Q&A: MHA’s Nicole Stallings discusses biggest needs for Maryland hospitals heading into 2023


James Sklar


Like hospitals and health systems in much of the nation, Maryland’s healthcare system is facing myriad challenges. These include a historic workforce shortage, unprecedented financial strain, and a behavioral healthcare crisis.

In this interview, Nicole Stallings, Executive Vice President and Chief External Affairs Officer at the Maryland Hospital Association, discusses how the Association’s legislative agenda for 2023 will help its members address these challenges and improve health and healthcare in Maryland.


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State of Reform: Heading into 2023, what are the biggest needs for Maryland hospitals?

Nicole Stallings: “Our members’ primary challenge over the past several years has been their workforce. Heading into 2023, these challenges are greater than ever. Maryland hospitals are facing a historic workforce shortage, with our data showing that one in every four nurse positions is vacant.

This trend continues despite our hospitals’ aggressive action to grow and retain its workforce, including wage increases, bonuses, and revising benefit structure. Since the start of COVID, Maryland hospitals have increased wages by 25% overall.

This persistent challenge is now colliding with significant financial pressures. Hospitals are at a breaking point and are forced to make difficult decisions about how to do more with less.

While Maryland’s unique financing model acted as a shock absorber to the early effects of the pandemic, our hospitals are not protected from record inflation for supplies, drugs, and equipment, as well as increasing labor costs.

Our most recent data show that in 11 of the past 13 months, Maryland hospitals had a negative median operating margin. October’s median margin was the lowest since June. These financial losses are unsustainable.”

SOR: Can you summarize some of the legislation you were tracking this year (whether passed or not) that pertains to hospitals? What does MHA consider to be the “wins” and “losses” at the capitol this year?

NS: “Our hospital workforce won in 2022, but we still have work to do.

MHA successfully advocated for several bills that will help hospitals support their staff and build a stronger pipeline of dedicated caregivers. This includes establishing a commission to study the health care workforce crisis, requiring the state to create a public awareness campaign to prevent violence in health care settings and continuing the ability to fast track licensing for physicians in compact states. 

We also secured additional support in Maryland’s budget for hospitals and health systems.

MHA garnered $80 million for the Hospital Workforce Fund to support hospital staff recruitment and retention efforts. Governor Hogan then contributed an additional $25 million to the hospital workforce, bringing our total to $105 million. This is the largest direct investment to Maryland’s hospitals in over a decade.

MHA also secured $7.4 million in loan repayment for physicians, physician assistants, and nurses, up from $400,000 in FY 2020.”

SOR: What are your top policy priorities for the 2023 legislative session? Are there any specific bills that you’re supporting?

NS: “In Maryland, our 90-day legislative session begins Jan. 11. During this time, we will advocate for legislation to strengthen our hospital workforce and improve access to care. That includes legislation to, invest in the health workforce and faculty pipeline, maintain telehealth flexibilities, reform the Maryland Board of Nursing, and improve the behavioral health system of care.”

SOR: Does MHA believe the change in party leadership in the legislature will impact your work on policy for Maryland hospitals?

NS: “MHA and our members are represented on transition committees for our incoming Governor, Wes Moore. 

We appreciate this opportunity to help shape the new administration’s positions on policies that will affect health and health care in our state and look forward to continued collaboration over the next four years.”

This interview was edited for clarity and length.