but the path is likely to look different.
There are several ways change can happen: executive orders, the budget reconciliation process (which requires only a simple majority of 51 votes in the Senate, not a veto-proof 60), and legislation. Change could come through one, or a combination of all three.
Keep in mind that any new administration's impact will reach beyond policy; it also is likely to affect the nation's - possibly the world's - economy. That also will have direct implications for your work to improve the health of the communities you serve.  
The American people have spoken, and they demanded change. We will continue speaking for you, tracking what that change will mean for hospitals and for Maryland, and advocating as always for your ability to be strong and effective local caregivers, no matter how policies and politics reshape Washington.

Commissioners Discuss CareFirst Request for Rate Support for Common Model
Health Services Cost Review Commission members this week considered a request from CareFirst to add funding in hospital rates to continue its Common Model for Medicare and dual eligible beneficiaries. In their monthly public meeting, commissioners also approved a second round of regional transformation grants totaling $6.5 million, and were notified that through the first seven months of calendar year 2016, the Medicare Total Cost of Care per beneficiary has grown approximately 1 percent less than the national growth rate.
Final Health Care Transformation Forum Held
In the final of a series of public forums to share information about the health care transformation in Maryland, faith and health leaders in Prince George's County gathered Thursday to discuss how hospitals can work with religious leaders to improve the health of their communities. During MHA's presentation, staff informed attendees of the Breath of Fresh Care campaign, which aims to empower health care consumers with valuable information about how to navigate the health care system. The forums, organized by the Maryland Citizens' Health Initiative, were designed to help the public understand changes to Maryland's health care system brought about by the modernized All-Payer Model, and share information about the Maryland Faith Health Network
PDMP Council Seats Open
DHMH is seeking nominees to the Prescription Drug Monitoring Program Advisory Council for two seats reserved for medical professionals who are licensed and practicing in Maryland and who have expertise in providing care for patients with behavioral health disorders. If you are interested or know someone who may be, please contact Brian Frazee at for application materials. The deadline to apply is November 28.
HSCRC Webinars Continue; Letter of Intent Due Next Week
The fourth of seven webinars with HSCRC staff to provide hospitals with detailed information on the amendment to the All-Payer Model and on care redesign programs is next week (Nov 18); the schedule for the remain webinars is below. 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)
The remaining webinars are:
  • Webinar 4: (9 a.m. Friday, November 18) - HCIP Program Template and Implementation Protocol
  • Webinar 5: (9 a.m. Wednesday, November 30) - Comprehensive Medicare Data Process and Use
  • Webinar 6: (9 a.m. Wednesday, December 7) - Care Redesign Program Monitoring
  • Webinar 7: (9 a.m. Friday, January 13) - Care Partner Agreements
During each webinar, participants can ask questions of HSCRC, the Center for Medicare & Medicaid Innovation, MHA, and CRISP. Click here to find the registration links for each webinar and the recordings of previous webinars.
For many hospitals, attending these webinars will culminate with the signing of a letter of intent - a nonbinding agreement submitted to the HSCRC that indicates interest in participating in one or both of the care redesign programs (Hospital Care Improvement Program and Complex and Chronic Care Improvement Program; details at the top of this page). Please note that the deadline to submit the letter of intent is November 18. Click here for the letter of intent template. In addition, should you submit a letter of intent to the HSCRC, please copy Pat Ross at MHA so we can tabulate the field's participation in the care redesign programs. If you have any questions, contact Nicole Stallings.
Reminder to "Unite Against the Flu"
The American Hospital Association has launched the United Against the Flu campaign, with several resources available to help hospitals get the word out to patients and communities about how to prepare for flu season. The United Against the Flu web page serves as a home base for the campaign and features infographics, helpful resources like the CDC's flu shot finder tool, and promotional messaging.

Other quick ways to get involved:
  • Provide a link to the AHA's Flu Vaccine landing page
  • Share a story about what quality care means to your community and why vaccination is such a crucial component of healthy communities
  • Follow AHA on Facebook and Twitter
  • Use the hashtag #UnitedAgainstFlu in your social posts
  • Post provided content from AHA on social media within 48 hours of receiving it via email
Leading Change
Mid-level leaders sometimes get confused between "leading change" and "managing change." And while much attention has been spent on helping managers "manage change," the real value to be gained is in teaching managers how to "lead change."

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.

CDC Issues Guidance on Outpatient Antibiotic Stewardship
The Centers for Disease Control and Prevention this week released a framework for improving antibiotic prescribing in outpatient settings. Its four core elements are commitment; action for policy and practice; tracking and reporting; and education and expertise. 

Tuesday, November 15
- Carmela Coyle presents at Fort Washington Medical Center's Annual Meeting
MHA Council on Financial Policy meeting

Wednesday, November 16
Carmela Coyle presents at Carroll Hospital Center's Legislative Breakfast
CNN, By Susan Scutti, November 4
The Washington Post, By Hannah Lang, November 4
Baltimore Magazine, By Amy Mulvihill, November 2016
WMDT, By Paul R. La Monica, November 8
The Baltimore Sun, By John Fritze, November 9
The Baltimore Sun, By Meredith Cohn, November 9