States Strategies

Maryland All-Payer Model

 The creation of this innovation was enabled by 1971 Maryland legislature act, and through which a Health Services Cost Review Commission (HSCRC) was established with various responsibilities relating to public disclosure of financial information of hospitals and even trustee relationships. This commission was given the mandate to set rates for hospital payments affecting all payers. The implementation of this system was driven by the need to address the rapid rise in hospital costs and risk of insolvency faced by many non-paying patients (Consumers Union, 2015). Hence, those patients who depend on these hospitals for healthcare were faced about to lose access to them.

 This system is enabled partly by a Medical waiver spanning 36 years, and Maryland is exempted from OPPS (Outpatient Prospective Payment System) and also from IPPS (Inpatient prospective Payment System) which accords it the authority to set payment rates for the health care services provided by hospitals. This waiver allows all the third parties to use the same rate while making payment .The expectations are that All-Payer Model can succeed in betterment of the health care provided while minimizing program expenditures among the residents of the State including the beneficiaries of CHIP, Medicaid and the Medicare (Center for Medicare & Medicaid Services, n.d).

 The system has been very effective in serving the purpose for which it was intended since its implementation. The state has been able to moderate the rise in costs for each hospital admission and has seen an improvement in financial stability among the various hospitals across the state. In addition, the state kept increase in costs for each service in the hospitals quite low in comparison to other states. Statistical data shows that the state has gone from 1967 26 % higher than national average to about 2 % lower as per 2007(Consumers Union, 2015).

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