MHA Update Newsletter
 February 27, 2015
Save the Dates!

 June 1 and 2, 2015

MHA Annual Meeting
Four Seasons

Hotel Baltimore


MHEI Programs & Webinars

March 3

Management Boot Camp


Quick Links


Enterprising Work

A little over a year ago, about the same time the state and federal governments put their final touches on the modernized Medicare waiver, Maryland's health secretary designated five Health Enterprise Zones - areas throughout the state with traditionally poor health outcomes that needed a boost.


The HEZs, slated for a four-year pilot run, are designed to do three things: reduce health disparities among racial and ethnic minority populations and among geographic areas; improve health care access and outcomes in underserved communities; and reduce health care costs and hospital admissions and readmissions.


Every once in a while, when separate but similar initiatives converge, as is the case with the revamped waiver and the HEZs, it confirms that innovators in the field are independently moving toward the same goals. That's an affirmation that Maryland's hospitals are heading in the right direction.


Now, all of Maryland's hospitals are working to develop population health management models to meet the waiver's goals and, if early results are any indication, the HEZs are proving to be effective catalysts in their communities. A brief overview of the five: 

  • Annapolis/Morris Blum (Suburban) -This project, led by Anne Arundel Health System and the City of Annapolis, established a primary care health center in the Morris Blum public housing building to reduce diabetes-related and smoking illnesses, obesity and cardiovascular disease.
  • Caroline/Dorchester Counties (Rural) -The zone targets primary care and behavioral health issues by supporting health care services teams.
  • Prince George's County Health Department/Capitol Heights (Suburban) -This zone expands primary care access by establishing five patient-centered medical homes to combat asthma, diabetes and hypertension.
  • St. Mary's County/Greater Lexington Park (Rural) -The project, spearheaded by MedStar St. Mary's Hospital, expands access to primary and behavioral health services to reduce emergency department and hospital admissions.
  • West Baltimore Primary Care Collaborative (Urban) -Led by Bon Secours Baltimore Health System, Maryland General Hospital, Saint Agnes Hospital, Sinai Hospital of Baltimore and University of Maryland Medical Center, this project aims to reduce cardiovascular disease through primary care providers, community health workers and access to resources such as gyms and healthy food retailers. 

While each of these programs has had some early challenges, all are reporting progress in meeting the zone's goals. Perhaps more important is that through the process of standing up these initiatives, these organizations are learning more every day about the trials and tribulations of population health management. As each of you forms new relationships and implements new procedures to keep your communities healthy, keep an eye on the progress of the HEZs. We can learn a lot from their work.

Carmela signature
In This Issue
At Work in Annapolis

The busy week started Wednesday with MHA's testimony in the Senate Finance Committee on priority legislation SB-281 Blue Ribbon Commission to Study Maryland's Behavioral Health System. The cross-file bill HB-650 will be considered in the House Government Operations Committee March 10. 


MHA also offered supportive testimony for SB 569-HB 724 Health Care Provider Malpractice Insurance-Scope of Coverage. This bill would repeal prohibiting coverage for the defense of a health care provider in a disciplinary hearing to be included in or to be offered and priced separately from a policy that insures a health care provider against damages due to medical injury arising from providing or failing to provide health care. This would repeal a prohibition on the inclusion of defense coverage for disciplinary hearings in a medical malpractice healthcare provider insurance policy. Prior to 2004, this type of coverage was included in medical malpractice policies in Maryland.


Wednesday, MHA testified in support of SB 586-HB 1010 Health Insurance-Federal and State Mental Health and Addiction Parity Law, requiring health maintenance organizations, insurers, and nonprofit health service plans that offer specified contracts and health benefit plans to submit to the Maryland Insurance Commissioner a report certifying and outlining how designated contracts and health benefit plans comply with the federal Mental Health Parity and Addiction Equity Act and state mental health and addiction parity laws.


This week MHA testified in support with amendments to SB 57-HB 72 Budget Reconciliation and Financing Act of 2015 in the House Appropriations Committee. The Budget Reconciliation and Financing Act of 2015 (BRFA) seeks to delay until fiscal year 2017 any reduction to Maryland's hospital Medicaid tax through savings that accrue to Medicaid as a result of reduced hospital spending under the state's waiver agreement with Medicare. In fiscal year 2016, $14.5 million was identified for this purpose. The BRFA also seeks to require an additional $16.7 million in hospital Medicaid general fund spending reductions through a series of actions to be taken by the Health Services Cost Review Commission (HSCRC), in addition to the Board of Public Works action to reduce hospital Medicaid general fund spending by $8 million for fiscal year 2015. MHA has offered an amendment to request in fiscal year 2016 that HSCRC enact policies that will achieve general fund savings to the Medicaid program by allowing the commission flexibility to work on a viable solution to the budget cut. 


On Thursday, MHA's Carmela Coyle testified as part of a panel to oppose SB 479-Civil Actions-Noneconomic Damages-Catastrophic Injury, which alters the maximum amount of noneconomic damages that may be recovered in health care malpractice and other civil actions for a catastrophic injury under specified circumstances. This proposal would raise fees for plaintiffs' attorneys and increase malpractice insurance rates (and thus health care costs for everyone). Further, the practice of defensive medicine, encouraged by astronomical jury awards, unnecessarily inflates the cost of providing health care, which threatens hospitals' ability to live within the fiscal constraints of a modernized Medicare waiver.  

MHA Seeking Comment on Work Group Definitions
Clinical and quality leaders this week received a request for comment on proposed definitions for obstetrical hemorrhage and obstetric laceration and pneumonia and aspiration pneumonia. These requests are part of an effort to address the variability in clinical criteria used to define certain diagnoses. Standardization of these definitions will support hospitals' ability to effectively collaborate on care improvement as well as facilitate accurate measurement of improvement under the new hospital waiver and the Maryland Hospital Acquired Condition (MHAC) payment policy. To support this work, MHA convened four multidisciplinary work groups from a cross-section of Maryland's community and teaching hospitals and health systems. In addition to the two work groups that are addressing obstetrical hemorrhage, laceration, pneumonia and aspiration pneumonia, two other work groups are concurrently developing proposed definitions on UTI and renal failure. Final definitions will be disseminated to all hospitals with the request that Medical Executive Committees consider them for adoption. Materials from each of the work groups can be found on MHA's website.
New MHA Infographics Available

MHA's Policy Data Analytics team has produced three new infographics for use in presentations or as leave-behinds in meetings. The new materials focus on budget-related matters, including information on the Medicaid tax, Medicaid's role in Maryland's economy and how hospitals are already helping the state balance its budget. You can access these infographics and others on MHA's website. 


Contact: Nora Hoban

HSCRC Webinar on RFP Set for Tuesday

The Health Services Cost Review Commission (HSCRC) on Tuesday March 3 will hold a webinar for hospitals interested in the Request for Proposals for the development of Regional Partnerships for Health System Transformation. As much as $400,000 will be provided to each of five or more partnerships across the state. As MHA stated in a February 12 Member Alert, the funding was included in last year's Budget Reconciliation and Financing Act to spur the collaborations needed to meet the goals of Maryland's revised all payer hospital rate setting system and transform care delivery. To accelerate this transformation, the state will fund regional partnerships to collaborate on analytics, delivery of care coordination and services based on patient and population needs, and population health improvement approaches. Awardees will be responsible for developing a Regional Transformation Plan that outlines a concept for a delivery and financing model. Applications are due April 15 and awards will be announced in early May. The Request for Proposals, which outlines application requirements and funding priorities, is available here.


Use this link to register for the webinar:
Registration Open for Medicaid Readmissions Webinars
The second and third webinars under MHA's Learning Network,
Updating Readmission Strategies for 2015 - A Focus on Medicaid, will be held March 11 and March 25 from 1 - 2 p.m. MHA has launched this Learning Network to implement AHRQ's Hospital Guide to Reducing Medicaid Readmissions. The March 11 webinar will focus on updating your avoidable utilization strategy for 2015 and the March 25 on high impact Medicaid-specific strategies. A face-to-face meeting will be held April 1 at Turf Valley.


To register for these webinars, please click here. Presentation slides and a recording of the first webinar can be found here.


Contact: Sheena Siddiqui 
CEOs to Receive AHA Annual Survey

The fiscal year 2014 AHA Annual Survey will be mailed to CEOs March 2. Survey responses are due by March 31. 


Contact: Rachel Schaaf

RTI Contacting Hospitals on Waiver Evaluation
The Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International to conduct an independent evaluation of Maryland's new all-payer model. The evaluation will occur over the next five years, with quantitative and qualitative data collection and analyses through site visits and health care provider focus groups at 10 Maryland hospitals each year, beginning with round one this year. MHA will work with RTI and the first-round hospitals in order to summarize the results from the initial focus groups. In a letter notifying hospitals of RTI's plan, CMS provides as a contact for questions Leslie Greenwald, RTI's qualitative research team leader, at
MHEI Assisting Physician Leaders
MHEI new logoThe Maryland Healthcare Education Institute is offering help to organizations recognizing the need for physicians in leadership positions to possess the knowledge and skills associated with good leadership. The MHEI Physician Leadership program is designed to assist leaders in understanding staff motivation, emotional intelligence, organizational culture and other leadership concerns. The purpose of the program is to, in an abbreviated format, give emerging leaders the opportunity to work through leadership issues and concerns that were not included in their medical school training. The program is conducted in a cohort format, limited to 15 individuals, and available to all MHEI member physicians on a first come, first served basis. For program details and dates contact Alison Burrows at MHEI.
Prime Introduces the Blood Bank of Delmarva
PRIME New logoAre you 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 to avoid blood shortages and saving thousands of lives with assistance from more than 150,000 current donors.

Licensed to collect blood in Delaware, Maryland, Pennsylvania and Virginia, BBD maintains five permanent donor centers including Salisbury, and utilizes more than 30 mobile donor sites throughout the Delmarva region. In addition, BBD operates a blood supply depot inside the Prince George's Hospital Center in Cheverly. The depot is a blood distribution center and patient reference laboratory testing facility designed to resolve transfusion related medical problems for Maryland member hospitals. Blood products available include red blood cells, platelets and fresh frozen plasma for transfusion and offers superior value along with quicker response times for delivery to existing and new hospital customers along the I-95 corridor. In 2014, BBD distributed over 100,000 blood products to hospitals, including MHA members.


BBD has positioned itself as an innovative, best in class blood bank committed to ensuring that their hospital partners and their patients are provided with the blood products that specifically fit their specialized needs. In addition to supplying blood products, BBD operates a full-service regional laboratory, now undergoing expansion, with the purpose of providing and expanding testing services for blood collection centers in the region and beyond.


For more information on BBD, visit or call Joe Yelo, Lead Executive of Business & Community Development at 302-737-8405 ext. 866. 

The Week Ahead

Monday, March 2 

CEO Small Group meeting at MHA (by invitation only)


Tuesday, March 3

MHA Operations Committee meeting


Thursday, March 5

- Prime Board meeting

Top News from This Week



More Health Clinics Opening at Drug Stores
The Baltimore Sun, By Andrea K. McDaniels, February 20


OPINION: Looming Crisis: A Center Maryland Series on Access to Maternity Care
Center Maryland, By Carmela Coyle, February 22


OPINION: Looming Crisis: A Center Maryland Series on Access to Maternity Care - Part 2
Center Maryland, By Carmela Coyle, February 23


Fancy Flourishes at Hospitals Don't Impress Patients, Study Finds
Kaiser Health News, By Jordan Rau, February 24


New Alliance Aims to Strengthen Maryland's Independent Hospitals
Baltimore Business Journal, By Sarah Gantz, February 24


Hogan Unveils Plan to Fight Heroin
The Baltimore Sun, By Michael Dresser, February 24


Supporters of Mental Health, Drug Treatment Providers Rally for Funds
The Baltimore Sun, By Michael Dresser, February 25


If Fee-For-Service is a Problem, What's the Solution?
Modern Healthcare, By Paul Demko, February 25