January 22, 2016
Out of the Gate Running
It would be something of an understatement to say that this year's General Assembly session is off to a quick start. Instead of the customary grace period at the outset that many have grown accustomed to over the past few years, by the end of the first two weeks in 2016, legislators had already requested more than 2,000 bills, several of which have required MHA action.
MHA's top three priorities - the Medicaid hospital tax, behavioral health improvements and liability costs - will continue to remain front and center, but since session began just a week and a half ago, several troubling proposals that require rapid attention have popped up. The tip of the iceberg: 
  • A proposal that would criminalize the care delivery process by imposing jail time and fines of up to $100,000 on providers who prescribe medication that is a factor in a patient's death (MHA's submitted testimony is available here)
  • A proposal to compile and publicize the value of hospitals' tax-exempt status juxtaposed with the value of community benefits (this is the first battle of a larger war on hospitals' nonprofit, tax-exempt status)
  • A proposal to mandate that birthing hospitals provide materials related to post-partum education, something hospitals already do
  • A proposal that would mandate, based on medical inflation, a rate increase for behavioral health providers (this is something we'll be watching for in the budget, so that dollars allocated for hospital resources are not redirected) 
While many of these bills will not even get out of committee, the pace and volume of legislation this year is frenetic. That's why MHA will be providing a weekly "Advocacy Dashboard" in Friday's Update newsletter - so you can stay informed of the latest news from Annapolis in a handy, at-a-glance spreadsheet.
The flurry of activity in the first couple of weeks is a sound reminder of the influence that your MHA brings to Annapolis, and of the value of our field speaking with one voice to legislators, regulators and policymakers to offset the many loud and influential voices that by design or accident would frustrate the delivery of health care for those we serve.

At Work in Annapolis
This week was the first full week of the 2016 legislative session. On Wednesday, Governor Hogan unveiled his proposed fiscal year 2017 budget to the Maryland General Assembly. MHA is working diligently to determine the full impact of the governor's budget on Maryland's hospitals. The $25 million reduction in the Medicaid hospital tax is included, but other areas of concern were less clear as of Friday. MHA's understanding at this point is that there is no funding in the governor's budget for Institutions for Mental Diseases (IMDs). Currently, federal funding for IMDs is only guaranteed through September 2016. Additionally, there is $4.8 million in new funding to implement recommendations outlined in the recent Heroin & Opioid Task Force report.
MHA participated in and attended several legislative briefings and hearings this week. This dashboard on our website provides an overview of actions MHA has taken in the past week and a look forward to important hearings and events next week.
AHA Issue Brief Looks at Bundled Payment Initiatives
The Centers for Medicare & Medicaid Services' Bundled Payment for Care Improvement and Comprehensive Care for Joint Replacement initiatives will be important tests of how well Medicare bundled payment efforts can encourage hospitals, physicians, and post-acute care providers to coordinate care to reduce spending and improve quality and the patient experience, according to an issue brief released by the American Hospital Association. The report describes the evolution of bundling within the Medicare program; the opportunities bundling creates for hospitals and post-acute care providers; the challenges providers have encountered in recent initiatives; the issues providers should consider when entering a bundled payment program; and policy considerations associated with a broader expansion of bundling initiatives in Medicare. As Maryland's hospitals work on their own strategies for coordinating care, they can consider the experiences presented in a recent AHA members-only webinar on strategies for redesigning care processes and workflows for success in bundled payment systems. To listen to a replay of this and other webinars in the AHA series on bundled payment best practices, visit www.aha.org/bundling.
Maryland Faith Community Health Network Pilot to Begin
The Maryland Citizens' Health Initiative (Health Care for All!) is making progress in developing the Maryland Faith Community Health Network - a pilot program with LifeBridge Health and dozens of local houses of faith that aims to improve the health of entire communities. In the pilot program, LifeBridge Health employees at Sinai, Northwest and Carroll hospitals will serve as "navigators" and work with "liaisons" from congregations to match up community resources and support with the medical care patients receive. The first in-person training of congregational liaisons is scheduled for February 15. This model was pioneered at Methodist Le Bonheur hospital in Memphis in 2006. The hospital entered into a "covenant" with local faith leaders that committed the hospital to hiring navigators whenever someone from their congregations was admitted to the hospital. The faith leaders agreed to promote the program and provide support to their congregational members when they were discharged from the hospital. The results: a $600,000 hospital investment followed by $4 million annual savings.
New Action Planning Tool for the AHRQ Safety Culture Surveys
The Agency for Healthcare Research and Quality (AHRQ) has released a new Action Planning Tool for the AHRQ Surveys on Patient Safety Culture. After an organization assesses their patient safety culture, this tool will help determine steps needed for making improvements. It provides step-by-step guidance to help develop an action plan to improve patient safety culture. For example, organizations may find it useful to brainstorm the potential barriers that make it difficult to implement initiatives and strategies to overcome them. The Action Plan Template is designed to record the goals, initiatives, resources needed, process and outcome measures, and timelines.
Focusing Effort on Core Issues
Every good senior leader recognizes the value of hospital staff who are dedicated to providing great care.

Reduce Lighting Energy Costs Up to 50 Percent
Lighting accounts for 30 to 60 percent of annual electric costs for many facilities, and many new advances in lighting technology can help your organization conserve energy and save money.

Senate HELP Committee Issues Draft EHR Interoperability Bill, Holds Mental Health Hearing
The Senate Health, Education, Labor and Pensions Committee yesterday released for comment draft legislation aimed at making electronic health records more interoperable. 

Tuesday, January 26
MHA Executive Committee

Wednesday, January 27
MHA Total Cost of Care Work Group meeting
MHA Joint Quality - Finance Work Group meeting
Herald Mail-Media, By Tamela Baker, January 16
The Washington Post, By Shefali Luthra, January 18
The Baltimore Sun, By Erin Cox and Michael Dresser, January 17
Modern Healthcare, By Shannon Muchmore, January 19
My Eastern Shore MD, By Jack Shaum, January 20
The Baltimore Sun, By Erin Cox and Michael Dresser, January 20
The Baltimore Sun, By David Anderson. January 21