Maryland hospitals have delivered wins under the All-Payer Model (2014-18) and the new Total Cost of Care Model contract with the Center for Medicare and Medicaid Innovation (CMMI). In addition to managing spending, we’ve grown savings while decreasing cumulative and year-to-date spending growth for Medicare beneficiaries.

Hospitals today face unprecedented challenges, seemingly from all sides. As we aim for better health for Marylanders, we encounter obstacles to building our workforce, upgrading our facilities, and strengthening our bonds with the communities we serve.

As we enter the holiday time and reflect on the year now ending, it’s striking how many challenges the Maryland hospital field faced and what you’ve accomplished. The new Total Cost of Care Model launched and you blew through the first year’s savings target. You built upon quality achievements from the previous model of lower readmissions and 30-day mortality.

As hospitals across the country face criticism for long emergency department wait times, the dearth of community-based behavioral health resources must be flagged as a significant cause. Many of your hospitals contend with behavioral health patients who simply have nowhere else to go—both at onset of an episode and when ready for discharge—due to lack of capacity in more appropriate care settings.