5 Things Maryland: Department of Health RFPs, Q&A w/ Joe DeMattos, Hospital price transparency
In this month’s newsletter we feature two new RFPs out of the Maryland Department of Health, a video interview with HFAM CEO & President Joe DeMattos, and a conversation on efforts to improve the implementation of Certified Community Behavioral Health Centers in the state.
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State of Reform
1. MDH releases two Medicaid-related RFPs
The Maryland Department of Health released an RFP this month seeking a contractor to administer dental benefits to eligible Medicaid beneficiaries. The search for a Dental Benefits Administrator or Dental Administrative Services Organization follows the passage of House Bill 6/Senate Bill 150 during the last legislative session, which requires the Maryland Medical Assistance Program to provide dental services to eligible adults beginning January 1st, 2023.
Also this month, MDH released an RFP for a statewide non-emergency medical transportation contractor for Medicaid enrollees. The RFP states: “… the most fundamental functions of a NEMT broker are to be a single point of contact for beneficiaries to request transportation assistance, and to directly arrange the least costly and most appropriate type of transportation for each Beneficiary.” Proposals are due Nov. 1st at 4 pm Eastern Time.
2. Experts discuss CCBHC implementation
In an effort to further improve the implementation of Certified Community Behavioral Health Clinics in the state, the Institute for Innovation and Implementation at the University of Maryland held a meeting last week to discuss improving CCBHC quality and reporting measures. The meeting brought together representatives from several states to discuss lessons learned during their implementations of CCBHCs.
A key lesson discussed was the importance of utilizing data and evidence-based treatments to improve outcomes. Specifically, the experts highlighted the importance of program assessments, data sharing, and the development of new partnerships within the health system. “As we continue to move forward in the mental health crisis that we’re in currently, we need to pay attention to two things in particular,” said Tennessee’s Keri Virgo. “One is that we need to be able to partner with anyone and everyone to give folks what they need. The second is services and supports that are well measured and show improvement need to be our standard of care.”
3. What They’re Watching: Joe DeMattos, HFAM
As President & CEO of the Health Facilities Association of Maryland, Joe DeMattos is focused on improving care integration for the state’s long-term care settings. In this edition of “What They’re Watching,” DeMattos discusses what can be done to improve access to care, particularly for underserved communities.
“Here in Maryland, we have outstanding teaching hospitals and outstanding medical centers,” says DeMattos. “We have great nursing homes and assisted living centers, but those dots are not often connected. Sometimes they’re connected—in communities that are more challenged—by dotted lines that need to be filled in. A big part of our work right now is on connecting the dots, but also recognizing the work that we have to do to reach underserved, more at-risk communities.”
4. Hilltop researchers to launch hospital pricing studies
Researchers at The Hilltop Institute at UMBC received a $282,412 grant from the National Science Foundation to launch an extensive data collection project on hospital pricing behaviors. Since 2021, hospitals have been required by federal law to provide standard charges for their services, as well as the negotiated rates for each payer. By gathering and assessing this new data from a sample of hospitals nationwide, the researchers hope to open up a new field of research on hospital pricing and payer negotiation.
“We feel like being in Maryland (with its all-payer model) gives us this quite unique and objective vantage point, because in virtually every other state, we’ve seen tremendous variability in pricing for the same procedure across payers within a hospital,” says Hilltop Principal Data Scientist Dr. Morgan Henderson. “… there’s a lot of interesting research to be done looking at hospitals on either side of Maryland and other state borders. That itself will be a fantastic study.”
5. Maryland excels in Medicaid redeterminations
States are continuing to prepare for the unwinding of the federal public health emergency and the subsequent Medicaid eligibility redeterminations that must take place. A new report from CMS studied each state’s ability to process modified adjusted gross income (MAGI) applications within Medicaid and CHIP, and found that Maryland processed nearly all applications in less than 24 hours, 2nd only behind Oklahoma.
Maryland has prepared for the PHE unwinding throughout the pandemic, in part through constant communication with its managed care organizations, local health departments, and community-based organizations. Following the report’s publication, a spokesperson for the Maryland Medicaid Administration said they are awaiting further guidance on the PHE unwinding from the US Department of Health and Humans Services.