September 4, 2015
Not the Way to Treat Our Patients
The federal government's decision to stop a pilot program that helped fund behavioral health treatment in Maryland is causing quite a challenge for hospitals. That's because the state, which had been informed about the funding decision months ago, did not take any budgetary steps to fill the gap, estimated by some to be as much as $20 million a year. Instead, the state has capped payments for those services, and told hospitals not to send patients to Maryland's three institutes for mental disease without first making at least four phone calls to try to place the patient in an inpatient hospital psych bed.
The details of the problem are many and complex, but its crux is simple: The treatment of thousands of Maryland's patients should not be compromised by the state's inaction on funding these critical services. Our job is to get people the right care, at the right time, in the right setting. And if that setting is an institute for mental disease, then that's where they need to be ... not a hospital emergency department while the hospital desperately tries to find an alternative to either Sheppard Pratt, Brook Lane, or Adventist Behavioral Health.
How is MHA working to solve the issue? The state has submitted a request to the Centers for Medicare & Medicaid Services for a waiver to restore federal funding; MHA submitted a letter in support of the application. Earlier, the state's budget cap on treatment for the patients affected by the federal funding was an act that, because it came with no notice, is a clear violation of the Administrative Procedures Act. We have briefed DHMH Secretary Van Mitchell on the overall problem as well as our legal concerns, and we are sincerely hoping that legal action will not be necessary. We also briefed Budget Secretary David Brinkley's team, to look for funding solutions. We updated the Lt. Governor's team, reminding them that this oversight flies in the face of the governor's behavioral health priorities. And we are drafting a letter to Maryland's congressional delegation seeking their support for the waiver that can re-open up the federal funding flow.
It's unfortunate when an issue like this arises and action is not taken in time to prevent problems. It's even more unfortunate that the treatment of patients could suffer. That's why we are working hard and quickly to get this matter solved. 

MHA, MPSC, DHMH Working to Lower C-Section Rate
MHA and the Maryland Patient Safety Center (MPSC) are partnering with the Department of Health & Mental Hygiene on an effort to lower Maryland's high rate of C-sections (Maryland has the seventh highest rate in the country for low-risk births). The decision to have a C-section is typically between mother and doctor, but those decisions aren't always made for medical reasons, and are sometimes based on convenience and other factors. MHA and MPSC will soon introduce to hospitals a resource from the American Congress of Obstetricians and Gynecologists designed to address the issue nationwide and that can be implemented voluntarily here in Maryland.
Contact: Bonnie DiPietro
Health Care for All Report to be Presented to HSCRC
A final report from the HSCRC's Consumer Outreach Task Force, which was led by the Health Care for All Coalition, will be presented to commissioners next week. The report was generated following 11 public forums that were held over the past seven months. More than 800 Marylanders attended the forums, which provided overviews of the modernized Medicare waiver and the care delivery transformation currently underway. Feedback shows that Marylanders are unaware of the state's unique and long-standing status as an all-payer state or of the new state/federal agreement that is further transforming the health system in Maryland. Once informed, however, consumers are eager to be engaged. They want a clear call to action and follow-up steps for ongoing collaboration. The full report can be reviewed here.
Public Launch of kIDsafe Initiative to be Rescheduled
The press conference to kick off the kIDsafe identity theft public awareness campaign, originally scheduled for Thursday, was cancelled out of respect for the funeral proceedings for former Gov. Marvin Mandel. A make-up date, likely in October, is being planned. In the interim, hospitals can continue to provide informational materials to families and to direct them to the new website,, as part of a soft launch for the campaign. The campaign is the result of an issue raised during the 2015 General Assembly session by Del. Craig Zucker, who had heard concerns about child ID theft and turned to hospitals to help inform parents of the proactive measures they can take to prevent it.
Contact: David Simon
Executive Committee Minutes Available
The minutes from the August Executive Committee meeting have been posted to the MHA website.
MHEI's Annual Conference Answers the Question, "WHY?"
Before he agreed to be MHEI's Annual Leadership Conference keynote speaker, Simon Sinek, author of the global best-seller "Start With Why: How Great Leaders Inspire Everyone to Take Action," asked us why we wanted him to lead our population health discussion.

Prime's Value to Member Hospitals
Prime is the shared service/group purchasing subsidiary of the Maryland Hospital Association. Its goal is to help our member hospitals reduce the cost of care.

AHA Supports Proposed Two-Midnight Changes; Opposes OPPS Conversion Factor Cute
The two-midnight policy changes proposed by the Centers for Medicare & Medicaid Services "are a good first step towards resolving some of the problems created by this policy," wrote AHA Executive Vice President Rick Pollack in an Aug. 27 letter to the agency.

MHA's offices will be closed on Monday, September 7 for the Labor Day Holiday

Tuesday, September 8

Maryland Healthcare Education Institute Board meeting
ICD-10 Payer meeting

Wednesday, September 9
Health Services Cost Review Commission monthly meeting

Thursday, September 10
MHA Behavioral Health Task Force meeting

Friday, September 11
3M and HSCRC meeting
The Baltimore Sun, By Meredith Cohn, August 28
WBAL, By Robert Lang, August 30
Delaware Online, By Jen Rini, August 30
The Wall Street Journal, By Joseph Walker, August 31
Fierce Healthcare, By Zack Budryk, August 31
The Washington Post, By Amy Goldstein, September 1
Kaiser Health News, By Jordan Rau, September 3
NPR, By Fred Schulte, September 3