The situation regarding coronavirus/COVID-19 is evolving at a fast pace. As of Sunday evening, the number of confirmed cases in Maryland remains just a handful, and it appears that all those patients acquired their illnesses on foreign travel. But a number of new cases have been reported in neighboring areas. We need to prepare for community spread. Your hospitals are clearly on the front lines, already being called and visited by people who believe they have symptoms and want to be tested or treated. This all needs to be managed.

A longtime Annapolis insider recently remarked that in nearly three decades of experience, he’s never seen so many bills aimed at hospitals.​ They’re challenging us on how we run our hospitals, care for and bill our patients, and deliver community benefit. The narrative is often negative—and often far off base. Opponents misconstrue data to deliver an unflattering blow to our field.​

Hospitals in Maryland deliver care to every person who comes through their doors. But it seems for some of our patients, those doors only swing in one direction. A recent National Public Radio piece on this issue caught my attention. It points out dozens of children in Maryland’s foster care system are languishing in hospitals when they no longer need hospital-level care. Sadly, we often face barriers transitioning young patients – particularly those with behavioral health concerns—to facilities or community-based services better suited to their needs.

You work every day to provide a safe and happy setting for patients to get great care. Yet sometimes violence erupts, often directed at caregivers in the hospital. Stemming violence against caregivers is a priority for hospital and health system leaders. In collaboration with the Maryland Nurses Association, MHA compiled best practices and resources and we’ve been in touch with your teams to connect them with state’s attorney liaisons in each county.

Hospital billing and collection practices are in the news a lot lately, often misinformed and sensational. Maryland legislators are paying attention. Legislative action is coming this General Assembly session on hospitals’ cost transparency, financial assistance policies, and account collection practices.

Maryland’s hospitals and health systems are getting it right. More validation keeps rolling in. The message is resonating in Annapolis, where it really counts.

It’s likely by now, nearly four weeks into 2020, that many of us already have given up on our New Year’s resolutions. Those well-intentioned goals to eat better, work out more and invest more time and energy into our physical and mental well-being already have been replaced by stresses at work and home that make these new habits seem impossible to form.

January is Human Trafficking Awareness Month. Fact: victims of human trafficking are seen in our hospitals and other sites of care every day. Your caregivers are on the front lines of this crisis. Studies show with certainty that survivors of trafficking are likely to have contact with the health care system during their abuse.

Maryland hospitals have delivered wins under the All-Payer Model (2014-18) and the new Total Cost of Care Model contract with the Center for Medicare and Medicaid Innovation (CMMI). In addition to managing spending, we’ve grown savings while decreasing cumulative and year-to-date spending growth for Medicare beneficiaries.

Hospitals today face unprecedented challenges, seemingly from all sides. As we aim for better health for Marylanders, we encounter obstacles to building our workforce, upgrading our facilities, and strengthening our bonds with the communities we serve.

As we enter the holiday time and reflect on the year now ending, it’s striking how many challenges the Maryland hospital field faced and what you’ve accomplished. The new Total Cost of Care Model launched and you blew through the first year’s savings target. You built upon quality achievements from the previous model of lower readmissions and 30-day mortality.

As hospitals across the country face criticism for long emergency department wait times, the dearth of community-based behavioral health resources must be flagged as a significant cause. Many of your hospitals contend with behavioral health patients who simply have nowhere else to go—both at onset of an episode and when ready for discharge—due to lack of capacity in more appropriate care settings.

Without fanfare, the Center for Medicare and Medicaid Innovation (CMMI) posted the final evaluation of the Maryland All-Payer Model. Overall the findings suggest the Model works. One good sign: CMMI’s project leader for Maryland praised the Model on social media last week, saying, “What I’m most impressed with is the decrease in potentially avoidable hospitalizations.”

The other day we got a preview of the headwinds the hospital field can expect to face when the Maryland General Assembly session opens in seven weeks. MHA participated in a Senate committee briefing on facility fees. At the briefing, MHA highlighted our field’s proactive effort to improve transparency for patients.

You may have watched in recent weeks as California residents fled their homes while flames from wildfires inched closer and hospitals faced the daunting task of swiftly evacuating all their patients.

Like many of you, I spent much of October staying up past my bedtime, bingeing on ice cream, and shouting at the TV—all while watching the Washington Nationals in inning after inning of nail-biting baseball. Fortunately, the elevated stress paid off. And, even if they hadn’t won the final game, it would’ve been worth it.

Maryland Senate President Mike Miller’s recent announcement that he will step down from the leadership position he held for 33 years marks a seismic change for the chamber. Though Miller intends to remain a senator, his absence at the dais will be felt in Annapolis.

Recently the Maryland Department of Health (MDH) released a new Diabetes Action Plan that aims to create conditions conducive to better health and reduce the impact of diabetes on Marylanders. MDH understands the plan will require an “all in” effort from a wide variety of actors, including state and local policymakers, payers, employers, school boards and administrators, community groups and others.

A groundswell of support is forming at the state and national levels to make hospital billing more understandable and transparent for our patients. Feeding that push are nearly daily headlines about patients who received bills that exceeded their expectations, people who were confused after receiving two bills for what looked like the same service, and hospitals’ efforts, legitimate as they may be, to collect on unpaid debts.

To best position Maryland hospitals and health systems for the future, partnering with state and local agencies is key. To that end, MHA participates in a group Secretary of Health Robert Neall convenes to help ensure the Maryland Model reaches its aims of better care and better health.