For nearly four decades, Maryland's “all payer” system has set hospital prices for the state's 53 hospitals. The state regulates prices for every insurer including Medicaid, Medicare and patients who pay their own bills. Last week the state proposed to substantially alter how it pays state hospitals by creating over time a capitated payment system (a hard cap) that would increase overall spending using a ten year rolling average. Maryland would save a minimum projected $300 million over the first three years of the program if the state managed to keep the pace of hospital costs commensurate with the state's economic growth. If successful, Maryland would join one other state, Massachusetts, in tying hospital spending to the growth of the state's economy.
During this 21-minute interview Mr. Cohen explains why Maryland's all payer system remains unique, why the state is now proposing to reform its all payer system, he explains how specifically it intends to revise its reimbursement formula, how it will work practically, how it will generate cost savings (largely through health care quality improvements) and what challenges the state will face should the federal goverment approve its proposal to revise its payment system.
Mr. Robb Cohen is currently Senior VP of Public Policy with the Gorman Health Group. Prior to Robb founded XLHealth, a Special Needs Plan (SNP), and served as their Chief of Goverment Affairs. Prior still Robb was the Founder and President of Phoenix Healthcare Consulting. Robb graduated from the Wharton School of the University of Pennsylvania, the Leonard Davis Institute in Health Economics with an MBA in Finance and Healthcare Management. Among other community activites Robb has served on a number of State of Maryland Department of Health & Mental Hygiene workgroups and task forces.
To learn more about the Maryland proposal go to: http://dhmh.maryland.gov/SitePages/Medicare%20Waiver%20Modernization.aspx.