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Annual Update to Unit Rates
Accounting and Budget Manual
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Community Benefit Program
The Maryland Department of Health and Mental Hygiene (DHMH) and the Maryland Health Services Cost Review Commission (HSCRC) are working on transforming Maryland’s healthcare payment and delivery system. Partnering with a broad group of stakeholders, the State is focused on three core goals: improving health outcomes, reducing costs, and improving quality of care and patient experience for all Marylanders.
To achieve these goals, consumer engagement is essential at all levels of the healthcare delivery system. Therefore, DHMH and HSCRC established the Consumer Standing Advisory Committee (C-SAC) to bring together a diverse cross-section of consumers, consumer advocates, subject matter experts, and other stakeholders.
The C-SAC will:
Background on the All-Payer Model and the Comprehensive Primary Care Model:Maryland, under agreement with the Centers for Medicare & Medicaid Services (CMS), launched the All-Payer Model in 2014 to transform the health care delivery system and improve care, while moderating cost growth. The All-Payer Model changed the way Maryland hospitals provide care, shifting hospitals from a financing system based on volume of services to a system of hospital-specific global revenues and value-based incentives. While still in the early stages of transformation, Maryland has employed a robust stakeholder process and has achieved many successes during its first term (2014-2019). For example, the All-Payer Model has encouraged hospitals to reduce readmissions, unnecessary emergency department utilization, and hospital-acquired conditions, while also limiting the growth in health care costs.
The current All-Payer Model is set to expire in 2019. As a result, the State is currently negotiating a second term of the All-Payer Model, as described in the State’s “Progression Plan.” In the Progression Plan, the State recognizes that further collaboration across the spectrum of health care delivery (i.e., beyond hospital walls) is necessary to support the health and well-being of individuals as they move across care settings. Thus, Maryland is expanding its efforts to support hospitals, physicians, and other providers as they take on increasing responsibility for improving care and population health, while moderating cost growth.
Maryland’s Comprehensive Primary Care Model (MD CPC) is key to the Progression Plan. While hospital-based programs are essential for complex and high-need patients who are already using extensive resources, primary care is critical for patients with rising needs, who may be able to avoid seeking care in higher acuity settings. Therefore, the MD CPC focuses on a targeted population of the approximately 800,000 Medicare patients in Maryland, who often have chronic illnesses and rising needs. The MD CPC supports the vision of the All-Payer Model by: implementing effective care management; connecting patients with social services; improving transitions of care between hospital-led care and community-based care; and providing additional reimbursement for MD CPC providers, practices and care management organizations to support care transformation.
The HSCRC and DHMH have appointed a diverse group of individuals to serve on the Consumer Standing Advisory Committee. The current list of workgroup members is available CSAC Roster
The Committee will reserve time at the end of each meeting for brief comments and questions from the public. The public is also encouraged to submit written comments related to C-SAC initiatives to: email@example.com
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