Hospitals in Maryland are in the midst of a tectonic shift, moving from volume to value and from taking care of patients to taking care of communities, all in a new world of global budgets. Health care is changing, hospitals are changing, expectations are changing. It's time for the way hospital revenues are updated to change as well.

A little less than a year ago, Maryland's hospitals received their largest annual rate increase (2.41 percent) since 2009. That hike was the product of the modernized Medicare waiver and some tough negotiations, and reflected a recognition that hospitals had been coping with below-inflation increases for several years.

Ahead of negotiations on a global budget update for the coming fiscal year, hospitals know that new thinking is needed on revenue increases, because you need resources to not only succeed under the waiver's short-term requirements, but also sustain that success for years to come.

With 95 percent of Maryland hospital revenue now governed by global budgets, the financial risk of caring for an unknown number of patients with unpredictable care needs within those fixed budgets has been wholly transferred to hospitals. The new update must reflect this risk and provide adequate funds for hospitals to invest in programs that will mitigate the risk by providing short- and long-term financial predictability.

We have been meeting with commissioners and staff to help them understand why HSCRC must take a broader, macro, multiyear approach to its regulation of the all-payer model. The new waiver agreement is working and the early successes - including a 16 percent reduction in potentially avoidable utilization and $90 million in savings to Medicare - are replicable and sustainable if we provide the necessary investment - not just in care coordination infrastructure, but more broadly in the hospitals, doctors and nurses, community resources and more that are needed to sustain that infrastructure.

This will be a challenging negotiation. As soon as the ink dried on the modernized Medicare waiver agreement, hospital CEOs and trustees had to overhaul their understanding of their role in this new world of global budgets. We're working with HSCRC commissioners and staff to help them better understand the new, highly experimental world in which hospitals are working.

MHA's annual meeting will be held at the Four Seasons Hotel on June 1 and 2 and is designed for senior leaders of Maryland's hospitals.

Topics for this year's breakout sessions were selected after feedback from hospital leaders, including those who participated in last year's sessions. In the breakout sessions you will hear from colleagues who have valuable lessons to share on three issues essential to success in this new era of care; sign up for one of the three when registering:

* Creating Community and Consumer Partnerships

It's one thing to provide care in a new way; it's another to help those we serve understand what the new era of health care means to them, and to how we take care of them and their families. Learn what consumers have told us about both, and how creating community partnerships can open the lines of communication and understanding.

Presenters:

Leni Preston, Chair, Maryland Women's Coalition for Health Care Reform

Steve Raabe, Founder and President, OpinionWorks

Vincent DeMarco, President, Health Care for All

* HEZs and House Calls

Meeting the needs of people who require more care than others is a significant part of population health management. Hospitals that are leading Health Enterprise Zones are reaching patients before they end up in the emergency department; other hospital-led programs are making sure doctors, nurses, social workers and others are all connected when caring for elderly patients at home.

Presenters:

K. Eric DeJonge, M.D., Director of Geriatrics, MedStar Washington Hospital Center

Victoria Bayless, President and CEO, Anne Arundel Medical Center

Christine Crabbs, Manager of Health Promotion, Anne Arundel Medical Center

* The Move to Population Health: Is It Working?

Patient-Centered Medical Homes, capitation, Accountable Care Organizations, employee wellness initiatives...all are designed to improve access and quality, increase satisfaction and reduce costs. Are they working? Hear from, and talk with, the people who are leading these large-scale efforts.

Presenters:

Chet Burrell, President & CEO, CareFirst BlueCross BlueShield

Kim Horn, President, Kaiser Foundation Health Plan of the Mid-Atlantic States

Carolyn Clancy, M.D., Interim Under Secretary for Health, U.S. Department of Veterans Affairs

Click here to view the annual meeting brochure.

Contact: Kathy Gotwalt

The Maryland Healthcare Education Institute has offered leadership and management education for hospital leaders for years, but with ever-evolving managerial roles in health care organizations, MHEI is working to connect young leaders between the ages of 25 and 40. On Wednesday, June 24, from 4 - 6 p.m. at Baltimore's Waterfront Kitchen, MHEI will host a free gathering of Maryland health care's young leaders so that they can connect with MHEI and network with their peers at other organizations. MHEI's goal is to assist all health care organizations in their efforts to improve through better information, education and leadership. If you know someone who like to attend, contact Mark Rulle.