The Coffee Klatch Gang

The “Coffee Klatch Gang” meets occasionally at The Johns Hopkins Club to discuss problems and other matters of mutual interest, particularly those affecting Baltimore area hospitals. The group is composed of chief executive officers—Dr. Edwin Crosby, of The Johns Hopkins Hospital; Harvey Weiss, of Sinai Hospital of Baltimore; P.J. MacMillen, of Baltimore City Hospitals; Dr. Merrill Stout, of Women’s Hospital; Bob Hoyt, of West Baltimore General Hospital; Doug Coleman, of Blue Cross, who was succeeded by Reg Dabney; and other administrators. The group informally represented hospitals’ best interests, particularly before the state legislature and other government agencies.

The Baltimore Hospital Conference

Organizes to work on problems arising from relationships with Blue Cross, the conference also attempts to improve primitive accounting systems, work on relationships with health professionals, and more. Without funds or staff members, the conference later disbands.

The Hospital Council

Established with Ralph B. Murphy as full-time executive and Margaret Jones as secretary, one of the council's aims is to deal effectively with Blue Cross on behalf of its member hospitals. At the time, Blue Cross provided office space for the group and a substantial portion of its budget. Despite this precarious relationship, the council whittles away at the financial problems of hospitals posed by both Blue Cross and state government programs.

Baltimore Hospital Council Hospital Survey

A hospital survey reveals the inadequacies of the greater Baltimore area hospitals in terms of their physical plants, financial conditions, accessibility, and availability. Published by the Baltimore Hospital Council, the study results garner recognition that a statewide council of hospitals is needed to deal with growing problems due to their Blue Cross relationships and increasing federal and state involvement.

The Hospital Council of Maryland

The Hospital Council, which serves Baltimore hospitals, becomes a statewide organization—The Hospital Council of Maryland.

Group Purchasing Program

The program is established to offer group purchasing for hospitals throughout the Mid-Atlantic region.

Maryland Healthcare Education Institute

The Maryland Hospital Education and Research Foundation Inc. launches to provide leadership, regulatory, and quality-related training and consultative services. The foundation is known as the Maryland Healthcare Education Institute.

Blue Ribbon Task Force

Reacting to the likelihood of future chaos in the state as a consequence of internal deficient planning, leadership and action, the Hospital Council of Maryland appoints a blue ribbon task force. The group studies the existing association organization and recommends changes to assist members collectively. The mission: To assure all Maryland hospitals provide for all people the highest quality health services in the most efficient and effective manner possible.

First CEO, Dick Davidson

The Maryland Hospital Association welcomes first Chief Executive Officer, Richard “Dick” Davidson.

First Board Chair, Sherburne Walker

MHA appoints first Board Chair: Sherburne B. Walker, of Anne Arundel Medical Center.

Hospital Council of Maryland Is Dissolved

Maryland Hospital Association Is Incorporated

Hospital Rate Regulation

Maryland General Assembly passes act that lays the foundation for hospital rate regulation with three goals: constrain hospital cost growth; ensure that hospitals have the financial ability to provide efficient, high-quality services; and ensure hospitals’ revenue is generated equitably.

Uniform Set of Cost Centers

State Uniform Accounting and Reporting System implemented, requiring that direct costs, revenue and prescribed output measures be submitted according to a uniform set of cost centers. The combination of financial and case-mix data collected according to audit standards, resulted in one of the most complete and accurate hospital databases in the country. The databases are updated continuously and serve as the foundation of the state’s rate-setting decisions.

Health Services Cost Review Commission 

An independent state agency is established and charged with setting hospital rates.

Maryland Obtains Its First Waiver

The Centers for Medicare & Medicaid Services requires hospitals to be paid the same rates as approved by the commission. Uniform rates set by the commission require that all payers be charged the same price for the same service at the same site. Previously, Medicare and Medicaid continued to pay individual hospitals under their own rules.

Standardized Discharge Abstract

Uniform Financial Accounting and Reporting System expands to include a standardized discharge abstract for each patient, termed “case-mix” data. The combination of financial and case-mix data results in one of the most complete and accurate hospital databases in the country.

Federal Inflation Adjustment System

The System gives hospitals an ongoing incentive to control costs in a more predictable and timely manner.

Guaranteed Inpatient Revenue System

The System emerges to provide incentives to control overall costs, not simply unit rates.

Board Chair, Eugene Feinblatt

Eugene M. Feinblatt, Esq., Board Chair of Sinai Hospital of Baltimore and Union Memorial Hospital, is named MHA Board Chair.

Continue the Maryland Waiver

U.S. Congress requires Secretary of Health and Human Services to continue the Maryland waiver if certain conditions are met.

Maryland Health Planning Legislation Bill Signed into Law

Diagnostic Related Groups

Medicare introduces Diagnostic Related Groups (DRGs) as a prospective payment system for inpatient hospital services. Maryland’s “waiver” makes the state exempt from this system.

Prohibits Physician Clinical Services

Legislation enacted prohibiting physician clinical services from being included in hospital rates.

Distinguished Service Award, Sister Mary Louise Lyons

First MHA Distinguished Service Award is presented to Sister Mary Louise Lyons, of St. Agnes Hospital.

Prime

MHA Group Purchasing Program is incorporated first as the Maryland Shared Services Program Inc., and eight months later changes its name to Maryland Prime, but is known as Prime.

Maryland Gov. William Donald Schaefer Attends MHA Annual Membership Meeting

First Set of Financial Condition and Cost Efficiency Targets

MHA and the Health Services Cost Review Commission create first set of hospital financial condition targets and cost efficiency targets.

MHA PAC

Hospitals form MHA Political Action Committee (PAC) to enhance advocacy efforts.

Dick Davidson Becomes President of AHA

MHA CEO Dick Davidson steps down to serve as president of American Hospital Association.

Concept of “Scaling”

Scaling, reallocating payments among Maryland hospitals to reward or penalize certain results, is introduced.

Cal Pierson Joins MHA as CEO

Maryland’s Cost Per Admission

Evidence shows the regulatory process is achieving significant success in managing costs. Maryland’s cost per admission is 14% below the national average.

Private Hospital Grant Program

MHA recommends this program for the allocation of state funds for private hospital and capital projects. Facilitated by MHA, an 11-member project review committee of hospital trustees and executives advocates for funding of the state’s hospitals recommended projects during legislative session.

25th Anniversary of MHA

Dick Davidson, former MHA CEO and AHA president, delivers first Davidson Lecture at the celebration.

Balanced Budget Act

The Act establishes timelines for implementing national prospective payment systems for hospital outpatient, skilled nursing, inpatient rehabilitation, inpatient psychiatric, and home health services for Medicare patients. Maryland is “waived” from the national hospital outpatient prospective payment program.

MHA Headquarters in Elkridge

MHA moves its offices from Heaver Plaza in Lutherville-Timonium to its current location at 6820 Deerpath Road in Elkridge.

Average Age of Plant Is 9.3 Years

Maryland hospitals’ average age of plant is 9.3 years, while the national average is 9.5. Adjustments to Maryland’s regulatory model had the intended effect of increasing margins, improving balance sheets, catching up on capital improvements, and enabling state-of-the-art technology acquisition.

September 11 Attacks (9/11)

Maryland hospitals treat victims of the September 11 terrorist attacks.

Board Chair, Gene Friedman

Gene Friedman, Esq., trustee at Northwest Hospital and LifeBridge Health, is named MHA Board Chairman.

State Legislation Establishes the Maryland Patient Safety Center

MPSC Receives Designation

Maryland Patient Safety Center (MPSC) receives designation by Maryland Health Care Commission. MHA and the Delmarva Foundation are jointly selected as operators of MPSC for a three-year period.

Chesapeake Registry Program

The program (“Registry”) is established by Prime and MHA to assist health care facilities with supplemental staffing needs. Registry contracts with selected nursing and allied health agencies to provide quality-oriented supplemental staff for per diem assignments and contract assignments.

Working Families and Small Business Health Care Coverage Act

Maryland passes the Act, expanding health care to more than 55,000 uninsured parents. This brings the state up from 44th to 16th in the nation in providing affordable health care coverage for lower income working adults.

MPSC Becomes an Incorporated, Nonprofit Organization

Cal Pierson Steps Down as MHA CEO

Hospital Payments Are Linked to Quality Performance Metrics

Carmela Coyle, First Female CEO of MHA

Patient Protection and Affordable Care Act

President Barack Obama signs the ACA, requiring all people have health insurance beginning in 2014.

Maryland Hospitals Are Incentivized by CMS to Reduce Readmissions

Medicaid Expansion

Governor Martin O’Malley authorizes Medicaid expansion under the terms of the Affordable Care Act. Expansion results in hundreds of thousands of new Medicaid enrollees.

All-Payer Model

Maryland’s “waiver” from Medicare rules is phased out in favor of the All-Payer Model, a five-year demonstration under CMS’ Center for Medicare and Medicaid Innovation (CMMI). The new model incentivizes proactive care and efforts to move from volume-to-value.

Maryland Hospitals on Front Lines of the Ebola Outbreak

Advanced Health Collaborative (AHC) LLC

Five major independent Maryland-based health systems with a combined total of 10 hospitals formalize an agreement to create the Advanced Health Collaborative (AHC) LLC. AHC offers its members the ability, without merger, to share ideas and explore opportunities to enhance the quality of health care, reduce costs, and improve the health of people in the State of Maryland–the “Triple Aim.” Members include Adventist HealthCare, LifeBridge Health, Mercy Health Services, Peninsula Regional Health System, and Trivergent Health Alliance, which includes Frederick Regional Health System, Meritus Health, and Western Maryland Health System.

Board Chair, Mary Pat Seurkamp

Mary Pat Seurkamp, Ph.D., president emeritus of Notre Dame of Maryland University and a trustee at Greater Baltimore Medical Center, is named MHA Board Chair.

Maryland Senator Thomas “Mac” Middleton Receives MHA’s First Outstanding Legislator Award 

Carmela Coyle Leaves MHA to Lead California Hospital Association

Stakeholder Innovation Group

MHA convenes and leads Stakeholder Innovation Group to influence the broader state innovation strategy around Total Cost of Care Model.

Bob Atlas Begins Tenure as Fourth President & CEO of MHA

Opioid Panel

MHA President & CEO Bob Atlas sits on opioid panel led by U.S. Sen. Ben Cardin and hosted by Tori Bayless, CEO of Anne Arundel Medical Center.

Total Cost of Care

Recognizing the cost savings and quality improvements Maryland’s hospitals have made under the All-Payer Model, CMS agrees to a new demonstration for the next five to 10 years. The Total Cost of Care Model begins in January 2019 and aims to build on the success of the All-Payer Model by extending cost savings targets to non-hospital health care providers and expand the range of population health improvement goals.

Total Cost of Care Bill Signing by Gov. Larry Hogan in Annapolis

Health Care Innovations

Statewide inventory of health care innovations, endorsed by the Stakeholder Innovations Group, launches.

New Model Contract

Maryland hospitals operate under a new, Total Cost of Care Model contract with the federal government designed to test whether the improvements hospitals made under the All-Payer Model can be expanded to all health care providers.

Maryland Hospitals Improve Patient Safety and Overall Hospital Quality 

Prime Becomes Known as MHA Prime

Discharge Delays for Behavioral Health Patients

MHA’s Behavioral Health Task Force launches study of factors contributing to discharge delays for behavioral health patients in emergency departments.

Medicaid System of Care Task Force

The task force is formed to develop hospital field positions on Medicaid policy issues.

Focus on Health Equity

MHA forms two new groups to focus on health equity: Diversity, Equity & Inclusion Advisory Group and Health Equity Task Force.

Reduce Costs

Maryland hospitals reduce costs since 2014 without shifting costs to other parts of the health care system, according to an evaluation from CMS and its CMMI.

Human Trafficking Resource Guide

MHA partners with University of Maryland SAFE Center for Human Trafficking Survivors to release a new resource guide for health care providers to better identify, support and care for survivors of human trafficking.

First Cases of COVID-19 Patients in Maryland Hospitals

National Hospital Week

In recognition of Maryland’s hospital heroes during the COVID-19 public health emergency, Gov. Larry Hogan issues a proclamation to celebrate National Hospital Week.

MHA Executive Committee of the Board Unanimously Adopts MHA’s Commitment to Racial Equity

Board Chair, Harry Johnson

Harry Johnson, Esq., former board Chair of Greater Baltimore Medical Center, becomes MHA Board Chair

Maryland hospitals successfully treated and released more than 14,600 COVID-19 patients.