December 11, 2015
Cutting the Red Tape
Last week, Gov. Larry Hogan's Regulatory Reform Commission released its initial 30-page report, taking aim at revising existing regulations to make Maryland more business-friendly. Included in the report are a number of recommendations that could affect hospitals, such as tasking the administration with streamlining, reviewing or eliminating the Certificate of Need for Health Care Facilities (CON) process. The report suggests the same consideration for a Department of Human Resources regulation on adult guardianships or protective services.
I'm appreciative of the governor's work to create the commission and take a hard look at some of the longstanding practices that, while well-intentioned, may now be outdated and often stymie progress in myriad fields. Hospitals in particular may benefit from this progressive thinking, as health care in Maryland has been in the throes of massive and rapid transformation.
The modernized Medicare waiver is nearly two years old and early data suggest that under its guidance, hospitals are making great strides toward better quality and lower costs.
But as we begin discussing how to sustain this progress in the long term, there are many factors to consider. We do know that at least one thing will be certain - hospitals will need a regulatory and legislative environment that enables them to operate in a nimble and flexible manner, so that the means needed to deliver care can change in accordance with new data, the shifting needs of whole populations, and technological and care delivery innovations.
One example of how MHA is working to improve this environment - in this case through the legislative process - is an effort now underway that would allow hospitals to convert outdated hospital buildings to Freestanding Medical Facilities - streamlined satellite branches of parent hospitals that provide local access to services like emergency care, medical observation, outpatient surgery and diagnostics - without going through a lengthy CON process. This will be an issue during the upcoming session of the General Assembly.
The Regulatory Review Commission is expected to take several years to complete its work (if you have ideas, you can submit them here) and it will take time to implement any changes. In the meantime, the commission shines a spotlight on the needs of organizations - particularly regulated ones like hospitals - to be provided the ability to rapidly adapt to the needs of those they serve. That in itself is a victory for our patients and communities.

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MHA's 2016 Annual 
Membership Meeting

June 13 and 14, 2016
Four Seasons Hotel, Baltimore

HSCRC Approves Jobs Program Funding
At this month's Health Services Cost Review Commission (HSCRC) meeting, commissioners approved a revised recommendation for the Health Jobs Opportunity Program, setting aside up to $10 million in rates effective July 1, 2016, to be matched by up to $5 million by hospitals that voluntarily agree to participate in the program. As further reported in this month's edition of Newsbreak, commissioners also discussed a draft recommendation for the Maryland Hospital Acquired Conditions program for fiscal year 2018 (performance of calendar year 2016).
Webinar on Total Cost of Care Set
MHA Vice President Brett McCone and Health Services Cost Review Commission (HSCRC) staff next week will begin a series of webinars to share Maryland's Medicare performance under the All-Payer model. The first webinar is Friday, December 18, from 11 a.m. to 12:30 p.m.
During the first webinar, presenters will summarize Maryland's performance in calendar years 2014 and 2015 on the Medicare hospital savings target and the Medicare statewide total cost of care guardrail. The data provided by the Center for Medicare & Medicaid Innovation to HSCRC on a monthly basis will be reviewed, along with the data source and validation process. Speakers will also present the detailed Medicare hospital and total cost per beneficiary calculations, including the underlying Medicare Part A and Part B components, and the hospital and non-hospital components of the total cost of care measure. Finally, the Maryland and national growth rates in hospital and total cost of care spending will be examined, including the trend from the base period to the current year-to-date 2015 performance.
Future webinars will dive deeper into underlying data, by service and by geography, and a process for providing more detailed data on a regular basis will be developed.

CFOs and other financial leads should expect to receive an email in the next few days with dial-in details on the webinar.
NICU TeamSTEPPS Webinar Scheduled
The Agency for Healthcare Research & Quality (AHRQ) will host a webinar January 13 from 1 p.m. to 2 p.m. on the use of TeamSTEPPS to improve quality and safety in the Neonatal Intensive Care Unit (NICU). The webinar, "TeamSTEPPS in the NICU and the Role of Leaders in the Process," will feature Jim Rost, M.D., medical director of quality, patient safety in the NICU at Shady Grove Medical Center, and Jennifer Ustianov, M.S., B.S.N., R.N., senior director of the National Institute for Children's Health Quality, in Boston. Their presentation will focus on the planning, implementation and sustainment of TeamSTEPPS in the NICU, and will highlight the facilitators and barriers to implementation associated with leadership involvement and support.
Specifically, the webinar will:
  • Discuss the identification of a need for and the implementation of TeamSTEPPS in the NICU
  • Discuss the importance of leadership (organizational and physician) involvement and buy-in in the implementation, planning and execution
  • Present results of the implementation
  • Discuss sustainment strategies and how leadership has played a role in this aspect of the work. 


There is no cost to participate. Click here to register.

CMS Video Reviews ICD-10 Coding Basics
The Centers for Medicare & Medicaid Services has released a video reviewing ICD-10-CM coding basics. On the video, Nelly Leon-Chisen, director of coding and classification at the American Hospital Association, and Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association, review valid versus invalid codes, coding examples and resources, and how to submit coding questions. Health care claims must include ICD-10 codes for medical diagnoses and inpatient hospital procedures under a final rule that took effect October 1. For more on the transition to ICD-10, visit and
Leveraging Population Health Leadership
As we heard at the recent MHEI Leadership Conference, the move toward population health demands a certain leadership resolve.

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.

Report: Access to Care Improving, but State Variation Persists
The uninsured rate declined in 42 states in 2014, and adults in 21 states were less likely to go without care due to cost, according to a new report from the Commonwealth Fund.

Tuesday, December 15
MHA Council on Financial Policy meeting
Joint Quality-Finance Work Group meeting
Maryland Healthcare Education Institute Board meeting

Wednesday, December 16
MHA Operations Committee meeting (conference call)
Behavioral Health Task Force meeting
Total Cost of Care Work Group meeting
The Baltimore Sun, By Meredith Cohn, December 6
The Daily Record, By Bryan P. Sears, December 7
The Washington Post, By Tara Bahrampour, December 6
The Daily Record, By Daniel Leaderman, December 8
The Daily Record, By Daniel Leaderman, December 8
Baltimore Business Journal, By Sarah Gantz, December 9
Washington Business Journal, By Tina Reed, December 10
Global Budgeting Webcasts to End Dec. 18
The Johns Hopkins Bloomberg School of Public Health, in collaboration with MHA and the American Hospital Association's Hospitals in Pursuit of Excellence, has provided a webcast series over the past several weeks on Global Budgeting for Hospital Services. The final session is Dec. 18 and will feature Patrick Conway, MD, acting principal deputy administrator, deputy administrator for innovation and quality, chief medical officer, Centers for Medicare and Medicaid Services (CMS). The webcast, titled The Future from the Federal Perspective, is at 11:30 a.m. Dec. 18 and can be viewed HERE.
Previous Sessions (video available here): 
  • Across the Care Continuum (Dec. 4): Featuring 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
  • 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