Maryland Gets Green Light For Unique All-Payer Model Geared Toward Helping State Control Health Costs
Maryland's current model, which was approved in 2014, doesn't provide comprehensive coordination across the entire health care system, so the federal government required the state to develop a new model to include health care that patients receive in the hospital and in the community.
The Associated Press:
Maryland Announces Agreement On All-Payer Health Model
Maryland officials on Monday announced federal approval of a new contract for the state’s unique all-payer health care model. Maryland is the only state that can set its own rates for hospital services, and all payers must charge the same rate for services at a given hospital. The policy has been in place since the 1970s, though Maryland modernized its one-of-a-kind Medicare waiver four years ago to move away from reimbursing hospitals on a fee-for-service basis to a fixed budget. “The new Maryland Model will expand health care access and affordability — and ultimately improve quality of life — for Marylanders, especially those with chronic and complex medical conditions,” said Gov. Larry Hogan, a Republican. (Witte, 5/14)
The Baltimore Sun:
Maryland's Plan To Control Health Costs Gets Federal Approval
The Centers for Medicare and Medicaid Services has been closely watching the state’s pilot program, first implemented in 2014, as a possible model for other states. The program scrapped a hospital payment model that reimbursed them for the volume of services they provided in favor of annual spending budgets that hospitals were not allowed to exceed. The medical institutions began working with doctors, social workers, community groups and others to ensure patients took their medications, made follow-up visits and took other preventive measure that would keep them out of hospitals. The pilot program resulted in substantial cost savings and improved care for patients, state officials said. The program saved $586 million in health costs between 2014 and 2016 and is now expected to continue to save an additional $300 million a year. (McDaniels, 5/14)