Health Services Cost Review Commission

The Health Services Cost Review Commission is an independent state agency that has broad responsibility regarding the public disclosure of hospital data and operation performance. The commission is authorized to establish hospital rates that promote cost containment, access to care, equity, financial stability and hospital accountability. MHA works closely to build consensus on issues affecting Maryland's hospitals to ensure their voices are heard during the commission process.

Maryland’s all-payer system

Maryland is the only state in the country that has an agreement with the Centers for Medicare & Medicaid Services requiring all payers — insurance companies, HMOs, Medicare, Medicaid, uninsured individuals and others — to pay the same rate for the same service at the same hospital. This agreement is often referred to as Maryland’s “Medicare waiver,” under which all payers reimburse Maryland’s hospitals according to rates set by the commission.

In January 2014, Maryland signed a modernized agreement with the Centers for Medicare & Medicaid Services that kept in place the nearly 40-year-old Medicare waiver — a system that provides a level of transparency and accountability unseen in other states. The waiver brings Maryland an estimated $1.5 billion more each year in federal dollars.

Under the revamped waiver, all of Maryland’s hospitals operate under fixed global budgets (they are provided a set amount of revenue per year and must care for all of their patients within that limit), providing strong incentives to keep people healthy and treat them in the most appropriate, lowest cost setting.