MHA Update Newsletter
April 3, 2015
Save the Dates!

 June 1 and 2, 2015

MHA Annual Meeting
Four Seasons

Hotel Baltimore


MHEI Programs & Webinars

April 7

Management Boot Camp


Quick Links


Experimentation Abounds

As Maryland's hospitals work to reduce readmissions, dozens of novel initiatives are popping up all over the state - some organically, as offshoots of relationships that hospitals have nurtured with community partners for years; others centralized and more formal. Meanwhile, the state's care coordination work group is preparing to recommend a large investment in data infrastructure to support coordination efforts throughout Maryland.


On Wednesday, MHA hosted a packed house of nearly 200 Maryland nurses, care coordinators, doctors, clinical resources managers and others who came to learn more about reducing Medicaid readmissions. Of Maryland's roughly 78,000 readmissions last year, nearly 75 percent were for Medicare and Medicaid patients, despite those populations accounting for just 59 percent of all discharges. In all, caring for patients who are readmitted costs more than $1 billion per year.


These are the hot-spots that hospitals can focus on to make a significant dent in our readmissions rate, a goal that is taking on even greater urgency. While Maryland's hospitals are reducing readmissions faster than the nation as a whole, because the national reduction is fairly significant, we must move even quicker to meet the five-year reduction goal outlined in the modernized Medicare waiver. And with just three-and-a-half years remaining in Phase 1, time is short.


That's why sessions like the one Wednesday - where attendees heard about successful intervention strategies from those on the front lines, as well as new data analyses from the Department of Health and Mental Hygiene and renowned readmissions reduction expert Dr. Amy Boutwell- are so important. In an environment where experimentation abounds, sharing our experiences and what made them successful is an essential component in favorably bending the readmissions curve.


Readmissions reduction is not a solo activity. It takes the concerted efforts of hospitals, post-acute care providers, social support agencies and many others to co-produce change. This is a shared venture and our early improvements are a testament to the hard work you've done so far in laying the foundation for future success.


With so many models and initiatives being tested, then refined, then re-tested, it's difficult to say precisely what recipe will effect dramatic change. But the multitude and variety of experiments you're conducting to tackle the problem has created an environment ripe for success.


Readmissions reduction is not just a Maryland goal; it's a national one, and there's nowhere else in the country where so much energy is being focused on such a specific health care outcome. Whether the right formula to drastically reduce readmissions is found here in Maryland remains to be seen, but the result of your hard work is that patients are realizing immediate benefits - from better care management, improved inpatient experience and lower costs. 


Carmela signature
In This Issue
At Work in Annapolis
This week, MHA testified in House and Senate committees in support of several bills that have crossed to the opposite chamber. MHA celebrated an early victory in defeating SB539 Patient Referrals - Oncologists - Radiation Therapy Services, which would have provided narrow exceptions to the state's prohibition on physicians and other health care providers referring patients to facilities in which the provider has an ownership or financial interest. The bill was withdrawn by the sponsor and the House cross-file has not been assigned a subcommittee or a vote. MHA is extremely grateful for all those who joined us in this effort.

On Tuesday, MHA supported SB607-Joint Committee on Behavioral Health and Opioid Use Disorders, which incorporates MHA's proposal for a Blue Ribbon Commission on Behavioral Health. This bill specifies the purposes of the joint committee as being to review the final report of the governor's Heroin and Opioid Emergency Task Force, review and monitor the activities of the governor's Inter-Agency Heroin and Opioid Coordinating Council, evaluate the effectiveness of specified programs, policies and practices, review compliance with specified federal and state laws by health insurance carriers, identify areas of concern and corrective measures, evaluate the state's behavioral health system, and identify needed funding. 

MHA supported via written testimony HB739- Task Force to Study Maternal Mental Health, which establishes a task force to study and make recommendations on legislation, policy initiatives, funding requirements, and budgetary priorities that can address maternal mental health needs in the state. By identifying vulnerable populations at risk of maternal mental health disorders, the task force could undertake important work to improve services in the state and identify prevention, screening, and early treatment strategies that will improve the delivery of services for this population.

MHA supports SB187- Governor's Workforce Investment Board - Workgroup to Study Access to Obstetric Services, which authorizes the Governor's Workforce Investment Board to coordinate with MHA, in consultation with the Secretary of Health and Mental Hygiene, health occupations boards, the Governor's Workforce Investment Board, and certain other entities and parties, to establish a work group to study access to obstetric services, develop a certain mechanism to evaluate certain factors and to make certain recommendations, report to the governor and certain committees of the General Assembly on or before a certain date each year. This bill has been amended to request that MHA be the lead for this group.

On Wednesday, MHA submitted written testimony in support of HB724- Health Care Provider Malpractice Insurance - Scope of Coverage, which repeals a prohibition on the inclusion of defense coverage for disciplinary hearings in a medical malpractice health care provider insurance policy. Prior to 2004, this type of coverage was included in medical malpractice policies in Maryland. This coverage is routinely included in medical malpractice liability policies in other states, and it is our understanding that the inclusion of such coverage in a medical malpractice liability policy has a negligible effect on the cost of such a policy. Finally, it eliminates the need by a health care provider to purchase an additional insurance policy to obtain such coverage.

On Wednesday, MHA offered written and oral testimony in support of, with amendments, HB327- Health - Ambulatory Surgical Facility - Definition, which alters the definition of an ambulatory surgical facility to one that operates primarily to provide surgical services to patients who require a period of postoperative observation, but not hospitalization that lasts more than 24 hours.

MHA supports HB978- HIV Testing - Informed Consent and Pretest Requirements - Modification, which alters specified requirements on health care providers before obtaining specified samples for the purpose of HIV testing and requires a health care provider to make available specified materials and specified language assistance to certain individuals.

On Thursday, MHA submitted written testimony in support of, with HSCRC amendments, SB513-HB613 Hospitals - Rate-Setting - Participation in 340B Program Under the Federal Public Health Service Act, which alters the definition of "hospital services" to include a specified hospital outpatient service of a specified hospital (those that are part of a merged asset hospital system) for the purpose of allowing the hospital outpatient service to continue to participate in the federal 340B Program under rates set by the Health Services Cost Review Commission.

And as expected, on Thursday, the Senate Budget and Tax Committee approved the capital projects recommended by MHA's Hospital Bond Project Review Committee. More debate and concessions will be made on the budget with the April 6 deadline approaching for both chambers to pass budget bills.
Contact: Jennifer Witten
HSCRC Favorably Modifies MHAC Policy

Based on recommendations from MHA, the Health Services Cost Review Commission has modified its fiscal year 2017 Maryland Hospital Acquired Conditions policy by lowering the scores hospitals must achieve to avoid penalties and to earn rewards in calendar year 2015. Lowering these scores is in line with the idea that while we need to sustain and maintain our good performance on MHAC, it's essential to focus our limited resources on readmissions and other care delivery changes. Under this new scoring, and with the first three months of calendar year 2015 preliminary data in, one hospital will be penalized, two will have no adjustments and the remainder will see a rate increase. The HSCRC's full memo on the change is available here.


Contact: Traci La Valle 

MHA Urges HSCRC to Address Disparity in Quality Amount At Risk

In a letter sent this week to HSCRC Commissioner John Colmers and copied to commissioners and executive director Donna Kinzer, MHA expressed the field's "deep concern" about the commission's March 11 decision on aggregate hospital revenue at risk for quality-related performance. Noting the decision to put the same amount at risk in Maryland as it is nationally, MHA points out in the letter that nationally, the 6 percent at risk applies only to Medicare inpatient revenue. In Maryland, it applies to all payer inpatient revenue. "A more appropriate interpretation is that the aggregate amount of inpatient revenue at risk in Maryland should not exceed 3.6 percent, or 2.2 percent of total revenue," the letter states. MHA asks for a meeting between MHA, hospital leaders, HSCRC, and the Center for Medicare and Medicaid Innovation to discuss the issue.


Contact: Traci La Valle 

MHCC Offers Grants for Telehealth

The Maryland Health Care Commission (MHCC) announced this week it will accept applications for a telehealth technology pilot. MHCC will fund up to three awards to demonstrate the impact of telehealth on any of the following use cases:


  • Use telehealth to manage hospital Prevention Quality Indicators
  • Incorporate telehealth in hospital innovative care delivery models through ambulatory practice shared savings programs
  • Use telemedicine in hospital emergency departments and during transport of critically ill patients to aid in preparation for receipt of patient
  • Deploy telehealth in schools for applications including asthma management, diabetes, childhood obesity, behavioral health, and smoking cessation
  • Deploy telehealth in schools for applications including asthma management, diabetes, childhood obesity, behavioral health, and smoking cessation
  • Use telehealth for routine and high-risk pregnancies


Funding per award is up to $30,000 and requires a 2:1 financial match rate. The application is available hereGrant applications are due to MHCC by 5 p.m. on Friday, April 24. For more information contact Christine Karayinopulos at

MHA Sells Former QI Project Building

MHA has completed the sale of a second building on its campus that formerly housed the Quality Indicator Project. In November 2010, MHA's Executive Committee approved putting the building on the market following the sale of the Quality Indicator Project to Press Ganey. MHA's Operations Committee reviewed offers as they came in and, in November 2014, MHA received an offer from the Pain & Spine Specialists of Maryland. The Operations Committee recommended that MHA accept the offer, and the Executive Committee agreed. Over the past few months, MHA staff have worked with our attorney and real estate agent, as well as the buyer and their agent, to execute the purchase, which was completed on March 31.


Contact: Meghan Allen

MHEI Creates Opportunities for Physician Leaders, Others
MHEI new logo

 The Maryland Healthcare Education Institute has offered leadership and management education for hospital leaders for many years, but with the advent of Population Health, MHEI has expanded its programming for physicians and other non-hospital providers. For physicians, MHEI is offering a Physician Leadership program along with its Annual Leadership Conference in October. Non-hospital leaders (e.g. physician office managers, social service agency employees, independent therapy managers, etc.) may take advantage of the many programs MHEI offers at its Elkridge offices or contract with MHEI to provide that programming on your campus. MHEI's goal is to assist all health care organizations in their efforts to improve through better information, education and leadership.


Contact: Mark Rulle
The Week Ahead

Thursday, April 9

MHA Financial Technical Work Group meeting

- MHA Infrastructure Reporting meeting

In Case You Missed It

AHA Offers Health DIsparities Tools

The American Hospital Association yesterday released a member advisory providing information and resources to help hospitals improve health disparities. The advisory comes in the wake of an NAACP report, Opportunity and Diversity Report Card, which evaluates various organizations' diversity practices with respect to leadership, workforce and procurement. The AHA's tools address three key areas that can lead to improvement:

  • increasing the collection and use of race ethnicity and language preference data
  • increasing cultural competency training
  • increasing diversity in governance and leadership

April is Donate Life Month

April is National Donate Life Month, a celebration commemorating those who have received or continue to wait for lifesaving transplants as well as the donors who save and heal lives. There are a wide variety of events and organizations promoting donation throughout the month. MHA and Donate Life America want to celebrate Donate Life Month by thanking all of our hospital partners and their staff for the vital role they play in donation and transplantation. Hospitals not only facilitate the medical procedures, but are a trusted source of information about donation and state donor registries. Currently more than 123,000 men, women and children in the U.S. are awaiting organ transplants to save their lives. Thousands more are in need of tissue and cornea transplants to restore their mobility and sight. Registering to be a donor can provide hope to those who wait. Help celebrate National Donate Life Month by installing a specially designed web banner on your hospital's intranet to let your staff know we appreciate their contributions and remind them of the importance of registering as organ, eye and tissue donors. The web banners are available for download at

Kaiser Health News, By Shefali Luthra, March 31
Top News from This Week



Carroll Hospital Center, LifeBridge Health Make Affiliation Official
The Baltimore Sun, By Meredith Cohn, March 27


OPINION: Quality Counts
Center Maryland, By Carmela Coyle, March 29


Maryland, D.C. Rank Among Worst States for Doctors
WTOP, By Sarah Beth Hensley, March 30


In Pursuit of Patient Satisfaction, Hospitals Update the Hated Hospital Gown
Kaiser Health News, By Shefali Luthra, March 31


You Can't Always Get What You Want: Just Ask Physician Owned Hospitals

Modern Healthcare, By Paul Demko, March 31

5 Ways to Involve Patients and Families in Achieving the Triple Aim

Fierce Healthcare, By Zack Budryk, March 31