Md.'s All-Payer Health Care Cost Model

David

Opinions are my own...
PREMO Member
Maybe someone smarter than I can make sense of this political mumbo jumbo. All I know is that government "solving" the health care crisis can only lead to (further) disaster:

Hogan Administration, CMS Announce Draft Terms of All-Payer Health Care Cost Model

First in the Nation “Maryland Model” Improves Health Care Access, Reduces Costs


ANNAPOLIS, MD
– Governor Larry Hogan, along with the Maryland Department of Health and the federal Centers for Medicare & Medicaid Services (CMS), today announced draft terms for Maryland’s Total Cost of Care All-Payer Medicare Model, a milestone reflecting the state’s continual commitment to improving residents’ health care quality while reducing costs. Building on the state's track record of innovation in the health care sector, the Maryland Model is designed to coordinate medical treatment for patients served in both hospital and non-hospital settings, to improve health outcomes, and to rein in the growth of health care costs.

“The terms reflected in this plan build on our state’s already strong tradition of innovation in health care access and affordability,” said Governor Larry Hogan. “I want to thank both our federal and state level health care partners, especially Health Secretary Dennis Schrader, who put hundreds of hours into this immensely important project. As we move forward in this process, our administration will remain focused on meeting the needs of the countless Marylanders who face critical medical decisions that far too often have life-changing implications.”


This model is the result of months of rigorous negotiations spearheaded by Maryland Department of Health Secretary Dennis Schrader and
Health Services Cost Review Commission Chairman Nelson Sabatini. These negotiations incorporated the direction received from stakeholders in the hospital, physician, insurance, and patient sectors, as well as from federal partners, and have produced a model that all sectors support. The terms of the Maryland Model were released today for discussion by the public and stakeholders.

“Our negotiations to continue and improve our cost-controlling system on behalf of patients have returned terms that also build upon Maryland’s commitment to improving health outcomes for our residents,” said Secretary Schrader.

Gene Ransom, CEO of MedChi, Maryland’s professional association for licensed physicians, expressed appreciation for all the hard work of the Hogan administration on maintaining Maryland's unique All-Payer Model, "Today’s announcement shows how close we are to keeping this model for another five years."

“Maryland’s hospitals support a successful, long-term, sustainable system that maintains Maryland’s special status with respect to Medicare,” said Maryland Hospital Association President & CEO Carmela Coyle. “Preserving the state’s Medicare demonstration is a top priority for us all. We look forward to working together to make this happen and working together to address the issues the state must lead to make this a successful arrangement.”

The model reflects the strategies and priorities identified in Maryland’s Progression Plan, a document that was submitted to the federal government in December 2016 that incorporated stakeholder feedback and guidance for the next phase of the All-Payer Model. Ensuring that Maryland’s health care delivery system remains one of the best in the nation is a top priority of the Hogan administration.
The Maryland Model limits cost-shifting by various health care payers, including Medicare, and protects the individual consumer. It also addresses primary care and allows for greater coordination among the medical community. The model also enables the state and provider communities to collaborate on critical health care issues, including opioid use, diabetes, hypertension, and other chronic conditions. This collaborative approach draws upon a strong partnership with key players in Maryland’s health system – hospitals, payers, physicians, long-term care providers, and regulatory agencies, along with state and federal partners.

Additional details on the proposed structure of the new model, including the process and timeline of negotiations with the federal government, can be found at http://hscrc.maryland.gov/Pages/progression.aspx.

Any additional questions or clarification can be directed via email to
hscrc.all-payermodel@maryland.gov. Implementation of the model will begin on January 1, 2019, pending final approval from the federal government.

About Maryland’s All-Payer Medicare Model


Maryland’s current approach to hospital payment is known as the “Maryland All-Payer Medicare Model Contract,” and runs from January 1, 2014, through December 31, 2018. The 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 of the health care that patients receive, both inside the hospital and the community. This model’s anticipated start date is January 2019.
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littlelady

God bless the USA
I didn't read the article, but I am referencing your mumbo jumbo part. I have said on here that hub retired early because USBank has lost their collective mind. That aside, we signed up for Obamacare in July in case of catastrophic. We had all our annuals before it ended, and still had to pay out of the butt. We chose Kaiser Perm as our new Obama insurance because most cost effective. Well, guess what. Our current docs don't accept KP, and, neither does CVS, which has been our pharmacy for years.
We needed a prescription filled yesterday and found out how bad KP is, so hub searched online and found Blink Health for prescriptions; way less than half the price. Hope this helps someone.
 

officeguy

Well-Known Member
It means the state of MD has taken over the finances for the hospitals in the state. No money can be spent on equipment or expansions without the state buerocrats having their say. The rates hospitals receive from private insurers are set by the state as well. So if you ever wonder why you wait 5 hrs in one of our local ERs, thank a buerocrat.
 

littlelady

God bless the USA
It means the state of MD has taken over the finances for the hospitals in the state. No money can be spent on equipment or expansions without the state buerocrats having their say. The rates hospitals receive from private insurers are set by the state as well. So if you ever wonder why you wait 5 hrs in one of our local ERs, thank a buerocrat.

:yay:

We did not want to retire in MD, but stayed for love of fam. Did not want to miss a thing. And, you can't take it with you. :smile:
 
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awpitt

Main Streeter
It means the state of MD has taken over the finances for the hospitals in the state. No money can be spent on equipment or expansions without the state buerocrats having their say. The rates hospitals receive from private insurers are set by the state as well. So if you ever wonder why you wait 5 hrs in one of our local ERs, thank a buerocrat.

I've never waited 5 hours in the ER. I always wonder where those stories come from.
 

vraiblonde

Board Mommy
PREMO Member
Patron
I've never waited 5 hours in the ER. I always wonder where those stories come from.

You probably haven't unless you live in a large city where the case load is enormous. You've probably also never been turned away based on your ability to pay. :whistle:

This whole "health care crisis" is fabricated bull####. It amazes me that the public at-large is falling for that crap.
 

Gilligan

#*! boat!
PREMO Member
It has not - and will not - do anything to reduce the cost of, or improve the quality and availability of, health care services in the state.
 

Chris0nllyn

Well-Known Member
It has not - and will not - do anything to reduce the cost of, or improve the quality and availability of, health care services in the state.

We'd be hard-pressed to see that happen with governmental control and regulation of the health care market
 

vraiblonde

Board Mommy
PREMO Member
Patron
Why? They fell for the Global Warming/Climate Change scams. :shrug:

They fell for Jill Stein's moneymaking scam, and they're also falling for Valerie Plame's scam, to the tune of $64k as of this post. Look up "gullible sheep" in the dictionary....
 

Gilligan

#*! boat!
PREMO Member
We'd be hard-pressed to see that happen with governmental control and regulation of the health care market

Exactly. Like college tuition, poverty and so many other things, if the government runs it or throws money at it, we're going to have more of whatever everyone hoped we would have less of. Duh.
 
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