Weekly Messages From MHA

Weekly Message From MHA

Progress on Two Fronts

October 12, 2018 By: Bob Atlas

This week I have two very different good news items: one related to improving the support for survivors of sexual assault and the other on the Health Services Cost Review Commission’s (HSCRC) Medicare Performance Adjustment (MPA) policy.

Last week, the State of Maryland was awarded a $2.6 million Sexual Assault Kit Initiative grant from the Department of Justice. Your MHA advocated for state legislation to allow Maryland to apply for the grant. The funds will be used to test untested and unsubmitted sexual assault evidence kits, develop a kit tracking system, and hire specialized victim advocates.

Last month MHA hosted a statewide forum for forensic nurse examiners, who collect evidence and assist victims of violence seen in your emergency departments. They discussed ideas to improve the way Maryland cares for survivors and how the state can improve reimbursement for these caregivers.

You, as leaders of Maryland’s health care community, have dedicated countless resources to care for these individuals during the most traumatic moments of their lives. Now the issue has garnered statewide and national attention. We’ll help shape the path forward via MHA’s seat on the state’s Sexual Assault Evidence Kit Policy & Funding Committee.

I’m also pleased to report that HSCRC staff included all of MHA’s recommendations in their draft MPA policy for fiscal 2021 (the performance period is calendar 2019).

MHA submitted two main recommendations to make the policy fairer and give hospitals a better shot at succeeding. The first is to use care management relationships hospitals already have with physicians when attributing beneficiaries to hospitals. Hospitals have invested in ACOs, employment models, and Care Transformation Organizations. Partnering with physicians in these vehicles is key to moving the needle on total cost of care (TCOC). HSCRC staff agreed with our recommendation to expand the types of physician-hospital relationships used in the beneficiary attribution algorithm.

The second is to adjust TCOC targets to reflect the risk profiles of attributed populations. HSCRC staff have agreed that, in 2019, the formula used to set the targets ought to adjust for a person’s age, sex, disability status, and living situation (home or long-term care facility). HSCRC staff also acknowledge that, in future, beneficiaries’ health status must be factored in as well. Downstream, we intend to advocate further for recognition of differences in socioeconomic factors that affect health status and health care usage.

MHA is here to support you on these and other measures aimed at advancing health care and the health of all Marylanders. As always, we welcome your feedback on the work we do on your behalf.