June 10, 2016
Maintaining Momentum
In a 4-2 vote Wednesday, the Health Services Cost Review Commission (HSCRC) provided Maryland's hospitals with an average global budget increase of 2.19 percent per capita (a 2.72 percent increase in total revenue) for fiscal year 2017 - well more than the original staff recommendation.
The willingness of the commissioners and staff to move - in a decisive vote and despite intense pressure from payers to actually decrease the update from the original staff proposal - suggests a recognition of the hard work you're doing and of the costs associated with those efforts. Your letters and testimony during this negotiation process were instrumental in helping the commissioners understand what's going on at the ground level.
Thank you for stepping up to share your stories.
While this increase provides a measure of stability for hospitals in fiscal 2017, hospitals must continue to achieve - and even accelerate - the progress that's been made so far, all while limiting the growth in statewide total cost of care and cutting down on unnecessary utilization. Commissioners approved a series of conditions that hospitals must meet (many of you are already engaged in these activities) to receive the full update. While the conditions do not mandate any measurable outcomes, they do call for, among other things: 
  • Monitoring the growth in Medicare total cost of care and total cost of care for a hospital's service area
  • Monitoring hospital performance on potentially avoidable utilization for Medicare and all payers
  • Implementing programs focused on complex and high needs patients with multiple chronic conditions, initially focusing on Medicare patients 
Underlying the commission's decision are critical questions about the future of the waiver; it is here where philosophical gaps between regulators and hospitals must be bridged, especially as negotiations on the next phase of the model begin in earnest. For example: 
  • What is the appropriate pace of change? Hospitals and regulators share the same goals, but diverge on the right path and the right timeline to achieve them.
  • How are we going to measure and create accountability for population health? Hospitals are being held accountable for more than just what goes on within their four walls, but lack reliable measures that are suitable for payment policies.
  • How do we build a shared understanding of what good performance means under the all-payer model? The same data sets can yield wildly different interpretations. Is drawing close to a target a failure or a success? If the vast majority of goals are met and just a single one missed, does that call for drastic action, or minor tweaks? 
These issues and others will be the focus of work going forward, as a unified effort on the part of regulators, hospitals, non-hospital providers, payers and others, will be needed to ensure that the model Maryland is building - one that is increasingly receiving national attention for its innovativeness and success - does not wither.

See you Monday at MHA's Annual Meeting!
If you are attending MHA's Annual Membership Meeting next week, you received an email earlier this week with details on the brand new mobile app we will be using for the first time! We are excited to offer this technology to bring attendees information on speakers, the schedule, sponsors and more. An important change from the printed brochure: our welcome reception at the Four Seasons Baltimore (click here for directions) will begin at 6:30 p.m. (not 6 p.m.) on Monday. The annual business meeting will be Tuesday, June 14 at 8:30 a.m. Two special guests will be joining us at the reception Monday evening: U.S. Senator Barbara Mikulski and State Senator Mac Middleton. And Governor Larry Hogan will be with us Tuesday morning. Please contact Kathy Gotwalt if you have any last minute questions.  We look forward to seeing you!
HSCRC Approves 2.19 Percent Per Capita Update
At its June meeting this week, the Health Services Cost Review Commission approved the amended staff recommendation for an update to global budgets for fiscal year 2017. As reported in this month's edition of Newsbreak, commissioners supported a 2.72 percent total revenue increase (2.19 percent per capita), with a larger portion of the global budget revenue to be allocated in the second half of the fiscal year, to allay concerns about calendar year 2016 Medicare total cost of care growth. Final action was also taken on the recommendations of the commission's uncompensated care policy, Potentially Avoidable Utilization shared savings policy, and competitive transformation grant programs.
MHA, MedStar Health to Host Cybersecurity Forum
Cybersecurity is hitting the headlines lately as hospitals across the country have been victimized by Malware attacks and cyber security breaches, resulting in several hospitals having to pay ransom to gain control of their information technologies.  Locally, MedStar Health was the victim of such a Malware attack, but was able to effectively manage the incident. In order to help their colleagues across Maryland learn from their experience, MedStar will present an in-depth cybersecurity discussion on Wednesday, June 29, at the Maryland Hospital Association's offices in Elkridge. At the forum, MedStar will discuss lessons learned during the March attack, share how they responded and discuss what they are doing to defend against future attempts to breach MedStar security systems. The forum is split into two sessions:  an executive overview for CEOs, CIOs, CMOs, CNOs and CFOs, and a more technical briefing for Information Technology (IT) leaders (CIOs, CISOs, CTOs, Directors) and emergency preparedness leads.  Space is limited - please register for only one of the two sessions.

Executive Overview
Wednesday, June 29, 1 to 2 p.m.
Maryland Hospital Association (MHA)
6820 Deerpath Road
Elkridge, MD 21075

Technical Briefing
Wednesday, June 29, 2:30 to 3:30 p.m.
Maryland Hospital Association (MHA)
6820 Deerpath Road
Elkridge, MD 21075

Contact: Meghan Allen
Changes Coming to PDMP
The Maryland Prescription Drug Monitoring Program (PDMP) was created to support providers and their patients in the safe and effective use of prescription drugs. On April 26, Governor Larry Hogan signed a new law requiring providers to register with and use the PDMP. Changes include:
  • Beginning October 1, practitioners authorized to prescribe Controlled Dangerous Substances (CDS) in Maryland must be registered with the PDMP prior to obtaining a new or renewal state CDS Registration or by July 1, 2017, whichever occurs sooner.
  • Prescribers must start querying the PDMP by July 1, 2018 (with some exceptions).
  • CDS prescribers and pharmacists may now delegate PDMP data access to health care staff, licensed or non-licensed staff, on their behalf.
Click here for a Department of Health & Mental Hygiene fact sheet with more details.
MHA Executive Committee Minutes Available
The minutes from the March Executive Committee meeting are available on the Governance page on our website. Members must be logged in to download the minutes.
Quarterly Financial, Utilization Reports Available
The financial reports for the first quarter of 2016 are now available for MHA members. To access the Accounts Receivable and Combined Financial Trends and Utilization reports, click here.
Contact: Brian Sims
Maryland to Participate in Federal Youth Behavioral Health Program
The Substance Abuse and Mental Health Services Administration has announced that Maryland is one of four states that will participate in its Policy Academy Initiative: Financing Effective, Community-Based Behavioral Healthcare Services and Supports for Youth Diverted from the Juvenile Justice System. The goal is to explore financing options to support community-based services needed to effectively divert youth with behavioral health conditions from the juvenile justice system.  Multidisciplinary teams from all four states will convene to do the following:
  • Discuss challenges to financing community-based services and supports for youth diverted from the juvenile justice system
  • Learn about financial resources currently available to support behavioral health care services and supports for these youth
  • Explore new sources of funding and examine options for financing structures and payment reforms to support diversion efforts for these youth
  • Develop an implementation strategy and formulate action steps 

For questions, contact the National Center for Mental Health and Juvenile Justice at
ncmhjj@prainc.com or 866-962-6455.

MHEI Annual Leadership Conference - October 16 & 17
We are pleased to announce that our annual leadership conference for 2016 will feature Daniel H. Pink, author of the groundbreaking book "Drive."

Prime Offers Guaranteed Savings on Biomedical and Diagnostic Imaging Service Costs
Are you looking for an approach to technology that fixes not just medical equipment, but the workflow and inventory management challenges health care organizations face?

More Mental Health Care Covered By Insurance, but Disparities in Treatment Persist
The share of mental health treatment expenditures financed by private insurance, Medicare and Medicaid increased from 44 percent in 1986 to 68 percent in 2014, according to a study published this week in Health Affairs. 

Monday, June 13
MHA Executive Committee
MHA Annual Meeting Welcome Reception

Tuesday, June 14
MHA Annual Meeting General Session

Thursday, June 16
Carmela Coyle to participate in a panel discussion with the HFMA Women in Leadership
  Session at the Hopkins Club
The Baltimore Sun, By Meredith Cohn, June 2
The Washington Post, By Arelis R. Hernandez, June 3
Hospitals & Health Networks, By Laurie Larson, June 7
The Baltimore Sun, By Bryna Zumer, June 6
The Baltimore Sun, By Meredith Cohn and Sarah Gantz, June 8
The Baltimore Sun, By Michael Dresser, June 8
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