March 16, 2018
Taking Stock on Care Transformation
Earlier this week, Maryland Health Secretary Bobby Neall sent a formal request to care transformation leaders at every hospital to help build an inventory of hospital-led transformation efforts. I want to underscore that request and invite a high level of participation.
The inventory is being developed for Maryland's Stakeholder Innovation Group (SIG), which MHA is spearheading to help align incentives for providers across the care continuum as we move to the next phase of the All-Payer Model. As a reminder, Secretary Neall several months ago requested the formation of a hospital-driven group to identify the most promising areas for innovation.
The new Enhanced Total Cost of Care Model will build on the cost containment and quality improvements realized under the current model, adding emphasis on increasing savings across all health care settings. This will not be easy, and it will require extraordinary cooperation and information-sharing among all providers. That's why it's important to create a comprehensive catalog of the good work you've been doing. It will help in several ways:
  • Initiatives can be identified that may be candidates for additional investment, either by individual organizations or on a larger scale
  • Providers can consider applying effective innovations in their own organizations
  • New community partners that can enhance your current work can be identified
  • Health care providers on the front lines can set their own course for the future of care delivery
To build this inventory, we ask that hospitals please complete this survey by April 6 . Consider submitting a handful of your most innovative programs that focus on improving population health and reducing costs. These programs may be part of national initiatives (e.g., Accountable Care Organizations) or may be "home-grown."
We appreciate your quick attention to this important effort.
If you have questions, contact Nicole Stallings at .

Bob Atlas
President & CEO

At Work in Annapolis
This week, the General Assembly focused on meeting Monday's crossover deadline, when each chamber must send to the opposite chamber bills they intend to pass. The House maintained the governor's $25 million sick tax reduction in its version of the budget, which now goes to conference committee to reconcile differences between it and the Senate version, which includes a $30 million reduction. Bills aimed at shoring up Maryland's health insurance exchange were voted out of their respective committees, with no new hospital assessments included in that legislation. The House and Senate versions of the capital budget both include a $5.5 million allocation to the private hospital bond program, which will provide matching funds for six projects throughout the state. MHA also testified against an SEIU-supported bill that would require hospitals to submit an itemized list of their tax benefits to the comptroller. Throughout the legislative session, you can track MHA's activities via our dashboard , which provides an overview of the previous week and a look at important hearings and events for the following week.
Commissioners Act on Final Readmissions Policy
The Health Services Cost Review Commission took final action on its Readmissions Reduction Incentive Program for Rate Year 2020 during its monthly public meeting this week. Commissioners also received a report on population health improvement activities at Peninsula Regional Medical Center, and a legislative update that noted support of HB 1782, a bill to stabilize the individual insurance market in Maryland, with an amendment to remove a hospital assessment as a source of funding for a reinsurance program. Read more in this month's Newsbreak .
Health Department, HSCRC Release Year 3 Model Results
The Maryland Department of Health has released data from the third full year of the All-Payer Model. Through year three, Maryland was on track to meet or exceed all model requirements, including hospital Medicare savings of $586 million and total hospital and non-hospital Medicare savings of $461 million through the end of calendar year 2016, while improving quality. A report summarizing the performance is available on the HSCRC website.
Registration Is Open for MHA's Annual Membership Meeting
MHA's Annual Membership Meeting will be held June 11 & 12 at the Four Seasons Hotel in Baltimore.
  • Monday, June 11 Evening Reception 6 - 8 pm: Join your colleagues from across the state, enjoy the waterfront views as you mingle with your peers, and get the chance to meet MHA's new President & CEO Bob Atlas.
  • Tuesday, June 12 General Session 8 am - 1 pm
Among the program's prominent speakers will be Dr. Atul Gawande, who has been named one of Time Magazine's 100 Most Influential Thinkers. A renowned surgeon and researcher and the author of Being Mortal: Medicine and what Matters in the End, Dr. Gawande will share his bold visions for improving performance by focusing on the needs of real people, the values that make for a healthy society, the science and technologies waiting over the horizon, and how to reform systems to make it all work. Gawande will also be available for a book-signing and to chat with attendees.
The time we spend together each year at our annual meeting is invaluable. Beyond the information and insight from speakers like Gawande, it's one of the times when we can truly connect to freely share ideas about the future of health care in Maryland.
Register now ! Be on the lookout for the brochure and other information coming soon. Hope to see you there.
Contact: Kathy Gotwalt
MHCC Posts Home Health Agency Guidelines
The Maryland Health Care Commission has recently posted the guidelines for the upcoming Home Health Agency (HHA) Certificate of Need (CON) review for the re-opened Upper Eastern Shore region (consisting of Caroline, Cecil, Kent, Queen Anne's and Talbot Counties). The purpose of the guidelines is to help potential applicants understand eligibility qualifications consistent with the CON application acceptance rules found in the HHA Chapter of the State Health Plan (COMAR This document also provides a listing of qualified Maryland HHAs, hospitals, and nursing homes based on the same quality metrics used for the 2017 HHA CON review, with the exception that CMS Compare scores have been updated for use in the Upper Eastern Shore review.  The HHA CON review schedule for this review can be found here. Contact Kevin McDonald, MHCC Chief, Certificate of Need, for additional information a or 410-764-5982.
IRS Monitoring 501(r) Status Requirements
The Internal Revenue Service continues to review hospital compliance with the requirements for maintenance of tax exempt status, including visits to a hospital's website to check whether required information - community health needs assessments and financial assistance policies - are clearly posted. Based on information published in a recent Tax Exempt Organization Tax Alert from Ernst & Young LLP, the IRS has identified 400 hospitals across the country on whose websites the required information was not readily found. These hospitals have been "referred for examination for non-compliance." As a reminder, hospital 501(r) requirements include:
  • Conducting a Community Health Needs Assessment (CHNA) at least once every three years
  • Making the CHNA publicly available on a website
  • Adopting an implementation strategy to meet the needs identified in the CHNA
  • Adopting a financial assistance policy and publicizing the policy, including by posting it on a website
  • Limiting the amounts charged to individuals who are eligible for financial assistance
  • Making individuals aware of the financial assistance policy prior to engaging in certain collection actions
Click here for more information.
Filling the Gaps

When a new project is being launched or an improvement needs to be made, we often look to the person in leadership who we believe has the time and energy to accomplish the task. In this environment, finding that person isn't necessarily easy.

Prime Offers Solutions for Market Analyses, Intelligence and Forecasting

Prime, through its affiliation with Vizient, offers solutions through Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services. Sg2 delivers an easy access platform of predictive analytics and consulting services that helps more than 1,400 hospitals and health systems - from small community hospitals to large integrated delivery networks - understand current and future market dynamics and capitalize on opportunities for growth and performance.

Report Highlights Hospital Quality Improvement

Unplanned hospital readmissions fell by 70,000 for Medicare Part C patients between 2011 and 2015, avoiding more than $1 billion in health care costs, according to the latest report on the impact of Centers for Medicare & Medicaid Services quality measures on patients and costs. 

Monday, March 19
- MHA's Certificate of Need and State Health Plan Work Group meeting

Tuesday, March 20
- MHA's Medicare Performance Adjustment Work Group meeting
- Maryland Healthcare Education Institute Board meeting
MedPage Today , By Joyce Frieden, March 13
Herald-Mail Media , By Tamela Baker, March 13
Bethesda Magazine , By Bethany Rodgers, March 14
The Baltimore Sun , By John Fritze, March 15
The Washington Post , By Fenit Nirappil, March 14
The Baltimore Sun , By Bonnie Berkowitz, March 14