All-Payer Hospital System Modernization

This model will be used to engage all Maryland hospitals, as well as other care providers, in payment reform and innovation.  The goals include:

  1. Shifting hospital payment away from per inpatient admission to per capita costs.  
  2. Requiring Maryland to generate $330 million in Medicare savings over a five year period.
  3. Requiring Maryland to limit its annual all-payer per capita total hospital cost growth to 3.58%.
  4. Over a five year period, shifting hospital revenue into global payment models, incentivizing hospitals to work in partnership with other providers to prevent unnecessary hospitalizations and readmissions.  
  5. Achieving a number of quality targets designed to promote better care, better health and lower costs. 

If Maryland fails during the five-year performance period of the model, Maryland hospitals will transition to the national Medicare payment systems.  

Learn more about the white papers that have been, and will be submitted.

Coalition letter to Phelps re Recommendation on Transitional Rate Setting
1/24/2014 - The Coalition commented on HSCRC’s transitional rate setting policies that went into effect January 1, 2014.  The Coalition raised concerns about whether there were adequate consumer safeguards, protections for vulnerable populations, need for risk adjustment, transparency of process, and the speed of implementation.

Memo to Colmers and Sharfstein on Maryland All Payer Proposal
11/20/2013 - The Coalition developed a set of principles for implementation of the waiver. Included were: having a patient/consumer/community perspective, including a focus on population health, safeguards for vulnerable patients, consumer protections, and including a robust evaluation process. These principles were submitted to the HSCRC Advisory Council.

Maryland Waiver application submitted to Kathleen Sebelius
10/11/2013 - Maryland’s waiver proposal to CMS for a model to improve health care outcomes, enhance patient experiences, and control hospital costs.  The proposal describes why a new model was needed, details of the proposed model , operational design elements of the model, and how the model will be monitored and evaluated.

Comments on guiding principles submitted to Donna Kinzer
1/27/2014-These comments updated the Coalition’s 11/20/2013 principles.  Additional emphasis was placed on need for testing global budgets, investments needed to protect vulnerable patients, assuring patient choice, and protecting consumers with improved quality of care.

Letter to Colmers and sharfstein
October 2013 - Letter submitted by Coalition to DHMH commenting on Maryland’s draft waiver application to be submitted CMS. The Coalition highlighted a series of process and policy concerns including the need for a reasonable implementation timeline, the need for a robust complaint and grievance process, safeguards for vulnerable patients, the need to be patient centered,  and the need to preserve culturally competent providers.

Testimony before Finance Committee of Colmers and Sharfestein
March 26, 2013 - Colmers and  Sharfstein presented testimony on why the waiver was needed and the model design.