July 14, 2017
Care Transformation in Action
Each of you, as a hospital leader in Maryland, knows firsthand the challenges and rewards of transforming health care delivery. Spurred by the All-Payer Model demonstration, for nearly four years, your hospitals have led the charge in this arena - innovating, experimenting, and ultimately succeeding with novel strategies to control costs, improve outcomes, and care for whole communities.

But, like the proverbial tree falling in the forest with no one around, if key policymakers and lawmakers aren't aware of the good work you're doing, they will be ill-equipped when making important decisions that affect your ability to continue to progress.
That's why, for several months, MHA has been coordinating with the Health Services Cost Review Commission to facilitate presentations before commissioners - so you have an opportunity to share the many ways you are transforming health care delivery.
During this week's commission meeting, representatives from the Nexus Montgomery Regional Partnership told commissioners about the important work they're doing to reduce avoidable hospital utilization for high-risk, high-cost populations.
Here's how it works. The partnership is composed of six hospitals/health systems in Montgomery County: Adventist HealthCare Shady Grove Medical Center, Holy Cross Hospital, Holy Cross Germantown Hospital, MedStar Montgomery Medical Center, Suburban Hospital and Washington Adventist Hospital. The organizations collaborate on four programs to improve the health of residents of Montgomery and Prince George's counties:
  • Stabilizing the health of older adults to reduce hospital admissions
  • Improving transitions from hospital to home
  • Connecting uninsured people to specialty care
  • Improving community-based resources for severely mentally ill
Among the services offered are: health coaches, connections to community-based services, specialty care visits by case managers, and expanded behavioral health crisis capacity.
These hospitals and health systems are facing their common challenges together. And while data on how the programs are helping patients aren't yet available, the early progress is encouraging in that a strong, inter-hospital foundation has been laid for all of the programs. Already, Nexus Montgomery is looking to broaden its scope. New and potential initiatives include deeper engagement with primary care physicians, partnerships with skilled nursing facilities, respite care for homeless people, and home health for people with serious mental illness.
During the meeting, Commissioner John Colmers put it well, saying that the collaboration among hospitals and health systems that have traditionally been competitive is "remarkable" and the work they are doing together is "transformative."
He's right about Nexus Montgomery, and what's more inspiring is that this is but one example of how hospitals throughout Maryland are continuing to make good on their commitment to improve the lives of entire communities. 

HSCRC Approves UCC, Nurse Support Policies
In the first meeting for new commissioner Adam Kane (see story below), commissioners approved without changes staff recommendations on the uncompensated care funding policy for fiscal year 2018, as well as funding for the Nurse Support I program. As reported in this month's edition of Newsbreak , commissioners also received a briefing on the activities of the Nexus Montgomery Regional Partnership, and decided at the end of its relatively brief meeting to cancel the August public commission meeting.

Contact: Mike Robbins
Adam Kane Appointed to HSCRC
Adam Kane, Senior Vice President, Real Estate Acquisition and Corporate Affairs for Erickson Living, has been appointed to the Health Services Cost Review Commission by Gov. Larry Hogan. Kane replaces Herb Wong, a senior economist at the Agency for Health Care Research and Quality, who was appointed to the commission in 2013. Kane is responsible for managing Erickson Living's government and regulatory relationships and was previously director of public policy for Mid-Atlantic LifeSpan, a long-term care association. He has an M.B.A. from the Wharton School of Business at the University of Pennsylvania; a J.D. from the Georgetown University Law Center; and a M.A. from the University of Maryland. Kane is an advisor to several health care enterprises, including the state of Maryland's Health Information Exchange, the Maryland Medical Society, and the University of Maryland School of Social Work.
AHA Releases Statement on Revised BCRA
The American Hospital Association released a statement following the revision of the Senate Better Care Reconciliation Act. The statement reads, in part, "Unfortunately, in the latest update released today, the unacceptable flaws of BCRA remain unchanged, and there are no significant changes to the massive Medicaid reductions."
Educational Session on Medicare Wage Index Scheduled
MHA will host an education session on the Medicare Wage Index on August 10 from 11:30 a.m. to 1:30 p.m. This session will cover how the Medicare cost report data are used in the wage index and how to improve the completeness and accuracy of the data. There will be a particular focus on reporting salaries, hours, physician Part A costs and contract labor. Kurt Schaeffler from Schiavi, Wallace & Rowe will lead the discussion. HSCRC has indicated that it may use Medicare Wage Index data in future methodologies to adjust for labor market differences. Hospital wage data directly affect other Medicare providers in Maryland, including skilled nursing facilities, home health agencies, and inpatient psychiatric and rehabilitation hospitals. Many of these are part of the same health system as our hospitals or are working in partnership with our hospitals to manage the total cost of care. If you're interested in attending, email Tracy Blanchard at tblanchard@mhaonline.org
Hospital Leaders Learn About Comprehensive Primary Care Model
More than 80 hospital leaders gathered Thursday for a presentation and Q&A session with representatives from the Maryland Department of Health (MDH) on the Maryland Comprehensive Primary Care Model (MCPC). Health Secretary Dennis Schrader, Deputy Secretary Howard Haft, Health Care Commission Executive Director Ben Steffen, and Chad Perman from MDH's Office of Population Health were on hand to discuss the model. Under the model, primary care and other patient-designated providers connect with care transformation organizations to provide increased access and improved care coordination and management, with the goal of reducing avoidable hospitalization. The model is going through the clearance process at the Centers for Medicare & Medicaid Services, and is tentatively scheduled to begin in summer of next year. MHA will continue to work with MDH on the role of hospitals in the implementation of the model. MDH's presentation slides can be found here
MDH Updating Professional Shortage Areas
The Maryland Department of Health is updating the state's Health Professional Shortage Areas. The department is notifying hospitals of their updated designations, and a webinar was recently held to discuss the Health Resources and Services Administration's National Update and its effect on Maryland's designations. If you have any questions, contact Elizabeth Vaidya, Director of the Office of Population Health Improvement, at Elizabeth.vaidya@maryland.gov or 410-767-5695. 
Re-Recruiting Your "A-Team"

In our busy work world of too many things to do and too little time in which to do them, we often take a "checklist" approach to our tasks. As such, we work on a project and when it's complete, we cross it off the list so something else can take its place. 

PRIME Offers Capital and Construction Solutions

Prime, through its affiliation with MedAssets, would like to introduce you to MedAssets Capital and Construction Solutions, which deliver end-to-end capabilities to help you complete successful, on-time and on-budget construction or renovation projects.

AHA Recommends CMS Actions to Stabilize Marketplaces

Responding to a Centers for Medicare & Medicaid Services request for information on ways to reduce regulatory burdens and improve health insurance options under the Affordable Care Act, AHA this week urged the agency to commit to funding cost-sharing reductions and enforce the individual mandate, among other recommendations. 

Tuesday, July 18
- MHA Council on Financial Policy Meeting

The Baltimore Sun, By Andrea K. McDaniels, July 8, 2017

The Washington Post, By Associated Press, July 7, 2017

Scramble Is on to Find New Ways to Stop Opioid Overdose Deaths
Modern Healthcare, By Steven Ross Johnson, July 10, 2017

CMS Seeks Closer Look at Quality of Care at Ambulatory Surgical Centers
Modern Healthcare, By Virgil Dickson, July 11, 2017

Health Insurers Try Paying More Up Front to Pay Less Later
NPR, By Mark Zdechlik, July 12, 2017