February 5, 2016
The Future of Hospitals Is in
Your Hands
If there was a dominant theme at the American Hospital Association's most recent Board of Trustees meeting last week, it was this: health care in the United States is at a critical evolutionary juncture, and without a firm, proactive response to the myriad forces shaping this environment, hospitals could quickly be left behind.
That might sound a bit ominous, but that's because the stakes are so high - the changes underway are transformative and long-lasting. And hospitals are in a position to either shape their own destiny or become swept along as bit players in a larger movement.
Much of this change is focused on these buzzwords: "volume to value." We all know the underlying concept - that payers, providers and consumers are moving toward a system that rewards quality rather than quantity. But, very quickly, this phrase has become a cliché. Its presence is ubiquitous, but its meaning is diverse or, worse, undefined.
Maryland's hospitals are very much at the leading edge of the shift from volume to value under our all-payer agreement with the Centers for Medicare & Medicaid Services and hospitals' subsequent global budget contracts. Yet just two years into this five-year experiment, there is much debate about how to proceed. Are the early successes sustainable? What policies are needed to continue to improve? And, perhaps most important, what type of health care will consumers need and seek in the next few decades?
If these issues aren't concerning enough, here's one more: the longer it takes hospitals to create their own future by defining "value" to health care consumers, the greater the chance of disruptive enterprises encroaching on a domain that at one time belonged almost exclusively to hospitals. Already, a Tennessee-based company is developing comprehensive, data-driven care coordination capabilities; a New York-based insurance startup is marketing to millenials by offering simple, tech-based health solutions and consumer-friendly interfaces; and Wal-Mart, which operates more than 400 care clinics in 19 states, would be more than happy to provide services traditionally delivered by hospitals, like MRIs.
These challenges are serious, but in no way insurmountable. Hospitals have long histories with their communities and are consistently ranked among the most trusted institutions in the nation. Those are strong fundamentals on which to reinvent our work to meet the needs of a changing and demanding environment. And because Maryland's hospitals have a couple of years of experience with this new model, you're already beginning to develop a sense of what truly works and what resonates with your communities and patients. Those are great advantages going forward.
The AHA meeting was my first as a member of the AHA board, and it was humbling to sit among so many women and men who think critically and seriously about how hospitals can better accomplish their missions. As we progress on this journey together, it will take the united efforts of Maryland's hospital and health leaders to reinvent our hospitals to thrive in the next chapter of health care delivery.

At Work in Annapolis
With the Senate bill introduction deadline today and the House deadline next week, bills continue to pour in by the hundreds. MHA participated in a three-in-one briefing this week before the House Health & Government Operations Committee. President and CEO Carmela Coyle briefed the committee on the all-payer model, the conversion of hospitals to freestanding medical facilities and the report from the work group studying access to hospital obstetrical services. Read more about what's coming up next week in our Advocacy Dashboard.
AHA Offers Zika Resources
The American Hospital Association has made available resources addressing the mosquito-spread Zika virus outbreak that originated in Brazil. The resources include Centers for Disease Control & Prevention interim guidelines for health care providers, a map of infected areas, and additional information from the American Medical Association, the American Academy of Pediatrics, and others.
KEPRO Seeking Peer Reviewers
KEPRO, the Centers for Medicare & Medicaid Services' Beneficiary and Family Centered Care Quality Improvement Organization for Maryland and other states, is seeking peer reviewers to assist them in reviewing Medicare discharge appeals and beneficiary complaints. In order to process these reviews, KEPRO has an extensive Peer Reviewer roster (opportunities are available from all health care disciplines such as advanced nursing, various therapies, and physicians).  

Peer Reviewers:
  • Can use their medical knowledge to improve the quality of health care
  • Enjoy competitive compensation
  • Receive complete confidentiality
  • Have the convenience of reviewing a case at home or at the office
  • Can join a pool of physicians who are leaders in their specialties 
For more information, contact Jessica Whitley, MD, Medical Director, at 216-447-9604, extension 5784, or email Jessica.Whitley@bfcc3.hcqis.org
Birth Injury Fund Hearing Scheduled
A joint hearing of the General Assembly's Health and Government Operations and Judiciary committees on the establishment of a birth injury fund has been scheduled for 1 p.m. February 12.
If you'd like to submit written testimony on this issue, please contact MHA Director of Government Relations Pete Baron. If there are physicians, nurses or other staff who would like to attend the hearing, please share this information (details about the hearing and the bill are available here) with them.
MHA Comments on Medicaid Methadone Re-bundling
MHA recently responded to Medicaid's Behavioral Health Unit's proposal to unbundle and reduce reimbursement rates for the administration of methadone at opioid treatment programs. In a letter to the Department of Health & Mental Hygiene, MHA mentioned its concerns for possible unintended, negative results on access to substance use disorder services. MHA is concerned that the proposal, which would unbundle the methadone maintenance service and lower the reimbursement rate for the medication administration portion of the service, could cause several Opioid Treatment Programs to cease operations, creating a situation where access to important services would become severely limited for a very vulnerable population. MHA asked the state to review and revise the proposal in order to protect access to the treatment programs.
Mark Your Calendars for MHA's Annual Meeting
MHA's Annual Membership Meeting will be held June 13 and 14 at the Four Seasons Hotel in Baltimore.

Speakers have been confirmed and we are offering an exciting lineup, including: 
  • Patrick Kennedy, former member, U.S. House of Representatives and a leading political voice on mental illness
  • Larry Sabato, political analyst and author and founder and head of the University of Virginia's Center for Politics, and an expert on presidential elections 
Be on the lookout for the full brochure and registration information coming soon. Click here to see the save-the-date brochure.
Questions? Contact Kathy Gotwalt.
Constant Change Demands Leader and Staff Resilience
While the prospect of moving toward population health is exciting and full of opportunities, it also demands much of our staff. This may be especially true of staff who are not involved with new initiatives but are working every day to care for patients in the traditional manner.

Prime Offers Guaranteed Savings on Biomedical and Diagnostic Imaging Service Costs
Are you looking for an approach to technology that fixes not just medical equipment, but the workflow and inventory management challenges health care organizations face?

Reminder: Hospitals Can Preview Overall Star Ratings, Other Quality Data Through Feb. 14
Hospitals participating in CMS's inpatient and outpatient quality reporting programs can preview their overall hospital quality star rating through February 14 at the QualityNet Secure Portal.

Tuesday, February 9
MHA's Council on Clinical and Quality Issues meeting

Wednesday, February 10
MHA's Total Cost of Care Work Group meeting
Health Services Cost Review Commission meeting

Thursday, February 11
MHA's Financial Technical Work Group meeting
My Eastern Shore MD, By Jacob Owens, January 29
The Baltimore Sun, By David Anderson, February 1
The Daily Record, By Daniel Leaderman, February 1
Kaiser Health News, By Barbara Feder Ostrov, February 2
The Daily Record, By Daniel Leaderman, February 2
Baltimore Business Journal, By Tina Reed, February 2
The Baltimore Sun, By Erin Cox, February 3
Baltimore Business Journal, By Sarah Gantz, February 4