As your hospitals shore up supplies and staff to care for the surge of COVID-19 patients, you’re also seeing a remarkable decline in other patients—those with emergency care needs. Rightly, much of our attention is focused on responding to this public health emergency and making sure you have the resources in place to deliver life-saving care. Yet, it’s important also to understand why Marylanders are avoiding emergency departments. Incredibly, some hospitals report seeing half or even less of the volume they did pre-COVID in their EDs.

This public health emergency has challenged all our organizations—and us personally and professionally—in so many ways. Yet, your hospitals and systems are rising to the challenge. Since the first cases emerged in Maryland, the stories of your inventiveness have been inspiring.

This week the White House issued guidelines for “Opening Up America Again.” And Governor Hogan announced Maryland “is now in a position to plan the gradual rollout of the state’s recovery phase.” He laid out four building blocks: (1) Expanding testing capacity, (2) Increasing hospital surge capacity, (3) Ramping up supply of PPE, (4) Building a robust contact tracing operation.

In the toughest of times, we often see the best of humanity. That has been true during past crises and it is now. Health care workers are stepping up to the front lines of this public health emergency—as they always do—more than earning the moniker of health care heroes. Communities are showing great support for them, with local businesses volunteering resources and our citizens donating their time, talents, and precious protective gear to your efforts to keep Maryland—and your workforce—safe.

So many are saying there’s no playbook for what we’re going through right now. You know better. You’re working nonstop according to the health emergency protocols that were prepared for situations of this sort. What you’re battling most are challenges created outside your control, like the faulty supply chain of PPE and testing materials and ventilators.

You know this. The events of the past week were unimaginable just a short time ago. The rapid spike in cases of COVID-19 around the country and here in Maryland is challenging us all like never before.

This is a grave moment. The coronavirus/COVID-19 outbreak is escalating. Fortunately, so is Maryland’s response to it. Hospitals are out front, working well with partners to protect the health of Marylanders. Gov. Larry Hogan’s bold decision to close schools, along with other measures to limit social contacts, has wide-ranging effects on our hospitals, our communities, and our lives. But it’s the right thing to do. We expect to hear even more from him mid-day Monday.

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.”