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Affordable Coverage = Accessible Care
Since the inception of the All-Payer Model in 2014, Maryland's hospitals have demonstrated to the nation that it is possible to hold down health care cost growth and improve quality at the same time. Next January, under the new Total Cost of Care Model, Maryland's bold experiment will expand to encompass not only hospital services but services of non-hospital providers, ranging from physicians to skilled nursing facilities. Of significance, our hospitals will have more potent incentives to work with care partners to mitigate chronic illnesses, like diabetes, for whole communities.
One of the keys to hospitals' early success, and an essential pillar for the new model, is for people to have good, affordable insurance coverage so they can access care when they need it. If Marylanders can't get the care they need in the most appropriate settings, then the system begins to break down. People delay care and get sicker until there's no alternative but a high-cost, acute setting.
This week, MHA testified in person and submitted a
letter
to the Maryland Insurance Administration weighing in on insurers' individual market rate increase requests for 2019. The carriers' requests are in some instances breathtaking and in most cases do not seem reflective of our moderate hospital cost trends. Considering that premiums have been climbing precipitously for several years, there is deep concern that many Marylanders will be left without decent coverage.
In addition to advocating that the savings achieved under the Maryland Model be passed on to consumers, MHA recommended that the administration do three things:
- ensure that the requests are based on accurate hospital spending and utilization trends
- conduct an in-depth analysis of enrollee characteristics and insurer programs to manage them
- explore care management incentives under a state reinsurance program to help drive down insurance costs
These actions could go a long way toward ensuring that all Marylanders have meaningful, affordable coverage.
MHA is also participating in a series of public hearings on the State Reinsurance Program, to further support broad-based coverage. And we have advocated with the federal government to approve our state's application for waivers under the Affordable Care Act to help fund the reinsurance pool.
The start of the new model is less than five months away and we need a strong foundation for launch. Achieving the model's core goals of controlling all health care costs and promoting the long-term well-being of all Marylanders demands a united effort from all stakeholders, including payers.
Bob Atlas
President and CEO
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| MHEI PROGRAMS AND WEBINARS |
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Webinars Offered on Primary Care Program
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The Maryland Primary Care Program is hosting a series of webinars in August for those interested in applying to participate:
To register, click the links above. Online applications for practices to participate will remain open until Friday, August 31. The
Request for Applications
has the full program requirements.
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Care Transformation Organizations Receive Approval
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The Centers for Medicare & Medicaid Services has released a
list of organizations
that have received preliminary approval to serve as Care Transformation Organizations for the Maryland Primary Care Program. More details on each are available in this online
Comparison Tool
. The tool allows practices applying to participate in the primary care program to compare key characteristics of Care Transformation Organizations available in their area.
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MPSC Launches Opioid Education Initiative
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The
Maryland Patient Safety Center
(MPSC) has launched a consumer education program to increase the public's understanding of issues surrounding opioid use and abuse. The statewide program will offer presentations led by physicians from various Maryland hospitals and health systems in all of Maryland's 23 counties and Baltimore City. Each educational session outlines the key messages surrounding the use of opioids. Topics covered include: proper storage and disposal of opioids, questions patients should ask their doctors, and conversations doctors need to have with their patients when opioids are prescribed.
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The Disruptors: How Google, CVS, and Amazon Plan To Change Health Care
As health care turns to data and digital health, organizations such as Google, CVS and Amazon are leveraging their already successful businesses and preparing to enter the health care field in a big way.
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Prime Offers Solutions for Market Analyses, Intelligence and Forecasting
Prime, through its affiliation with Vizient, offers solutions through Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services.
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FCC Seeks Comments on Connected Care Pilot Program
The Federal Communications Commission is accepting
comments
on a new $100 million Connected Care Pilot Program to support telehealth for low-income Americans, especially those living in rural areas and veterans.
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Tuesday, August 7
- MHA Behavioral Health Task Force meeting
Thursday, August 9
- MHA Technical Work Group meeting
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The Baltimore Sun
, By Jeff Barker, July 27
WTOP
, By Liz Anderson, July 28
Washington Business Journal
, By Sara Gilgore, July 30,
Baltimore Business Journal
, By Morgan Eichensehr, July 31
WBOC
, By Amy Lu, July 31
Delmarva Now
, By Gray Hughes, July 31
WCBC Radio
, August 1
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