Statewide Integrated Health Improvement Strategy
In 2019, the State of Maryland collaborated with the Center for Medicare and Medicaid Innovation (CMMI) to establish the domains of health care quality and delivery that the State could impact under the Total Cost of Care (TCOC) Model. The collaboration also included an agreed upon process and timeline by which the State would submit proposed goals, measures, milestones, and targets to CMMI. As a result of the collaboration with CMMI, the State entered into a Memorandum of Understanding (MOU) that required Maryland to provide a proposal for the Statewide Integrated Health Improvement Strategy (SIHIS) to CMMI by December 31, 2020. The SIHIS aligns statewide efforts across three domains that are interrelated and, if addressed successfully, have the potential to make significant improvement in not just Maryland’s healthcare system, but in the health outcomes of Marylanders.
- Domain 1: Hospital Quality
- Domain 2: Care Transformation Across the System
- Domain 3: Total Population Health
Domain 3, total population health, includes a commitment to improving childhood asthma in Maryland, in addition to improvements in diabetes, opioid overdose, and severe maternal morbidity.
Asthma Goals for SIHIS
Asthma is a priority for MDH and is one of the largest racial and ethnic health disparities in terms of ED visit rates. Asthma is responsible for more Emergency Department (ED) visits than some other major chronic disease such as hypertension and diabetes ED visits. Asthma was responsible for greater than $73 million dollars in hospital charges (2018) for Maryland children less than 18 years old. In addition, children with asthma miss an additional 2.3 days of school.
To see how Maryland is doing, visit the Environmental Health Bureau's SIHIS Dashboard, part of the Maryland Environmental Public Health Tracking Portal.
Severe Maternal Morbidity Goals for SIHIS
Optimizing maternal health and eliminating disparities is a priority for the Maryland Department of Health. Severe maternal morbidity (SMM) is defined as various conditions and adverse events experienced by birthing people during their delivery. These events include heart attacks, high blood pressure resulting in seizures, organ failures due to an infection, sickle cell disease with crisis, blood transfusions, and hysterectomy.
In 2018, there were 1,508 SMM events in Maryland out of 62,423 delivery hospitalizations for women ages 12-44. Many of these events are preventable, and they occur more frequently in racial/ethnic minority populations where health disparities are the greatest.
Initiatives to Improve Maternal Health
Addressing maternal health will take a broad and systemic approach working with various partners. Please see below for select initiatives addressing maternal health in the State.