Cost Review Commission adds maternal and child health to priority list

Maternal and child health priorities have been added to Maryland’s Total Population Health list of priorities. Diabetes was identified as a statewide priority in 2019, as was addressing the opioid crisis. Though not specifically Medicare-focused, maternal and child health was added because of its history of health care disparities and the potential for significant improvement.



The recommendation was made at the Maryland Health Services Cost Commission Review meeting Dec. 9, which is in the process of improving care and slowing the increase of health care spending through the Maryland Total Cost of Care model. The model builds on the All-Payer model, which is a five-year demonstration project that established global budget goals for hospitals.

The workgroup recognizes hospital quality must continue to improve, with a focus on health equity. An additional measure is now included to reduce the readmission disparity gap. It also is in the process of developing goals, measures and milestones that will measure the success of the program.

Overall, the Statewide Health Improvement Strategy Presentation workgroup is looking to increase the quality of hospital care and transform care across the health system, while improving the total health of its beneficiaries. Its proposal will be complete by Dec. 31. Tequila Terry, principal deputy director of payment reform and provider alignment of Maryland Health Services Cost Review Commission, presented a progress update that includes milestones and targets. The goal is to develop a clinically focused measure for coordination of care for patients with chronic conditions, as well as a way to measure the total cost of care for those enrolled in value-based payment models.

Coronavirus has somewhat stymied efforts to develop this plan, as was pointed out by Commissioner John M. Colmers, but Dr. Alyson Schuster, Deputy Director, Quality Methodologies for the commission, believes plan development is still achievable despite setbacks.

This meeting is part of an ongoing effort by the Maryland and the Centers for Medicare & Medicaid Services to improve care and control health care costs. In 2014, the state and CMS entered into a new initiative to modernize Maryland’s all-payer rate-setting system for hospital services. The new Total Cost of Care (TCOC) model builds on the All-Payer model. However, the state’s Medicare spending growth must be maintained at below the national average growth rate. The TCOC model will give the state flexibility to tailor initiatives within Maryland’s health care context and encourages providers to drive health care innovation.

Maryland operates the nation’s only all-payer hospital rate regulation system.