MHA's Friday Update Messages

MHA Friday Update Weekly Messages

What Does the New Model Delay Mean?

January 12, 2018 By: Your MHA Team

Earlier this week, the state announced a one-year extension for Maryland’s All-Payer Model contract, through December 31, 2019. The extension provides the U.S. Department of Health and Human Services more time to understand the model and its next phase, as well as additional time for a new health secretary to be installed prior to approval.

While the delay may carry some risks, CMS Administrator Seema Verma is a strong proponent of our system and is pushing for HHS to have its review and approval completed in the first quarter of this year. If approval comes before the end of 2018, the hospital field will have an opportunity to weigh in on the start date for the new model.

The strong support from CMS is demonstrated by anticipated actions in the coming months, including a determination that the Maryland model is an Advanced Alternative Payment Model – a designation that will facilitate physician eligibility under MACRA for hospitals participating in Maryland’s care redesign programs. This suggests that for now, hospitals should keep doing what they are doing.

There are outstanding questions around the timing of HHS’s review, and the development of the savings target for the sixth year of the current model. Answers to those questions should emerge over the next few weeks, as your MHA team meets with HSCRC and federal staff.

As it stands now, the process remains on track for Maryland’s hospitals to continue to build on the successes they’ve realized over the first four years of the All-Payer Model: lower cost growth, better outcomes for patients, and healthier communities. These improvements are a prime reason why CMS supports our new model, and that support will be the driving force behind HHS approval of the model’s next iteration.