Last week the number of people hospitalized in Maryland with COVID-19 fell below 400 for the first time since March. We expect some fluctuation, yet over the last two months, trends in our state are positive—fewer hospitalizations, less death, and a lower rate of positive tests.

The Centers for Medicare & Medicaid Services (CMS) can require hospitals nationwide to publicly share charges they negotiate with payers, a federal court ruled Tuesday. The field has prepared for this rule since last year, yet we’d hoped this burdensome mandate would be scrapped through a challenge from health care groups, including the American Hospital Association.

Two weeks ago I shared that we can and must do better as a field to address racism as a public health crisis. As you and your associates demonstrated during the recent White Coats for Black Lives tributes and in your celebrations of Juneteenth yesterday, it is not enough to denounce hateful behavior and systemic racism—we must act.

Maryland’s hospitals are committed to ensuring the safety and well-being of every person in your care.​ The advances in patient safety that you are striving for are needed urgently. As has been widely reported, nationally, more than 250,000 deaths each year may be caused by medical errors.​ Patient Safety Awareness Week, March 10-16, offers a chance to refocus on eliminating harm.

Hospitals have long been dedicated to the proposition that the people they serve must have health insurance, so that they can afford care and so that risks and costs are spread equitably. That enables people to live healthy, productive lives. However, about 1 in 20 Marylanders still lack health insurance. And because of efforts at the federal level to undercut the Affordable Care Act, the number of uninsured once again could rise.

Patient safety and the delivery of quality care are central to every decision Maryland’s health care leaders make. It comes as no surprise, then, that evidence is accumulating showing that our hospitals are making great strides in improving patient safety and raising quality.​

There is a crisis in our state, faced by an estimated one in five Marylanders: mental health and substance use disorders (SUD).​ That is why your Maryland Hospital Association (MHA) created the Behavioral Health Task Force. Fifteen months ago, that group – made up of hospital leaders and experts in mental health and SUD — presented the Roadmap to an Essential, Comprehensive System of Behavioral Health Care for Maryland.

Last week’s tragic shooting outside a Maryland hospital was yet another reminder that health care facilities — seen as safe harbors — are not immune to the violence that plagues our communities.​ That message also was driven home during a recent hospital visit, when executives told me that a spate of multiple-victim shootings in their normally quiet county had truly shaken associates and affected their work performance. The CEO of another hospital lamented countless assaults on hospital staff by both patients and visitors.

Maryland is a national leader in health care, Governor Larry Hogan proclaimed during Wednesday’s State of the State address.​ He held up Maryland’s success under its unique health care financing model against what he described as the health care failures at the federal level.​

The new Total Cost of Care Model presents ambitious targets for hospitals and health systems. And as you well know, the hospital field cannot meet them alone.​ That is why leaders in Annapolis and elsewhere must become fully informed about the model – its aims and the challenges our hospitals face – and how they can support your efforts. ​

Gov. Larry Hogan’s proposed fiscal year 2020 budget, released Friday, includes investments that support your mission of care, the health of all Marylanders, and the goals of the new Total Cost of Care Model.​

No matter your political leanings, it is obvious that Washington, D.C., is plagued by dysfunction and gridlock. The ongoing partial government shutdown, which began in December, is the third to have occurred in 2018 and, as of Saturday, is the longest in our nation’s history.​

When the General Assembly reconvenes in Annapolis Wednesday for the start of the 2019 legislative session, their docket will include many topics that affect your health systems, your patients, and your communities.

As we come to the close of 2018 and take a moment to reflect on the past year, Maryland’s hospitals and health systems are gearing up for the next phase in your efforts to transform health care. Beginning January 1, Maryland’s hospitals will operate under a new contract with the federal government, the Total Cost of Care Model.

By now you know that a federal district court judge in Texas ruled Friday that the entire Affordable Care Act (ACA) was rendered unconstitutional when Congress eliminated the individual mandate penalty in last year’s tax act.

Maryland’s hospitals work every day to coordinate care across service domains, to build efficiencies, to raise up quality and patient safety, to eliminate health disparities in your communities, and much more.

A child who misses school due to a parent’s inability to get her to the doctor may fall behind in learning. A hungry child cannot pay full attention in his class. And the effects of insecure housing or at-home trauma most definitely spill over into school performance. The evidence is clear. There is a direct two-way link between children’s health and educational attainment, from pre-K through high school and beyond.

Thanksgiving is, of course, a time to reflect on what we all are thankful for – family, friends, our health, meaningful work, and more. This year, as I gathered with my family, I was mindful – and thankful – that there are so many hard working doctors, nurses, and other caregivers in our hospitals and medical centers day and night – including holidays – to ensure that every Marylander who needs care can get it.

Caring for the most vulnerable among us is at the heart of our mission each day in Maryland’s hospitals. The federal 340B drug pricing program supports that mission by allowing about half of our hospitals to purchase outpatient drugs at discounted rates. Hospitals can reinvest savings to reduce avoidable utilization and improve outcomes for our patients.

Last Tuesday’s midterm elections have shaken up the political landscape – both nationally and here in Maryland. At the federal level, Democrats regained control of the United States House of Representatives for the first time in almost a decade, with health care at the top of the Democratic congressional campaign platform this year.

For the Jewish doctors and nurses at Allegheny General Hospital, the fact that their patient was accused of mass murder at a nearby Pittsburgh synagogue did not alter their treatment. That he continued to spew anti-Semitic vitriol did not change the care they rendered. Neither did the fact that among his victims were their family, friends, or neighbors.

It’s no secret that health care, particularly hospital care, is ripe for disruption. Why else would giants like Amazon, Google, and CVS be diving into clinical practices with both feet?

Entering into the new model contract, Maryland’s hospitals and health systems are doubling down on the effort to improve health outcomes. Recent reports show where some of the key opportunities lie: maternal health; health care-associated infections; and opioid mortality.​