October 2, 2015
A Call to Action


Maryland is changing. And fast.


The state is on track to be 50 percent minority by 2019. And by 2040, it's estimated that minorities will outnumber non-Hispanic whites by about 1 million people. Already, Maryland is the seventh most diverse state in the nation.


But our rich diversity is not reflected in the board rooms and C-suites of Maryland's hospitals. Nor is it reflected in the health outcomes of the people we care for.


African-Americans in Maryland, for example, have a lower life expectancy than whites, and their infant mortality rate is nearly three times greater than that of whites. While our mission of course doesn't change based on the race or ethnicity of our patients, there's something amiss here.


There's also something we can do about it. Earlier this month, MHA committed to the National Call to Action to Eliminate Health Care Disparities Equity of Care Campaign, launched by five national health care associations (American College of Healthcare Executives, American Hospital Association, Association of American Medical Colleges, America's Essential Hospitals and Catholic Health Association of the United States).


I would like to see every hospital in Maryland participate. Click here to sign your pledge.


The campaign's goals are in concert with ongoing efforts to eliminate health disparities, reflect our communities and achieve the Triple Aim. And all this must be done under global budgets - that means effective management of the health of populations, a task that requires understanding each community's unique makeup and needs.


Already a handful of Maryland's hospitals have joined. By participating, your organization would agree to:


   Choose a quality measure to stratify by race, ethnicity and language preference (to jumpstart this effort, MHA will soon send to each hospital a handful of quality measures that we have already stratified by race, ethnicity and language)

   Determine whether a health care disparity exists, and if so, implement a plan to address the gap

   Provide cultural competency training for all staff or finalize a plan to ensure staff receives cultural competency training

   Have a dialogue with the hospital board and leadership team on how the organization reflects the community it serves, and what actions can be taken to address any gaps if the board and leadership do not reflect the community


Not only do these commitments support work we're already doing, but they also demonstrate to the public and elected leaders that hospitals take this issue seriously. To help, MHA has developed a new web resource to connect you with the information and tools you need to make this campaign a success.


It seems like every other day, hospitals are asked to track something new, or direct resources to another initiative, but this one's different - it can help us use existing information to get to the very heart of our service to those who need healing and those who provide it. Put simply, this is the right thing to do for the diverse communities we serve.

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MHA's 2016 Annual 
Membership Meeting

June 13 and 14, 2016
Four Seasons Hotel, Baltimore 

Help Available on Transition to ICD-10
The transition to International Classification of Diseases, 10th Revision (ICD-10) began this week and MHA wants to make sure you are aware of several sources of assistance.
  • Medicare activity: The Centers for Medicare & Medicaid Services (CMS) named Bill Rodgers, M.D., the ombudsman to help providers with the transition. CMS's ICD-10 resources, which include a "latest news" tab, are online. In an email to the field, Dr. Rodgers said that "Your first line for help for Medicare claims questions is to contact your Medicare Administrative Contractor." Providers can also email the ICD-10 Coordination Center or email the ICD-10 Ombudsman directly. CMS also is providing resource at its Road to 10 website, which connects providers with the appropriate Medicare Administrative Contractor to discuss claims.
  • Maryland Medicaid: dhmh.ICD-10@maryland.gov is the program's dedicated email address for ICD-10 issues, in addition to the Medicaid helplines (for professional services, 410-767-5503; for institutional services, 410-767-5457). When raising concerns with Amerigroup, MedStar Family Choice, ValueOptions, and CareFirst, continue to use the same contact that your staff uses on day-to-day issues. Click here for United Healthcare's online resource.
  • MHA activity: MHA hosted two meetings to connect hospitals with regulators and payers on the transition to ICD-10. September 8 featured panelists from private payers as well as representatives from Novitas, Medicare's administrative contractor, and Maryland Medicaid. The discussion provided the financial staff, billing leads and coders in attendance details about various payers' billing processes during the transition. A meeting summary is here (you must log on to mhaonline.org). September 11 featured representatives from the Health Services Cost Review Commission and 3M, discussing how the transition would affect the calculation of potentially preventable complications in the Maryland Hospital Acquired Conditions payment program. Meeting materials can be found here. MHA will schedule a follow-up meeting within the next two months to answer questions and address concerns that may arise after the new system is underway. Your MHA contact on ICD-10 is Senior Vice President, Policy & Data Analytics Nora Hoban (nhoban@mhaonline.org).
Executive Committee Discusses Waiver, Approves Legislative Priorities
At its meeting last week, MHA's Executive Committee focused on planning for the next phase of Maryland's Medicare waiver, with discussion centering on hospitals' experience with Phase I and the process for working with the Health Services Cost Review Commission on Phase II. The committee discussed and approved MHA's legislative priorities for the 2016 legislative session, as well as the continuation of data collection for certain quality and patient safety activities. The committee also heard details of a national equity of care initiative that MHA has joined and is encouraging all hospitals to participate in as well (see Carmela Coyle's Update message in today's edition for more information). Meeting minutes will be available on the MHA website next week.
Marylanders Can Window Shop 2016 Health Plans
Open enrollment at MarylandHealthConnection.gov begins in a month, but Marylanders can "window shop" the 2016 health plans and prices now. Without having to create an account first, Marylanders can shop and compare 53 available plans, including 18 silver plans, from five carriers (CareFirst BlueCross BlueShield, Kaiser Permanente, Evergreen Health, UnitedHealthcare and Cigna). Anonymous browsing for dental coverage will be added later this month. Open enrollment for 2016 qualified health plans official begins Nov. 1 and ends Jan. 31, 2016.
CMS Funds Nursing Home Sepsis Project
The Centers for Medicare & Medicaid Services has funded a Virginia Health Quality Center (Maryland's quality improvement organization) project to reduce instances of sepsis coming to hospitals from nursing homes. Under the Maryland Patient Safety Center's (MPSC) Sepsis Collaborative, the project will work with the 20 Maryland skilled nursing facilities that send the most sepsis patients to hospitals. The CMS funding will help nursing homes employ effective early detection screening tools and best practices for the early treatment of sepsis. The program will also work with MPSC to provide opportunities for the 17 sepsis collaborative hospitals to work with the nursing homes. 
Population Health Requires Skilled Leaders
While the planning of population health strategies is occurring at the top of many organizations, operationalizing those strategies takes place at all levels of leadership.

Prime Offers Solutions for Market Analyses, Intelligence and Forecasting

Prime's affiliate, MedAssets, has acquired Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services. Sg2 delivers an easy access platform of predictive analytics and consulting services that helps more than 1,400 hospitals and health systems - from small community hospitals to large integrated delivery networks - understand current and future market dynamics and capitalize on opportunities for growth and performance.

AHA-Supported Bill to Standardize Merger Review Process Advances

The House Judiciary Committee this week voted 18-10 to approve the Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act, AHA-supported legislation that would standardize the merger review process so that the Federal Trade Commission would be required to rely exclusively on the federal courts to determine the competitiveness of a merger or acquisition.

Tuesday, October 6
- Joint Quality Finance Work Group meeting
The Wall Street Journal, By Laura Landro, September 27
The Wall Street Journal, By Dr. Robert M. Wachter, September 27
The Baltimore Sun, By Meredith Cohn, September 29
Brookings, By Stuart M. Butler, Jonathan Grabinsky and Domitilla Masi, September 28
The Baltimore Sun, By Meredith Cohn, September 2
Capital Gazette, By Elisha Sauers, September 29
The Baltimore Sun, By Andrea K. McDaniels, September 30
The Baltimore Sun, By John-John Williams IV, September 30