June 24, 2016
Seeking Assurances on Insurance
All of the work that you are doing to transform health care in Maryland by working more efficiently, partnering with local organizations, cutting down on potentially avoidable utilization, and helping people and communities stay healthy is for naught if it does not translate into better care and lower costs for Marylanders.
Better care? Check. You're doing the right things to get people the right care, at the right time, in the right setting. Just look at hospitals' impressive performance on the waiver metrics. Lower costs? You're certainly delivering on that front as well: total hospital growth through April of fiscal year 2016 was just 2.02 percent per capita, according to HSCRC. For the fiscal year that begins July 1, 2016, HSCRC approved total hospital cost growth of 2.72 percent. And these trends are not fading: between now and June 30, 2017, hospital costs will grow annually by 2.5 percent, less than half of the highest requested insurance increases.
So, why aren't consumers benefiting? Why are insurers asking for rate increases of as much as 30 percent for 2017? With insurers realizing savings as a result of your hard work to control the rate of growth in both spending and utilization, one would expect at least some of those savings to be passed on to individuals enrolled in their plans. After all, isn't affordability one of the key reasons we have a new waiver?
Last year, the hospital field helped save Marylanders nearly $70 million by advocating for lower health insurance premium increases that were more in line with the lower-cost trends being experienced by hospitals. It's time to do it again. Washington, D.C. does not parallel Maryland, but it is telling when the D.C. insurance commissioner won't let CareFirst raise rates there until it complies with a plan installed two years ago to spend on health services $56 million of a $1 billion surplus.
Maryland Insurance Commissioner Al Redmer, Jr. last year heeded MHA's call for a more open process, no longer leaving public information to those who stumble across the MIA website, but opting to create a more open process so legitimate questions can be raised and rates are not boosted in a public vacuum. MIA will hold a public hearing on the requests at 10:00 am Wednesday, July 6 at the MIA's Baltimore office. A summary of the requests can be found at http://www.healthrates.mdinsurance.state.md.us/Default.aspx. Public comments are being accepted through next Wednesday, June 29 at healthinsuranceratereview.mia@maryland.gov.
MHA's comment letter to the Maryland Insurance Administration is on our website, and available by clicking here. It has the key arguments you can tailor to your own comments. But the key message is this: Hospitals are doing their part to keep costs down; why aren't consumers benefiting?

AHA Features Coyle on Quality Award
MHA President and CEO Carmela Coyle this week was featured in the American Hospital Association's weekly publication AHA News on MHA being named the 2016 winner of the Dick Davidson Quality Milestone Award for Allied Association Leadership. The award, named for AHA President Emeritus and first MHA president Dick Davidson, is presented each year to a state, regional or metropolitan hospital association that demonstrates leadership and innovation in quality improvement. The winner also must contribute to national health care improvement efforts. You can read the interview here.
End-of-Life Council Accepting Applications
The Governor's Appointments Office (GAO) is accepting applications from those interested in being appointed to the Advisory Council on Quality Care at the End of Life. The council meets four times a year at the Department of Health and Mental Hygiene's Office of Health Care Quality in Catonsville. Applications are being accepted for the following seats: 
  • One physician with experience in end-of-life care
  • One pharmacist with experience in end-of-life care
  • One physician with experience managing long-term care
  • One nurse with experience managing long-term care
  • One representative of the health insurance industry
  • One representative from a managed care organization
  • One representative of the legal community
  • A representative from advocacy groups for end-of-life care
  • A representative from religious groups
  • Two representatives of the general public with experience with end-of-life or long-term care issues
  • One representative of the hospital industry
  • One representative of the nursing home industry 
Applications may be submitted via the GAO website, http://govappointments.maryland.gov/ through August 9. Click here for more information on membership criteria and duties.
Register for Health Cybersecurity Forum
There's still time to register for an in-depth cybersecurity discussion at MHA's offices next Wednesday, June 29. The forum will be presented by MedStar Health, which was the victim of a Malware attack earlier this year that they were, fortunately, able to effectively manage. The headlines have been full of stories lately of other hospitals across the country also being victimized by these Malware attacks and cyber security breaches and many had to pay a ransom to regain control of their information technologies. 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 security systems. The forum is split into two sessions: an executive overview for CEOs, CIOs, CMOs, CNOs and CFOs at 1 p.m., and a more technical briefing for information technology leaders (CIOs, CISOs, CTOs, Directors) and emergency preparedness leads that begins at 2:30 p.m. 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
Sepsis Collaborative Enrolling Participants
Earlier this year, VHQC (Maryland and Virginia's Quality Improvement Organization), in partnership with the Maryland Patient Safety Center (MPSC) and MHA, launched "Stopping Sepsis in Long-Term Care." The collaborative broadens the scope of the "Improving Sepsis Survival Collaborative," led by MPSC with 21 hospitals throughout the state. The project aims to reduce mortality rates, hospitalizations and health care costs by implementing infection-prevention strategies and treating residents with infections before they become septic. The collaborative is still enrolling new facilities. Senior quality leaders and executives are encouraged to contact skilled nursing facility (SNF) partners, particularly those that may be a source of readmissions due to infections or sepsis, and encourage them to join if they haven't already done so. Interested SNF partners should contact Candace Hamner at chamner@vhqc.org.
MHEI's Annual Conference Prompts Leadership Thinking
Conference keynoter Daniel Pink is the author of five thought-provoking books about the changing world of work. Given Maryland's leadership position in the evolving world of health care delivery, Pink has much to offer to hospital leaders.

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.

Survey Highlights Hospitals' Progress, Opportunities to Increase Equitable Care
Hospitals are making progress to achieve health equity, but more work needs to be done, according to a biennial benchmarking survey released this week by the AHA's Institute for Diversity in Health Management.

Tuesday, June 28
A Breath of Fresh Care Press Conference

Wednesday, June 29
MHA Joint Quality-Finance Work Group meeting (conference call)
Joint MHA/MedStar Cybersecurity Forum
Capital Gazette, By Amy Rubino, June 19
The Baltimore Sun, By Meredith Cohn, June 18
CBS Baltimore, By Tracey Leong, June 19
The Washington Post, By Ariana Eunjung Cha, June 20
CBS Baltimore, June 20
The Baltimore Sun, By Meredith Cohn, June 22
The Baltimore Sun, By Meredith Cohn, June 22
The Baltimore Sun, By Meredith Cohn, June 22