October 30, 2015
All in the Family
Last week, I drove south on Route 2 to Prince Frederick to meet former Calvert Memorial Hospital President & CEO Jim Xinis for lunch. I hadn't seen Jim in a while, and the drive for me was full of anticipation. Jim has been battling an aggressive lymphoma for more than a year-and-a-half and hadn't been up for social calls lately.
The purpose of my visit was twofold. First, I wanted to hand Jim MHA's Lifetime Achievement Award, which was announced at the annual meeting in June that his treatment prevented him from attending. Second, I wanted to catch up with my friend, a man I respect as a person and admire as a health care pioneer. 

I'm more than pleased to let you know that Jim's latest test results show his cancer is in complete rem
ission, a remarkable outcome considering that his prognosis wasn't always sunny. 

My time with Jim reinforced a belief that I've held since I began my tenure at MHA more than seven years ago:  your hospital association is more than a forum to haggle over payment policies, debate quality metrics or develop legislative priorities. It is, as well, a family. That word can become cliché - how many times when a pro football team is winning do you hear the word uttered, until the losing streak sets in? But for us as a field it seems appropriate, through all the ups and downs.
MHA's role in this family has always been one of convener - bringing together hospital and health care leaders from throughout the state, each with valuable ideas and perspectives about the challenges and opportunities we face together. Earlier this month, I had dinner with three recently appointed hospital leaders - Cynthia Kelleher, President & CEO of the University of Maryland Rehabilitation & Orthopaedic Institute, Dean Teague, President & CEO of Calvert Memorial Hospital and Erik Wangsness, President of Washington Adventist Hospital.
These types of gatherings are immensely important. The better MHA understands your views, the better we can meet your needs in an ever-changing environment. And like Thanksgiving dinner with our own families, discussions among MHA members can sometimes be lively and heated, but in the end, we know that we are stronger together.
That bond will be especially important as we embark on the next phase of the Medicare waiver's implementation, with the prospect of non-hospital health care providers being brought into the fold. Doctors, skilled nursing facilities, home health services and others must be on board for this experiment to prove a success over the long term. But there is no doubt that hospitals will be relied upon to once again lead the way, so we must remain united.
My visit with Jim served as an important reminder that, even with all that is before us, once in a while it is good to step back from the intensity of our daily tasks and just appreciate each other. Because the friendships we make and the support we provide one another as we work so hard to take care of people enrich us in ways that go beyond boardroom success.

MHA Offers Clarity on IRS Reporting
As we discussed during our weekly member call yesterday morning, MHA engaged the law firm Ober/Kaler to help clarify for Maryland's hospitals new IRS reporting rules for charitable, tax-exempt hospitals. Specifically, the task was to look at the differences in federal and state rules. A memo that contains background information and a side-by-side analysis of the state and federal requirements are available here.
Contact: Mike Robbins
Birthing Hospitals Drop Free Formula
The Department of Health & Mental Hygiene (DHMH) announced yesterday that all 32 of Maryland's birthing hospitals are free of infant formula marketing in the form of company-sponsored discharge bags. Maryland is only the fourth state in the nation to make this change, joining Rhode Island, Massachusetts and Delaware in strengthening support for women who choose to breastfeed. According to the DHMH announcement, "studies show that mothers who receive formula samples are less likely to breastfeed exclusively and that overall breastfeeding durations are shorter compared with mothers who do not receive the samples." The elimination of formula discharge bag giveaways brings Maryland's birthing hospitals in compliance with this best practice of DHMH's hospital breastfeeding policies and with the World Health Organization's International Code of Marketing of Breastmilk Substitutes.
Rules Change for Home Health Value-Based Purchasing
This week, the Centers for Medicare & Medicaid Services (CMS) released final 2016 payment rules for home health agencies (HHAs).  These rules include the requirement that all Medicare certified HHAs in nine states, including Maryland, take part in the home health value-based purchasing initiative (HHVBP).  Similar to the hospital value-based purchasing program, the HHVBP is part of CMS' ongoing efforts to tie reimbursement dollars to quality performance, and HHAs will have a payment adjustment of 3 percent (upward or downward) starting in 2018 based on their performance on a series of metrics in 2016. This program is expected to save Medicare an estimated $380 million over the next six years.
Contact: Justin Ziombra
MHA Opposes Eligibility Changes for 340B
MHA this week submitted a comment letter on the Health Resources and Services Administration's (HRSA) proposed 340B drug pricing program omnibus guidance. The guidance proposes, among other things, to change the eligibility definition for 340B covered patients and covered outpatient drugs. In its letter, MHA urged HRSA to reconsider major aspects of its proposal and noted the particularly detrimental impact any narrowing of the program would have on Maryland's hospitals.
Contact: Maansi Raswant
Maryland Gets Grant for Behavioral Health Clinics
Maryland has been awarded $982,373 by the Department of Health & Human Services to establish Certified Community Behavioral Health Clinics (CCBHCs) and a Medicaid prospective payment system for their services. CCBHCs aim to improve somatic and behavioral health by utilizing a patient-centered approach for community-based mental and substance use disorder services. There are a core set of mandatory services CCBHCs must offer including, but not limited to, 24-hour mobile crisis teams, outpatient mental health and substance use services, and screening, assessment, and diagnosis. MHA supported the state's application. To read the announcement from the Substance Abuse and Mental Health Services Administration, click here
MHA Gathering Regulatory Reform Input
MHA is gathering suggestions from hospital leaders to submit ideas for regulatory reform. Responses to our online tool will be presented to Gov. Larry Hogan's Regulatory Reform Commission on an ongoing basis. This commission is examining ways to make the state more efficient. The form asks that you designate a category, provide a brief description of the issue and then offer a potential solution. The form can also be accessed from MHA's home page, www.mhaonline.org.
Hospitals Reminded to "Pledge to Act"
At the beginning of October, MHA committed to the National Call to Action to Eliminate Health Care Disparities Equity of Care Campaign and we asked every hospital in Maryland to participate. As of this week, 38 percent of Maryland's hospitals have pledged to select a quality measure to stratify by race, ethnicity, and language preference. (MHA will soon provide each hospital in Maryland with a handful of quality measures that have already been stratified by race, ethnicity and language.) Hospitals also will determine whether a health care disparity exists and, if so, implement a plan to address that gap. Those signing the pledge also agree to provide cultural competency training for staff. Read more about the Equity of Care campaign and sign up to "pledge to act" here
MHA Executive Committee Minutes Available
The minutes from the September Executive Committee retreat are available on the Governance page on our website. Members must be logged in to download the minutes.
Atlantic General Honored for Health Literacy Efforts
Atlantic General Hospital has received the Maryland Rural Health Association's 2015 Outstanding Rural Health Program award for its Integrated Health Literacy Program. The program is a collaboration with Worcester County Public Schools and the Herschel S. Horowitz Center for Health Literacy at the University of Maryland and has developed health literacy standards for elementary and middle school educators to integrate into lesson plans. The program is currently implemented in grades one through five and has so far reached 37 percent of the student population. The award, presented at the Rural Health Conference this week, was accepted by Atlantic General President & CEO Michael Franklin and Health Literacy Liaison Chelsea Leonard.
Population Health Generates Additional Leadership Programming
This fall, MHEI provided population health training for nurse leaders (Population Health and the Role of Nursing), Case Managers (Case Management as a Population Health Strategy), and Senior Leaders (MHEI Annual Leadership Conference).

PRIME Offers Capital and Construction Solutions
Prime, through its affiliation with MedAssets, would like to introduce you to MedAssets Capital and Construction Solutions, which deliver end-to-end capabilities to help you complete successful, on-time and on-budget construction or renovation projects.

CDC Reports Increase in Fentanyl-Related Overdoses
The Centers for Disease Control and Prevention (CDC) and the Drug Enforcement Administration (DEA) are investigating recent increases in overdose fatalities related to fentanyl, a synthetic opioid 50 to 100 times more potent than morphine, according to a CDC advisory this week. 

Monday, November 2
MHA Corporate Affiliate Member meeting

Tuesday, November 3
Joint Quality-Finance Work Group meeting
Carmela Coyle presents at the Nexus Health Annual Public meeting on
  "The Future of Health Care and How Hospitals Can Get in on the Forefront" in Fort Washington

Wednesday, November 4
MHA Fall Briefing

Thursday, November 5
Waiver Phase II Work Group meeting
Carmela Coyle presents at the Maryland Association of Adult Day Services Annual
  Conference at Turf Valley
NPR, By Audi Cornish, October 23
The Washington Post, By Josh Hicks, October 26
Modern Healthcare, By Virgil Dickson, October 26
Modern Healthcare, By Shannon Muchmore, October 27
Baltimore Business Journal, By Tina Reed, October 27
The Frederick News-Post, By Rebecca Savransky, October 28
The Washington Post, By Lenny Bernstein, October 28
Healthcare Dive, By Heather Caspi, October 28