What does the committee do:
- The GBC Health Care Committee formed in 2014 an exclusive partnership with the Maryland Chapter of the American Diabetes in a year-long pilot program “CEOs Stopping Diabetes.” Data has shown that when CEO’s personally lead corporate wellness programs the results improve dramatically in terms of compliance. The GBC recruited six of its CEOs to take part in this program. The CEOs came from both large and small companies with diverse types of employees ranging from investment bankers to young techies. Each CEO was encouraged to initiate and lead his or her own programs to promote corporate wellness. At the end of the pilot year, an evaluation will be made of each program but early reports have already shown that the CEO engagement made a difference and inspired workers to pursue a healthier lifestyle.For the last two years, the Health Care Committee has worked closely with the Healthiest Maryland initiative under the auspices of the Maryland Department of Health and Mental Hygiene. As a partner in the Healthiest Businesses component of Healthiest Maryland, the Health Care Committee signed up 130 private companies to participate in programs that would encourage workforce wellness.
- The Health Care Committee has hosted a series of experts on different aspects of the implementation of the Affordable Care Act in order to learn more about how the ACA will affect hospitals, insurers and businesses in Maryland.
2017 Health Care news:
Chet Burrell, President and CEO of CareFirst BlueCross BlueShield, delivered a presentation at the Health Care Committee’s November 7, 2017 meeting highlighting the current state of health care and CareFirst’s operations.
Overall, health care premiums are up more than 200 percent since 1999, although workers’ earning are up only 64 percent and inflation 47 percent. Out of pocket costs alone have risen nearly 16 percent since 2014. Due to rising costs, employers with fewer than 50 employees are choosing to introduce high deductible plans or dropping coverage. One of the reasons for rising costs is the consolidation of providers into bigger systems. Consolidation does not produce economies of scale in health care. Another driver is pharmacy costs.
Burrell also addressed addiction and opioid abuse. More people died in 2016 from drug overdose than during the Vietnam War, he said. CareFirst has actively monitored this issue and implemented a strategy to combat the national problem. Most significantly, CareFirst has limited opioid prescriptions to seven days and limited the dosage prescribed. The health care provider has also found ways to waive certain fees and follow up with individuals after they have been in treatment for up to one year to increase their likelihood of success.
Gene Ransom, CEO of MedChi, delivered a presentation at the committee’s October 17, 2017 meeting, highlighting top issues for physicians. Founded in 1789, MedChi is the medical society for the State of Maryland representing the interests of physicians and enhancing healthcare for all Marylanders.
Many changes are taking place the within health care industry and Maryland is currently experiencing major changes to its health care financing model. Ransom explained that MedChi is a resource and can assist with new regulations and changes. The MedChi House of Delegates debates policy positions at bi-annual meetings that sets the organizations policy and guides its advocacy efforts. The group is actively defending the interests of physicians on medical liability including filing amicus briefs for landmark cases. Most importantly, it operates the Maryland Physician Health Program, which is a voluntary and confidential resource where medical professionals may seek help with mental health, behavioral, or addiction issues.
Health Care Committee Chair Bonnie Phipps introduced the presenters for the July 24, 2017 meeting: Mark O’Brien, Director of Opioid Overdose Prevention and Treatment for the Baltimore City Health Department (BCHD); Evan Behrle, Special Assistant to the Health Commissioner for the BCHD; and David McShea, Executive Director of the American Diabetes Association (ADA), Maryland Chapter.
O’Brian and Behrle focused on the opioid epidemic in Baltimore City while McShea discussed the ADA’s upcoming Step Out: Walk to Stop Diabetes event in October.
Behrle began with an overview of the BCHD. The agency was founded in 1793, making it the oldest health department in the country. BCHD’s funding structure is unique compared to other city agencies because 80 percent of its funding comes from grants while the remaining 20 percent is contributed by the city. This formula allows for BCHD to be nimble and respond quickly to the health disparities currently plaguing the city. For example, 20 years ago BCHD created one of the first needle exchange programs in the country. Although controversial at its conception, the program was instrumental in reducing HIV transmission rates in city. The same program is now being employed in the fight against opioids.
O’Brien reviewed the data regarding Maryland’s opioid deaths. Since 2012, the number of overdose deaths nearly tripled. In Baltimore City, overdose deaths have risen from 225 to 694 in the same time period. The increase in the number of deaths is attributed to Fentanyl — a cheaper, synthetic opioid that is more potent than morphine and heroin. For the first time in 2016, fentanyl and heroin deaths reached a parity.
BCHD currently implements an aggressive multifaceted approach to fighting opioids: Use of the drug Naloxne, public education and access to treatment. Naloxne is a powerful antidote used to reverse opioid overdoses and is available as a nasal spray or a needle injector. It takes only a few minutes to learn how to administer the drug. To date, BCHD has distributed more than 21,000 kits of the antidote to city residents, saving more than 1,000 lives.
When it comes to public education, BCHD runs the “Don’t Die Campaign” which focuses on the dangers of opioids and opportunities to learn about how to effectively use Naloxone. The campaign utilizes bus stops, busses, billboards, metro stations and libraries in the city. Regarding access to treatment, BCHD utilizes a buprenorphine expansion plan and hosts a work group that meets monthly on treatment access and neighborhood relations.
Switching gears, the committee heard from McShea who provided an overview of the ADA, whose mission is to find a cure for diabetes and improve the lives of those living with the disease. Every year, 1 million new individuals are diagnosed with diabetes. Currently, more than 600,000 individuals – or 12 percent of Maryland’s population – has diabetes. The disease is an underlying cause for many deaths each year despite going unreported on the death certificate.
The ADA hosts two primary walks in Maryland. The first walk will take place on October 1 at the Canton Waterfront Park in Baltimore and the second will be held on October 8 at Baker Park in Frederick. GBC members that achieve fundraising goals will be rewarded with various prizes and benefits including a “Lunch and Learn” presentation provided by the ADA and six month family membership to The Y in Central Maryland. This year GBC members will participate in the walk as an umbrella team — Team GBC.
At the Health Care Committee’s May 16, 2017 meeting, committee members heard from Carmela Coyle, President and CEO of the Maryland Hospital Association (MHA). She focused on the 2017 legislative session of the Maryland General Assembly from a health care perspective.
Coyle discussed the MHA’s three priorities during the session. The first was the Medicaid tax on hospital care which was initiated by former Maryland Governor Martin O’ Malley in 2009, which grew from $19 million to $365 million in 2016. The tax was meant to help curb the impact of the 2008 economic recession. Currently, the tax adds approximately 2.3 percent to every hospital bill in the state. It also artificially inflates spending costs which negatively impacts Maryland’s federal waiver since the state has agreed to stay below a certain spending threshold.
The next priority was liability costs. Maryland has one of the most challenging environments in the nation with regards to malpractice lawsuits. Currently, the cap for non-economic related damages is $785,000 and there is no limit for compensation for economic damages. Maryland ranks ninth in the nation for medical malpractice payouts per capita and Coyle believes the funding could be allocated for health care.
The third priority was behavioral health, a popular issue which resulted in an overwhelming number of bills filed related to the topic. Coyle highlighted three specific behavioral health bills: Keep the Door Open Act, HOPE and Treatment Act and Prescriber Limits Act.
Don Fry, President and CEO of the GBC, presented the outgoing Health Care Committee Chairman Albert “Skip” Counselman with a gift and thanked him for his tenure at the committee’s February 6, 2017 meeting. Counselman is succeeded by Bonnie Phipps.
Patrick Redmon, Director of Berkley Research Group, presented at the committee meeting about transformative changes to the health care delivery model. Redmon has more than 20 years of health care economics experience and was the former head of the Health Services Cost Review Commission.
Redmon began by discussing national health care trends. In 2014, health care expenditures accounted for 17.5 percent – or $3 trillion – of Gross Domestic Product (GDP) in the United States. These costs are projected to reach 20.1 percent of GDP by 2025. The upward trend is the result of an aging population.
He then focused on a review of Maryland’s payment model. Maryland has had a federal waiver from Medicare since 1977 which stems from provisions in the Social Security Act which allowed the state to set its own rates for all-payers. Maryland is the only state to continue the practice of Medicare, Medicaid and commercial payers all paying the same rate for a unit of service. Redmon mentioned that the longevity of Maryland’s payment system is due to its flexibility and the general consensus around great regulation in the state.
Now Maryland’s all-payer model has shifted from being volume based to population oriented. The model includes two phases: Phase I began in 2014 and will run through 2018 and focus primarily on removing substantial hospital spending from the economy. Phase II is slated for implementation in 2019 and will focus on Total Cost of Care over the course of five years.
2016 Health Care Committee news:
Denise Shope, Riggs Councilman Michaels & Downes’ (RCM&D) nationally recognized Risk Management Consultant, presented to the Health Care Committee on the topic of opioid addiction from an employer’s perspective on November 7, 2016.
Shope began her presentation by defining which drugs can be categorized as opioids. She highlighted how certain practices in pain management — the over prescribing of drugs, for example — by health care providers produced the unintended consequences of addiction. This was followed by an explanation of how opioid addiction can plague an organization’s personnel, and how employers can properly identify a possible addict.
She concluded the presentation by elaborating on solutions to combat opioid addiction like having an enterprise risk management plan and the comprehensive Addiction and Recovery Act of 2016.
Gabriel Auteri, Deputy Chief of Staff for the Baltimore City Health Department, and Mark L. O’Brien, Director of Opioid Overdose Prevention and Treatment for the Baltimore City Health Department, presented to the Health Care Committee at its October 4, 2016 meeting about how synthetic opioids, such as Fentanyl, are negatively impacting the health of Baltimore City residents.
Auteri began with a brief history of the health department, how it is structured and explained the framework for Healthy Baltimore 2020, or HB 2020, a five-year strategic blueprint for health in Baltimore City which outlines key priority areas, goals and activities.
O’Brien delivered a presentation about opioids and the health department’s plan to combat the effects of Fentanyl on a person through the use of the drug Naloxone, which is used to treat a narcotic overdose in an emergency situation. He ended the presentation by showing how to effectively administer the drug to someone who might be suffering from an overdose.
The Health Care Committee heard from Dr. Samuel Ross, CEO of Bon Secours Baltimore Health System, at its June 15, 2016 meeting. Dr. Ross discussed the hospital’s implementation of the Community Oriented Primary Care (COPC) model which he implemented after arriving in Baltimore from Parkland Hospital in Texas.
COPC has four components: identify the community; together with the community you diagnose and agree on what the issues are (transportation, housing, dental care, jobs, health care); mutually agree on interventions; and implement and measure results. The goal is to have a continuous improvement cycle. Housing is a huge problem in the neighborhood in proximity to Bon Secours and the hospital has purchased 119 low income housing units. The commitment Bon Secours has made it to address the social determinants of health.
At its April 13, 2016 meeting, the Health Care Committee heard from The Coordinating Center, a nonprofit funded by the Health Enterprise Zones legislation that provides funding to address health disparities in underserved communities. The Coordinating Center works directly with 1,200 clients in West Baltimore. The committee will be working to ensure that funding for the Health Enterprise Zones continues as it expires next year.
The Health Care Committee learned about The Medi Community Resource Center (CRC) at its February 8, 2016 meeting. The CRC is a virtual support center that works to help social service organizations develop a culture of collaboration through education and the use of technology, said Larry Gourdine, who delivered the presentation.
The CRC, which is powered by Healthify, allows organizations to search for a plethora of behavioral health services, community-based organizations and social services and share resource information with patients and colleagues quickly and accurately when referring them to community and social services, Gourdine said. The CRC serves as a community utility to connect people to services they need.