What Maryland hospitals need to address in 2023


James Sklar


Like hospitals and health systems in much of the nation, Maryland’s hospitals are facing myriad challenges, which include an unprecedented financial strain, an historic workforce shortage, and a behavioral healthcare crisis.


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Financial strain

Maryland’s Health Services Cost Review Commission (HSCRC) published recommendations for 2023, and to keep up with current inflation and to account for underfunding of inflation through the pandemic, HSCRC staff requests that all hospitals increase each hospital’s budget by 3.38% for global budget revenues and 4.06% for non-global budget revenues. 

HSCRC recommends this increase to provide for operational readiness, ensure affordable healthcare for patients, and slow the growth of healthcare costs.

Workforce shortage

The 2022 State of Maryland’s Health Care Workforce Report, released by the Maryland Hospital Association (MHA), found that there is a workforce crisis in Maryland’s healthcare sector. The report detailed that one in four hospital nursing positions are vacant, and also cited high staff turnover and an insufficient nursing pipeline.

In a former interview with State of Reform, Nicole Stallings, Executive Vice President and Chief External Affairs Officer at the Maryland Hospital Association, commented on the impact of this shortage. 

“Our members’ primary challenge over the past several years has been their workforce. Heading into 2023, these challenges are greater than ever. Maryland hospitals are facing a historic workforce shortage, with our data showing that one in every four nurse positions is vacant.”

MHA’s task force proposed a strategy and recommendations for legislation to build a sustainable healthcare workforce. MHA said lawmakers should focus on four main policy areas: expanding Maryland’s workforce pipeline, removing barriers to healthcare education, retaining the healthcare workforce, and leveraging talent with new care models.

Under the four target areas, the top five highlights MHA recommends for policy makers include designating a state entity responsible for multi-agency coordination of data driven policy changes and programs, establishing stipends or financial incentives for healthcare jobs, removing barriers to internationally trained providers, allowing discharged/retired military personnel with caregiver experience to transition to caregiver careers more easily, and passing legislation to lower costs for students pursuing healthcare careers.

Behavioral healthcare crisis

The workforce shortage has extended to a shortage of behavioral health practitioners, which limits access to those who need this healthcare. Extending beyond the workforce shortage, to help with the behavioral health crisis in Maryland, MHA offers five policy recommendations, which include providing all patients with behavioral health screening, creating an infrastructure needed to provide immediate access to care, integrating and coordinating behavioral healthcare, investing in the high-skilled workforce, and investing in and making available prevention and harm reduction services.