July 24, 2015
No Summer Breaks from Legislative Vigilance

This week, the Maryland Health Care Commission (MHCC) work group studying self-referral laws for physicians held its second meeting, discussing how participation in shared savings programs or enhanced quality reporting could be conditions for new exceptions to existing law. At the table were seven hospital representatives - a number that is worth noting because the initial composition of the group had just three.


The expanded representation on this important panel is the result of work that your MHA is doing to remain vigilant against efforts - even when the General Assembly isn't in session - to undermine your ability to provide quality, efficient care to your patients and communities. A recent and ongoing push to loosen self-referral regulations is among them.


As you know, during the past legislative session we were able to fend off legislation that would have watered down self-referral laws related to oncology radiation therapy services and CT services, and potentially cast doubt on the intentions of physicians' decisions. But supporters of this endeavor are regrouping and reinforcing to make another push in 2016.


The report from the work group, due to MHCC in the fall and to the House Health & Government Operations Committee in December, will be a factor in next year's debate. That's why it was so critical to ensure that the group included a greater voice for hospitals, and to augment our argument that doctors and others should make decisions based on the needs of patients and not on the potential for financial gain.


To build the case for next year, MHA is working to help legislators fully understand that this is not a local effort among local provider businesses, but rather a well-funded national effort by large corporations that want to get a foothold in the Maryland market. It has little if anything to do with what's best for the care Marylanders receive.


In addition, MHA is helping lawmakers understand the straw-man "access" argument that proponents have put forward. They argue, for example, that some patients have to travel several hours from home to receive the care they need. But, in fact, 42 hospitals throughout the state currently offer radiation therapy services, and some have already begun free transportation programs for patients who live in more remote areas.


But this won't be enough. MHA will continue to need your help to tell your legislators the real stories of how Maryland's hospitals are providing for those who need these services, and how, unlike those outsiders who seek to dilute longstanding and effective state safeguards, you have the interests of Marylanders and their health care at heart.

MHA Releases Two Tools for Partnership Development
MHA has released the Home Health Agency Partnership Development Guide (modeled on the Skilled Nursing Facility Partnership Development Guide, which was released in May) along with the Post-Acute Care Market Profile. Together these documents can support hospitals' efforts to identify, develop, and strengthen formal and informal partnerships. The Home Health Agency publication contains quality and cost measure data, including all-cause readmissions rates, on all Medicare-certified agencies in Maryland.  The Market Profile offers a clear picture of not only which partners hospitals are referring patients to, but also how much referrals to individual SNFs and HHAs contribute to the market shares of those SNFs and HHAs. The information in these documents can help organizations better understand their relationships with post-acute partners and may be used to request regular meetings, encourage greater collaboration/information sharing, and develop shared innovative procedures.
MHA to Host Meeting on ICD-10 Transition
MHA will host a meeting on the transition to ICD-10 with 3M and the Health Services Cost Review Commission on August 19, from 9 a.m. to 11:30 a.m. at MHA's Elkridge offices. The meeting also will be simulcast via webinar for those who can't attend in person (register here). The goal is to help hospital staff better understand how the transition from ICD-9 to ICD-10 will be addressed for the Maryland Hospital Acquired Conditions (MHAC) payment policy. The meeting is the result of quarterly meetings MHA has been convening to request changes to the grouper logic used in the MHAC program. Quality leads, infection preventionists, senior coding professionals and any others who coordinate complication reductions are invited to attend. For more information contact Justin Ziombra at jziombra@mhaonline.org or 410-540-5056.
State Seeks Federal Funds for Behavioral Health

Maryland's Behavioral Health Administration is applying for as much as $2 million in federal funds from the Substance Abuse and Mental Health Services Administration to develop Certified Community Behavioral Health Clinics. The clinics would help hospitals address long-term behavioral health issues in designated communities. If awarded, the grant requires Maryland to select and certify at least two clinics -- one in an urban area and one in a rural area. The clinics must use a patient-centered approach that focuses on the provision of community-based mental and substance use disorder services; support the continued integration of behavioral health with physical health care; use evidence-based practices; and improve access to care. Up to eight states will be selected to participate in the demonstration program.


Contact: Jennifer Witten
AHRQ Tool Shows Effect of Medicaid Expansion on Hospital Use
A new online tool from the Agency for Healthcare Research and Quality shows state-level trends in hospital stays for adults with Medicare, Medicaid, private insurance and the uninsured. The Fast Stats tool allows users to examine hospital stay information for about 40 states. Because it includes at least one quarter of 2014 data for 17 states, it can be used to analyze the effects of Medicaid expansion and other Affordable Care Act provisions on hospital utilization levels and payment sources, the agency said. The tool includes hospital stay information for diabetes, asthma and congestive heart failure as well as broad condition categories. Additional conditions will be added over time and updated as new data become available.
Sinek to Keynote MHEI Conference

The keynote presentation at the Maryland Healthcare Education Institute's annual Leadership Conference on Oct. 18 and 19 concentrates on a key population health issue that hasn't yet received much attention: How to create the right work environment to succeed in the world of population health.

Improve Patient Access Management

With increasingly changing reimbursement models and high-deductible health plans forcing patients to shoulder more payment liability, health systems must improve their registration and financial clearance to ensure up-front cash collections, reduce front-end denials and improve patient registration efficiencies to maintain patient satisfaction.

House Subcommittee Approves Bill to Address Newborn Opioid Dependency

The House Energy and Commerce Health Subcommittee this week approved the AHA-supported Protecting Our Infants Act (H.R. 1462).

Thursday, July 30
Carmela Coyle presents to Anne Arundel Medical Center Board on waiver and MHA priorities

What Do You Do When Your Prescription Costs $34,000 a Year?

The Washington Post, By Michael Ollove, July 20


Baltimore County to Charge for Ambulance Rides; Change Could Raise $26M Annually

The Baltimore Sun, By Pamela Wood, July 20


States May Tap Hospitals to Help Pay for Medicaid Expansion in 2017

Modern Healthcare, By Virgil Dickson, July 21


State to Recoup $45 Million It Paid to Build Failed Health Exchange

The Baltimore Sun, By Meredith Cohn and Andrea K. McDaniels, July 21


On-Demand Doctor Apps Bring Uber Approach to Medicine

ABC News, By Matthew Perrone, July 22


Medicare Trust Fund Outlook Unchanged

Modern Healthcare, By Shannon Muchmore, July 22