MHA Update Newsletter
June 26, 2015
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Trust and the Triple Aim

A quick fact: nationwide, medical doctors make up about 5 percent of hospital leadership. Here in Maryland, that number is a bit higher, a little more than 12 percent. For these men and women who straddle the CEO and physician worlds, the new era of value-driven rather than volume-driven care may be a bit easier to navigate


The main problem in transitioning to value-based care has been one of incentives. In a traditional fee-for-service model, the incentives for physicians and hospitals worked in concert. But now, with Maryland's hospitals operating under fixed annual budgets yet physicians still paid by the case, the incentives have diverged.


MHA has been working on a physician gainsharing program similar to the ones in place in New York and New Jersey, but there's more to cracking this puzzle than just a financial fix. True change, so the reality of hospital-physician relationships matches the rhetoric of value-based care and progress can be made toward the Triple Aim, will be based on six principles of integrated leadership put forth jointly by the American Medical Association and the American Hospital Association. Briefly, the six are: 

  • Physician and hospital leaders who share: values and expectations; aligned incentives; goals across the board with appropriate means of measuring them; responsibility for financial, cost and quality targets; accountable service line teams; strategic planning; and a focus on engaging patients as partners
  • A structure incorporating all disciplines and supporting collaborative decision-making between doctors and hospital executives, with physicians maintaining their clinical autonomy
  • Hospital and clinical leadership integrated at all levels of the health system, including nursing and other caregivers, participating in all key management decisions
  • Collaborative, participatory and trust-based partnership, as well as interdependence and a thrust toward achieving the Triple Aim
  • Transparency of both clinical and business information, across the entire enterprise
  • An IT system that allows clinicians to capture and report quality and performance data of all participants, with leadership holding its workforce accountable for those measurements 
I had the opportunity to help shape these principles through AHA's Regional Policy Board and each is critical for success when health care systems focus on the quality, rather than the quantity, of care. As hospitals and physicians embark on a new path together, these principles will be an important part of boardroom conversations, as will the constant reminder that, ultimately, hospitals and physicians share the same goals for their patients and communities.
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In This Issue
MHA Marks New Waiver's First Year with Articles, Resources

To mark the first year of results under Maryland's revised Medicare waiver, MHA next week will distribute to hospital leaders several resources to use in discussing the milestone, and has submitted two written pieces for publication in Health Affairs and The Baltimore Sun. These resources were shared with hospitals' public relations leads this week. The items include: 

  • An article that has been submitted to Health Affairs' blog
  • An op-ed that has been submitted to The Baltimore Sun
  • A press release that will be disseminated to Maryland media on Monday, June 29
  • Talking points for you to use should you get media calls following the press release
  • A PowerPoint presentation that may be of assistance when discussing the first year of the waiver with trustees or the public 

Contact: David Simon

DHMH, HSCRC Memo to Hospitals Describes Population Health Support, Funding
The Maryland Department of Health & Mental Hygiene and the Health Services Cost Review Commission this week sent a memo to hospitals on the agencies' recent work to support hospitals' population health efforts. The memo highlights the availability of technical assistance and educational events addressing care coordination and provider alignment, and the opportunity to apply for transformation implementation funding in fiscal year 2016. The memo also includes important clarifications about upcoming reporting requirements.
New MHA Website Launches Tuesday

A redesigned launches Tuesday, June 30 and MHA is looking forward to providing hospital leaders and their teams with a revised site that is easier to navigate, more intuitive to search, and mobile-friendly. We will also offer some new features, including a Member Forum (for members-only communication between hospital leaders) and a social media feed that showcases the work of your hospitals. All current users of the website will be asked to re-register when the new site launches. Watch Monday and Tuesday for more information on the new site and registration instructions.


Contact: Dana Bonistalli
Sinek to Keynote MHEI Conference
MHEI new logo

Simon Sinek, author of the global best seller, "Start with Why: How Great Leaders Inspire Everyone to Take Action," will be the keynote speaker at MHEI's 2015 Annual Leadership Conference in October. Sinek asks us to consider the following questions: 

  1. Imagine a world where people wake up inspired to go to work
  2. Imagine a world in which trust and loyalty are the rule rather than the exception
  3. Imagine a world where we feel safe at work 
If this is not the culture that exists in your organization then how are you going to be efficient, effective and competitive as we all struggle to move forward in the world of population health? Join your health care colleagues as Sinek engages with conference participants to explore recreating organizational culture into one that supports and leads your population health initiatives. All senior level staff are invited to the conference so bring the team who can take the information from the conference and use it to enhance the work that has already begun.

Contact: Alison Burrows
The Week Ahead

Monday, June 29

Quarterly 3M/HSCRC meeting


MHA offices will be closed July 3 in observance of Independence Day

In Case You Missed It

Requested Health Insurance Premium Increase in Md. Unjustified
The Baltimore Sun, By Leni Preston, Carmela Coyle, June 24

Health insurance companies in Maryland are asking the state for premium increases that are way out of line with the actual cost of providing health care and it's the people who pay for that care whose wallets would be hit hardest. Last week, Maryland regulators considered drastically steep and widely varying increases in health insurance premiums that are being proposed by the state's health insurers. The state's largest insurer, CareFirst, is asking for rate hikes that would raise by more than 30 percent the cost of a policy for people purchasing health plans at the state's health benefit exchange, Maryland Health Connection. This contrasts with much smaller increases - even decreases - proposed by other insurers. If CareFirst's rates are approved, a 40-year-old Baltimore-area non-smoker would pay $134 more each month for the lowest-cost preferred provider silver plan from CareFirst compared to Kaiser's comparable plan. ...


Read Full Article


Top News from This Week



In-Home Senior Care Program Saved Medicare $25M
Fierce Health Payer, By Leslie Small, June 19


Program Helps Caregivers Under Stress After Errors
The Baltimore Sun, By Jonathan Pitts, June 21


Hogan's Cancer is Advanced, But There's 'Reason to be Optimistic'
The Baltimore Sun, By Meredith Cohn, Scott Dance, and Andrea K. McDaniels, June 22


Hogan's Illness Raises Lieutenant Governor's Profile
The Daily Record, By Adam Bednar, June 22


Hospital Cost of Uninsured: $900 Per Patient, Per Year
Modern Healthcare, By Melanie Evans, June 23


Baltimore Health Commissioner Leana Wen Doesn't Sleep, Works Harder Than You Do
Baltimore Business Journal, By James Briggs, June 24


Nonprofits Want Seniors to Stay Healthy and at Home
The Daily Record, By Daniel Leaderman, June 19