Opportunities to maximize the waiver model in Maryland

Maryland’s waiver model of care – the “Maryland Model” – is well regarded by a range of stakeholders, but that doesn’t mean there isn’t still work left to do. At the 2021 Maryland State of Reform Health Policy Conference, a panel of experts talked through how best to continue to improve on Maryland’s model of care, and where efforts at system improvement will yield the best returns.

 

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The panel included:

Bob Atlas (Chief Executive Officer, Maryland Hospital Association), Maria Harris Tildon (Executive Vice President, Public Policy & Government Affairs, CareFirst BlueCross BlueShield), Joe DeMattos, Jr. (Chief Executive Officer, Health Facilities Association of Maryland) and Joshua Sharfstein, MD (Vice Dean for Public Health Practice and Community Engagement, Johns Hopkins Bloomberg School of Public Health).

The panelists discussed all things related to the Maryland Model, from why it was developed to how it was adopted to how it is doing today.

Around 2011-2012, there was a bit of crisis in the health care system in Maryland. It was in that context that the Maryland Model was born, said Sharfstein.

We had this system of rate setting for hospitals that had been in place for 30 years and had done a lot of great things for the state, but it was on a shaky foundation. The shaky foundation was caused by some general health care trends and some challenges in Maryland. That led to a review with the Centers for Medicare and Medicaid Services in the federal government of how things were going and whether the system that had been developed could be built on. That led to an opportunity for the state of Maryland.

The federal government was prepared to support Maryland if the state remained to “The Triple Aim” – better health, lower costs and a better patient experience.

From that starting point, Atlas and DeMattos discussed what the data says about the Maryland Model. The group looked at the Maryland Model’s savings goals, Maryland’s outperformance of other states with respect to hospital spending in employer-sponsored plans, key quality metrics, and more.

Watch the full conversation above or at this link.