MHA Update Newsletter
June 19, 2015
MHEI Programs & Webinars

June 24

WEBINAR: Empowering Physicians for Population Health


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Transparency in Health Insurance

Under the modernized Medicare waiver, Maryland's hospitals have performed impressively when it comes to holding health care costs in check - 1.47 percent and 2.61 percent growth, respectively, in calendar year 2014 and the coming fiscal year. That's why it raised more than a few eyebrows last month when Maryland's insurers put forth rate request increases of as much as 30 percent for some plans.


Hospitals account for 40 percent of health care spending in Maryland, and there's something that doesn't quite add up when comparing the minuscule cost increases hospitals are seeing with the massive premium increases that insurers are seeking. To address this issue, MHA submitted a letter to the Maryland Insurance Administration asking that insurance regulators reconcile the discrepancy between these two sets of numbers, and testified at a public hearing held by the administration on Wednesday.


One of the primary goals of the waiver, and of the Triple Aim, is to reduce the cost of health care. Insurers that are realizing savings by way of more efficient hospital care ought to be able to pass on at least some of those savings to consumers in the form of reduced premiums. As MHA's letter states, " is critical to demonstrate that the significantly lower rates of growth in total per capita hospital spending be translated into significantly lower rates of growth in insurer premiums as well."


Unfortunately, the state's process to determine insurer rate increases is not as transparent as the one to update hospitals' global budgets. Only those who review the administration's website currently have the opportunity to get a sense of any concerns raised regarding the magnitude of the insurers' requests. A more open approach, similar to the one used by HSCRC, would allow for a full airing of the rationale for the increases and any public concerns about them.


Health care, particularly in Maryland under the five-year demonstration agreement, is a highly complex system, with many players. Each of them, however, serves the exact same clients - patients and communities. And because we all have the privilege of working for the same people, it is their interests and needs that should be at the forefront of any regulatory decisions. 


The evolution of health care is happening in real time, and empowered consumers, informed by a transparent system, will dominate the future. Hospitals have transformed quickly to thrive in this new world by focusing on value, rather than volume. That's something everyone involved in health care should be able to get behind.

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In This Issue
MHA Testifies Before MIA on Insurer Rate Requests
At a June 17 hearing before Maryland Insurance Administration (MIA) Commissioner Al Redmer, Jr., MHA Senior Vice President Mike Robbins raised concerns with the trend assumptions used by commercial insurers in their rate filings for the plan year beginning January 1, 2016. Highlighting the difference in total hospital spending under Maryland's all-payer model and the trends assumed by insurers, Robbins asked Commissioner Redmer to reconcile these differences before taking final action on the insurer requests. Commissioner Redmer has extended the public comment period until July 1 and indicated that the MIA was hoping to announce its final action on the rate requests by the end of July.

Contact: Mike Robbins
MHA to Launch New Website
Keep an eye out June 30 for a redesigned The upgraded website will offer a richer digital experience (geared to any screen, including tablets and phones) that is easier to navigate and more intuitive to search. The new site will make it easier for members to find and access content through the use of keywords that will help narrow queries. We will also offer a few new features, including a Member Forum (for members-only communication between hospital leaders) and a social media feed that showcases the efforts of your hospitals. All current users of the website will be asked to re-register when the new site launches. Look out for more information on the new site and registration instructions.

Contact: Dana Bonistalli
GME Work Group Drafting Report
The Innovations in Graduate Medical Education (GME) Work Group met at the Health Services Cost Review Commission (HSCRC) on June 17 to begin to outline the report it is required to submit to the Centers for Medicare & Medicaid Services (CMS) as part of Maryland's all-payer model. The work group discussed the key themes and takeaways from a May 20 statewide summit that addressed the major goals of the work group for a future GME process to support transformation of the health care delivery system and potentially serve as a model for the rest of the country. Work group members and staff will draft the report and recommendations over the summer and will provide opportunity for public comment in September and October when the draft is complete. The final report is due to CMS by January 1.

Contact: Mike Robbins
Applications Being Accepted for Circle of Life Awards
The Circle of Life Awards, sponsored by the American Hospital Association, honor innovative palliative and end-of-life care in hospices, hospitals, health care systems, long-term care facilities, and other direct care providers. The Circle of Life Awards seek to shine a light on programs and organizations that can serve as models or inspiration for other providers. The 2015 awards are supported, in part, by the California HealthCare Foundation, based in Oakland, California and Cambia Health Foundation.  Major sponsors of the 2015 awards are (along with the American Hospital Association) the Catholic Health Association and the National Hospice and Palliative Care Organization & National Hospice Foundation. The Circle of Life Award is administered by the Health Research & Educational Trust. Applications are available for the 2016 Circle of Life Award and are due August 10
MHEI, Physician Leaders and Population Health
MHEI new logoThe Maryland Healthcare Education Institute is investing in Physician Leadership Development as one of the key strategies to maintain the momentum of the population health movement in Maryland. The MHEI Physician Leadership Initiative begins its second year this September and all but five of the available seats have been claimed.  This initiative, best suited to young leaders, begins the leadership journey with four full days in the fall and three follow-up breakfast meetings the following spring. Concentration is on the basic leadership skills that are not taught in medical school but are valuable when working with a multidisciplinary team in a hospital setting. Registration includes attendance at the MHEI annual conference on population health in the fall following completion of the seven face-to-face meetings.

Contact: Alison Burrows
In Case You Missed It

DHMH, Hopkins Selected as Regional Ebola Treatment Center

The U.S. Department of Health and Human Services has selected nine health departments and associated partner hospitals to become special regional treatment centers for patients with Ebola or other severe, highly infectious diseases. The Maryland Department of Health and Mental Hygiene, in partnership with Johns Hopkins Hospital in Baltimore, will be the center for this region (including Maryland, Virginia, West Virginia, Pennsylvania and Delaware). The regional facilities are part of a national network of 55 Ebola treatment centers, but will have enhanced capabilities to treat a patient with confirmed Ebola or other highly infectious disease. Even with the establishment of the nine regional facilities, the other 46 Ebola treatment centers and their associated health departments will remain ready and may be called upon to handle one or more simultaneous clusters of patients.



Top News from This Week



Hospitals Rake in $1.3 Billion from Medicare Appeals Settlements
Modern Healthcare, By Bob Herman, June 12


How a New Regulation Could Force Maryland Small Businesses to Change Health Insurance Plans
Baltimore Business Journal, By Sarah Gantz, June 15


Funding Source or Transformation Tool? CMS, States Disagree
Modern Healthcare, By Virgil Dickson, June 15


U.S. Payments to Health Insurers Still Lack Verification
The Wall Street Journal, By Louise Radnofsky, June 16


Vote on Md. Health Exchange Call Center Delayed
The Baltimore Sun, By Andrea K. McDaniels, June 16


Optometrists Push for Bigger Role in Managing Chronic Conditions
Modern Healthcare, By Andis Robeznieks, June 16


CareFirst Proposed Premium Increases Unreasonable, Advocates Say
The Daily Record, By Daniel Leaderman, June 17


5 Concerns From AHA on Proposed FY 2016 Inpatient Rule
Beckers Hospital Review, By Emily Rappleye, June 17