December 4, 2015
No Challenge Too Great
It might have gotten lost in the holiday shuffle last week, but there was some important and welcome news from the March of Dimes organization about Maryland's progress toward protecting moms and babies by reducing the number of early elective deliveries.

Last week, the Maryland Patient Safety Center was notified by the March of Dimes that the state was the first in the country to have 100 percent of its birthing hospitals reduce the rate of early elective deliveries to less than 5 percent for six consecutive months.

Congratulations to all of our birthing hospitals!

This news came on the heels of an initiative launched in September that brought together the state Department of Health & Mental Hygiene, MHA and the Maryland Patient Safety Center to reduce the number of non-medically indicated Cesarean deliveries. The initiative has adopted strategies recommended by the American College of Obstetricians and Gynecologists, Society of Maternal Fetal Medicine, Joint Commission and U.S. Department of Health and Human Services.

The progress documented by the March of Dimes is especially noteworthy because Maryland's Cesarean delivery rate had been among the highest in the country, accounting for 35 percent of births, compared to 21 percent nationally. This positive news means better health and better care for Maryland's mothers and their newborns.

After more than seven years leading MHA, Maryland's hospitals never cease to amaze me in what they can accomplish when their collective strength is rallied behind a clear vision. Whether it's maintaining more than 90 percent hand hygiene compliance (up from 71 percent when the program began in 2010), this recent achievement on C-sections or shifting 95 percent of all hospital revenue to global budgets within six months, Maryland's hospitals are proven and committed innovators.

Indeed, it seems that no challenge is too great. Your track record of creative thinking and problem-solving in service to your patients and communities will be our greatest asset as we continue to lead the evolution of health care in Maryland and the nation.

DHMH Seeking Members for Dual-eligible Patients Work Group
The Department of Health and Mental Hygiene (DHMH) and the Health Services Cost Review Commission are seeking volunteers to participate on a new work group designed to inform the state's dual eligible care delivery strategy. The work group is being created following Maryland's award of State Innovation Model funding to design innovative payment and care delivery models. The work group, which will consist of representatives from hospitals, the physician community, and long-term care and behavioral health providers, will discuss ways to coordinate care delivery for individuals dually-eligible for Medicaid and Medicare. The work group will serve as a forum for DHMH to present its vision and receive feedback and guidance from stakeholders. The attached letter details how to apply to participate. If you are interested in becoming a member, you must apply before December 11, 2015
Opioid Report Calls for Changes Affecting Hospitals
The Heroin and Opioid Emergency Task Force this week released its final report, which includes the following recommendations that may affect hospitals and their behavioral health initiatives:
  • Phasing in mandatory registration and querying of the Prescription Drug Monitoring Program
  • Requiring insurance carriers to provide prospective enrollees with updated provider directories for the enrollee's health benefit plan
  • Transitioning inmates to outpatient addictions aftercare and community providers and applying for health insurance upon release
  • Developing a pilot program with the Department of Health & Mental Hygiene, local hospitals, skilled nursing facilities, rehabilitation centers, and law enforcement that establishes a full continuum of substance use disorder services in a target area
The report also references hospitals' commitment to implementing opioid prescribing guidelines, the experience of which will be examined in the spring. MHA has resources for hospitals regarding the use of Emergency Department Opioid Prescribing Guidelines here.
Regulatory Reform Report Includes CON Recommendation
Gov. Larry Hogan's Regulatory Reform Commission's initial report, released this week, includes a recommendation for the administration to streamline, review or eliminate the Certificate of Need for Health Care Facilities (CON) process and a Department of Human Resources regulation on adult guardianships or protective services. The commission, tasked with finding ways for Maryland government to be more efficient and responsive to residents and businesses, also discussed high air ambulance rates, and occupational safety and health regulations that might affect hospital workers. If you have ideas for the commission, you can submit them here.
OB Work Group Recommends Birth Injury Fund
The Maryland Work Group to Study Access to Obstetric Services, led by MHA, released its recommendations in a report this week. The recommendations encompass three areas: improving access, promoting better health, and improving available data. The report also recommends a No-Fault Birth Injury Fund, one of MHA's three top priorities in the coming legislative session
AHA Seeking Committee Members
The American Hospital Association is seeking hospital and health system trustees to help develop national health care policy. Appointments are available on AHA's Committee on Governance and on Regional Policy Boards. Applications are due February 24. To qualify, applicants must be associated with an AHA institutional hospital/system, have a minimum of three years of trustee experience by January 2017 and be the sole candidate from an organization. Community advisory and foundation board members may apply. Approval of appointments will take place in the fall. If you have any questions, contact AHA's Rita Harmata at
Population Health for Managers
As we continue to think through the implications of population health it becomes apparent that we'll need the full engagement of our management teams if we are to be successful to the extent that we are thriving and not just "getting by." 

Prime's Value to Member Hospitals
Prime is MHA's shared service/group purchasing subsidiary. Its goal is to help our member hospitals reduce the cost of care.
Working with Prime directly benefits hospitals. Each year, revenue from Prime is sent to MHA to support advocacy efforts that improve the overall health care environment in Maryland. These revenues are critical to MHA's work on issues like the Medicare waiver and the elimination of the onerous Medicaid tax.

CMS Extends Deadline for Submitting Electronic Clinical Quality Measure Data
The Centers for Medicare & Medicaid Services has extended to December 31 the deadline for submitting electronic clinical quality measure data for eligible hospitals participating in the Hospital Inpatient Quality Reporting program voluntary electronic reporting option.

Tuesday, December 8
MHA Council on Clinical & Quality Issues meeting
Maryland Healthcare Education Institute Board meeting

Wednesday, December 9
HSCRC meeting

Thursday, December 10
Financial Technical Work Group meeting
- FY 2017 Uncompensated Care Policy Work Group meeting
The Washington Post, By Josh Hicks, December 2
The Baltimore Sun, By Editorial Board, December 2
The Baltimore Sun, By Meredith Cohn, December 1
The Baltimore Sun, By Meredith Cohn, December 1
The Wall Street Journal, By Christopher Weaver, Anna Wilde Mathews and Tom McGinty, December 1
Modern Healthcare, By Steven Ross Johnson, November 28
Global Budgeting Webcasts Slated
The Johns Hopkins Bloomberg School of Public Health, in collaboration with MHA and the American Hospital Association's Hospitals in Pursuit of Excellence, is providing a webcast series over several upcoming weeks on Global Budgeting for Hospital Services. Today's webcast will feature John Chessare, MD, president and CEO, Greater Baltimore Medical Center, Vincent DeMarco, president, Maryland Healthcare for All! Coalition, and Jonathan Blum, executive vice president, CareFirst BlueCross. The webcast, titled Across the Care Continuum, is at 1 p.m. and can be viewed HERE.
The final session is:
  • The Future from the Federal Perspective (Dec. 18, 11:30 a.m.): Featuring Patrick Conway, MD, acting principal deputy administrator, deputy administrator for innovation and quality, chief medical officer, Centers for Medicare and Medicaid Services (CMS).
Previous Sessions (video available here):
  • Global Budgeting in Your Neighborhood (Nov. 24): Featuring Darrell Gaskin, PhD, associated professor, Johns Hopkins Bloomberg School of Public Health
  • Case Study (Nov. 13): Featuring MHA's President and CEO, Carmela Coyle, along with Carroll Hospital CEO Leslie Simmons
  • The Maryland Experience (Nov. 5): Featuring Health Services Cost Review Commission Chairman John Colmers and Executive Director Donna Kinzer