July 1, 2016
A Breath of Fresh Care
For those of you whose life's work is dedicated to helping others, there are moments that bring you back to the heart of why you choose to work at a hospital. When I visit Maryland's hospitals, I often see these small, telltale signs peppered through their halls - handwritten letters, Hallmark cards, flowers - thanking your caregivers for tending to those in need. It's a heartwarming reminder of why what you do is special.
Now it's my turn to say thank you.
Over the past two-and-a-half years, spurred by a modernized agreement with the Centers for Medicare & Medicaid Services, hospitals have been transforming health care delivery to better serve their patients and communities. Those words, "transforming health care delivery" are tossed around quite a bit, but it's truly more than just a catchphrase. It's the real work that you're doing to care for people so they need fewer emergency department visits, so that they can live healthier lives, so that they can know their health care system is there for them when they need it.
We've dubbed this change "A Breath of Fresh Care," for Maryland - because not only is what you are doing different, but it has a very real impact on people's lives. Last week, I sent an email to hospital CEOs with information about our new A Breath of Fresh Care public engagement campaign to engage health care consumers in this transition.
In the meantime, thank you.
Thank you for working through the internal adjustment that it has taken to shift your organization's focus from volume to value.
Thank you for reaching out to your trustees, political leaders, staff, patients and communities to explain how their hospital is changing for the better.
Thank you for being patient with state and federal regulators who don't immediately grasp the scope of change that you're effecting and how quickly you're moving.
Thank you for returning the focus of your hospital to where it should always be: on patients and communities.
Thank you for showing the nation that the Triple Aim is indeed achievable.
Most of all, thank you for bringing hope and healing to all Marylanders by reminding them that hospitals are trustworthy community institutions that have their interests at heart. In other words, by bringing them "A Breath of Fresh Care."

U.S. News to Acknowledge Maryland Differences in Ratings
U.S. News and World Report this week announced that the magazine's upcoming hospital ratings will use claims data collected by HSCRC in lieu of data from the Centers for Medicare & Medicaid Services (CMS) when calculating patient safety indicators. The change, advocated for by MHA in a September letter to the magazine, "will result in a more equitable comparison between hospitals in Maryland and those elsewhere, because CMS data from Maryland hospitals have historically contained incomplete present on admission (POA) information, which is a key component of calculating the PSIs," the announcement says. State reporting is more rigid than national, thus making HSCRC data more complete when compiling present-on-admission diagnosis coding. "To maximize comparability between Maryland hospitals and hospitals in other states, we will only use HSCRC data for Medicare patients; non-Medicare Maryland patients will be excluded from our 2016 analysis," the announcement added. Please contact Nora Hoban with any questions.
MHA and Others Launch Breath of Fresh Care Campaign
As MHA President and CEO Carmela Coyle mentions above, the new Breath of Fresh Care campaign was launched this week with a press conference at MHA. Our partners in this effort are the Maryland Faith Health Network, AARP Maryland, NAACP, and the Young Invincibles. Representatives from each spoke as this important campaign was launched. A Breath of Fresh Care is a consumer engagement campaign to help Marylanders learn how they can participate in keeping themselves healthy and out of the hospital. The effort involves printed rack cards that we will ask hospitals to display for their patients and a video that is available for hospitals to play in their waiting areas and on their websites. The video can be downloaded at the Breath of Fresh Care website at breathoffreshcare.org.
Speaking at the "Breath of Fresh Care" news conference this week were, clockwise from upper left, MHA President & CEO Carmela Coyle, Young Invincibles National Training Director Erin Hemlin, AARP Maryland State Director Hank Greenberg, Maryland State Conference NAACP President Gerald Stansbury, and Maryland Citizens' Health Initiative President Vincent DeMarco. Not pictured is Gwynne Oak Methodist Church Pastor Dellyne Hinton. Image credit: Maryland Faith Health Network
Press Coverage from Breath of Fresh Care Launch
Skilled Nursing Facility Spending Reports Available
New reports summarizing hospital-specific skilled nursing facility (SNF) spending and other trends were included in the financial metric component of this month's MHA dashboard report. Last year, Maryland's hospitals exceeded the national growth rate on Medicare all-provider spending per beneficiary. Under the terms of the state's waiver, this cannot happen for two consecutive years. SNF spending is one component of this measure and we will continue to release reports such as these on other components such as home health use. These reports, which depict spending and volume trends for those patients who utilized SNFs within 30 days of a hospital discharge, can provide insight to hospitals as they consider how best to work with partners to manage the health of their patients. Please contact Nora Hoban with any questions. 
Summary Infection Reports Available for Hospitals
Hospital-specific summary infection reports are now available on MHA's website. These summary infection reports are targeted towards senior quality leaders and executives, and are meant to be a companion to the more detailed infection reports that are released monthly and geared towards infection preventionists. The reports, updated quarterly, are made possible by rights conferred to MHA to the data reported to the Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network. The summary reports display standardized infection ratios relative to prior period performance and relative to the thresholds used for Maryland's quality-based reimbursement program, the state program that incentivizes hospitals' infection reduction by placing significant revenue at risk. The careful monitoring of these data are important in light of the CDC's recent National and State HAI Progress Report, which showed an unfavorable collective performance by Maryland's hospitals. Please email Justin Ziombra with any questions.
AHA Cybersecurity Alert
In order for hospitals to effectively prepare and manage cybersecurity risks, they must be aware of new and emerging threats and vulnerabilities. The American Hospital Association (AHA) is working with the Federal Bureau of Investigation (FBI) and other federal agencies to share important cybersecurity intelligence so that hospitals are informed of significant threats that may affect the health care sector.
The FBI has asked the AHA to share with members the following document:
  • Private Industry Notification - Master Decryption Key Released for TeslaCrypt Ransomware Versions 3.0 and 4.0 Note: You must be logged into the AHA members-only cybersecurity webpage to review this document.
In addition, because of the sensitive nature of the information contained in this document, please share it only with colleagues who have a valid need to know, including your chief information security officer, chief information officer, chief technology officer, legal counsel and others who are critical to your cybersecurity efforts. No portion of this document should be released to the media, posted to public-facing websites, or transmitted over non-secure, external communications channels or otherwise made publicly available.
For additional AHA resources on cybersecurity, visit www.aha.org/cybersecurity. Questions should be directed to AHA Assistant General Counsel Lawrence Hughes at lhughes@aha.org or (202) 626-2346, or AHA Vice President of Policy Chantal Worzala at cworzala@aha.org or (202) 626-2313. 
Medicare Providers to be Reevaluated
In accordance with the Patient Projection and Affordable Care Act, all new and existing Medicare providers must be reevaluated under new screening guidelines. The Centers for Disease Control's (CMS) Medicare Administrative Contractors (MACs) are sending notices to all providers/suppliers selected for revalidation 2-3 months in advance of their revalidation deadline. However, due to contact information that may be wrong or outdated, the MACs are not able to reach all providers/suppliers. CMS maintains a "Revalidation Due Date List" available at https://data.cms.gov/revalidation. The revalidation list is updated periodically and displays the due dates for providers/suppliers who need to revalidate within the next 6 months. It is extremely important to note, a provider/supplier is still responsible for revalidating by their deadline even if the MAC's notification attempts are unsuccessful. More information on revalidations, including MAC contact information and frequently asked questions can be found at http://go.cms.gov/MedicareRevalidation
Mount Washington Partnership Marks 10 Years
Mt. Washington Pediatric Hospital (MWPH) today officially celebrates ten years under the joint ownership of the University of Maryland Medical System and Johns Hopkins Medicine. In MHA's Annual Report from 2006, a spokesperson for MWPH wrote, "The hospital is now jointly owned and equally owned by the University of Maryland Medical System and the Johns Hopkins Health System. This unprecedented partnership is of great significance to our hospital, our community and - most importantly - the children and families we serve.  Our association with two leading academic medical centers will bring additional distinction and attention to our vital work strengthening our institution in many ways." MWPH provides post-acute care in inpatient, outpatient and day treatment settings. Of the approximately 800 inpatient admissions, 45 percent are from Hopkins-related facilities and 30 percent are from UMMS-related facilities. In addition, 60 percent of the hospital's outpatient clinics and diagnostic studies involve doctors from the partner institutions.
MHEI Taps Institute for Healthcare Improvement
One of the featured speakers at MHEI's Annual Leadership Conference in October will be Trissa Torres, MD, senior vice-president at the Institute for Healthcare Improvement (IHI) and the person responsible for implementing IHI's North American strategy.

Prime Offers Solutions for Market Analyses, Intelligence and Forecasting
Prime's affiliate, MedAssets, has acquired Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services. Sg2 delivers an easy access platform of predictive analytics and consulting services that helps more than 1,400 hospitals and health systems - from small community hospitals to large integrated delivery networks - understand current and future market dynamics and capitalize on opportunities for growth and performance.

Hatch Issues Paper to 'Jumpstart' Stark Law Reform Discussion
Senate Finance Committee Chairman Orrin Hatch (R-UT) this week released a white paper examining potential reforms to the physician self-referral law to remove barriers that prevent moving to alternative payment models.

Thursday, July 7
MHA Council on Legislative and Regulatory Policy meeting

MHA's offices will be closed Monday, July 4 for Independence Day.

The Baltimore Sun, By Carrie Wells, June 24
The Baltimore Sun, By Michael Anft, June 24
The Baltimore Sun, By Andrea K. McDaniels, June 27
WMDT, By David Caldwell, June 27
The Baltimore Sun, By Brian Witte, June 28
The Baltimore Sun, By Andrea K. McDaniels, June 28
The Baltimore Sun, By Meredith Cohn, June 29
Becker's Hospital Review, By Brian Zimmerman, June 29