The Maryland Department of Health and the Health Services Cost Review Commission Announce Third Year Results of Maryland’s All-Payer Model
Maryland is on Track to Meet or Exceed All Model Requirements by Contract Completion
, 2018) –
The Health Services Cost Review Commission (Commission), together with the Maryland Department of Health, today announced results from the third full year of Maryland’s All-Payer Model (Model). According to data released by the Centers for Medicare and Medicaid Services (CMS) that captures Model performance through year three of the five-year Model, Maryland is on track to meet or exceed all Model requirements. This includes delivering hospital Medicare savings of $586 million and total hospital and non-hospital Medicare savings of $461 million through the end of calendar year 2016, while at the same time improving quality and reducing complications for patients. A report summarizing the performance results to date is available on the HSCRC website http://www.hscrc.maryland.gov/Pages/hscrc-modernization-news.aspx
The innovative per capita Medicare savings model maintains financial stability in rural hospitals and provides opportunities for health care providers to transform their delivery of care while improving health outcomes and quality of care. It also addresses primary care, allowing for greater coordination of care among the medical community. The Model enables the State and providers to collaborate on statewide population health efforts such as diabetes, hypertension, and other chronic conditions in addition to a purposeful emphasis on reducing opioid use in Maryland. To draw upon a strong partnership with key players in Maryland’s health system, the Stakeholder Innovation Group, an industry-led stakeholder group, was formed.
“A strong coalition of health care stakeholders—hospitals, community providers, community organizations, and State and federal leaders—have led the development of innovative provider-led strategies to improve the delivery of care for patients in Maryland over the last three years,” said Commission Chairman Nelson Sabatini. “Coordination and alignment among the various health care sectors is vital to driving down costs and improving care in the State of Maryland.”
Maryland Department of Health Secretary, Robert R. Neall, stated, “I applaud Maryland’s care partners on their outstanding efforts to transform and expand patient-care delivery, while improving the quality of care at lower costs to the consumers. Identifying the most promising areas for innovation while fostering the goals of our Model, the stakeholder group has been
integral to the success of our efforts— focusing on quality care that reduces re-admissions and encourages hospitals to transform their care models to be value driven.”
“Our system fosters a patient-centered approach to health care that puts patients at the center of delivery system innovations. Care coordination, enhancement of primary care delivery system, and management of chronic disease are central to the success of our Model and central to the improvement of health for all Marylanders,” said Donna Kinzer, Executive Director of the Commission.
In 2014, the State of Maryland and CMS entered into an agreement and established a five-year period in which a series of key requirements were to be met. The requirements included:
- All-payer per capita total hospital revenue growth must be limited to 3.58 percent per year;
- Five-year Medicare per beneficiary total hospital cost savings must equal or exceed $330 million;
- Total Medicare spending per beneficiary growth must fall below certain national growth rates;
- The aggregate Medicare 30-day all-cause readmission rate must be reduced to at or below the national average;
- The rate of hospital-acquired conditions must be reduced by 30 percent;
- Hospital payment must transition away from volume-based payments; and,
- Maryland must submit a plan at the end of 2016 to move beyond hospitals and limit the growth in total hospital and non-hospital spending for Medicare.
About Maryland’s All-Payer Model
The Maryland All-Payer Model’s success metrics are based on enhancing quality, improving health outcomes, and constraining the growth of Medicare costs for hospital inpatient and outpatient services.
Since 2014, Maryland’s hospitals have successfully reduced unnecessary readmissions and hospital-acquired conditions, while decreasing the growth in hospital cost per capita. However, the current approach focused on hospitals does not sufficiently provide for comprehensive coordination across the entire health care system. Because of this limitation, the federal government required Maryland to develop a new model that encompasses all the care that patients receive, both inside the hospital and in the community.