Earlier this week, Gov. Larry Hogan, along with officials with the Centers for Medicare & Medicaid Services, announced the approval of the next phase of Maryland’s unique health care financing system, the Enhanced Total Cost of Care Model. The successor to the highly effective All-Payer Model will begin in January and build on the impressive accomplishments hospitals have made in the past five years.
The new model, which could run 10 years depending on a federal review of the progress at the five-year mark, solidifies Maryland’s place as a leader among states in the volume-to-value movement in health care. And it shines a spotlight on everything you’ve accomplished: transformations and novel partnerships that have yielded slower cost growth, reduced readmissions, and fewer infections and complications, among other achievements.
The eyes of the nation have been on us over the past five years as we’ve tested a model to control cost growth and improve quality all at once. Your hard work made that a reality, and the nation will be watching again as we expand our scope beyond hospitals to nearly all health care providers.
This is an opportunity to innovate even further and on a scale that has never been tested. To get this right will take the collective strength of every hospital in Maryland, as well as engagement with health care practitioners, government leaders, regulators, payers, and patients and families.
Other states are poised to try elements of the Maryland model.
That doesn’t mean it will be easy. The financial targets are aggressive and demand a savings of more than $1 billion over the first five years. Quality targets also will be challenging, as health care providers will be expected to control chronic, far-reaching illnesses like diabetes, opioid use disorders, and heart disease.
To be successful, hospitals will need the state’s legislative and regulatory bodies to break down legal barriers, uphold financial commitments, and fulfill their duty to pave the path toward a high-performing health care system for our state.
That’s where your MHA will be integral over the life of this new model. One of our most important roles will be to keep the state focused on ensuring that the wholesale transformation of care in Maryland is not borne solely by hospitals, but shared among everyone who is invested in the well-being of all Marylanders.