Oct 11, 2013 • 22M

Interview with Robb Cohen on Proposed Changes to Maryland's Hospital All Payer System (October 17th)

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Appears in this episode

David Introcaso, Ph.D.
Podcast interviews with health policy experts on timely subjects. The Healthcare Policy Podcast website features audio interviews with healthcare policy experts on timely topics. An online public forum routinely presenting expert healthcare policy analysis and comment is lacking. While other healthcare policy website programming exists, these typically present vested interest viewpoints or do not combine informed policy analysis with political insight or acumen. Since healthcare policy issues are typically complex, clear, reasoned, dispassionate discussion is required. These podcasts will attempt to fill this void. Among other topics this podcast will address: •Implementation of the Affordable Care Act •Other federal Medicare and state Medicaid health care issues •Federal health care regulatory oversight, moreover CMS and the FDA •Healthcare research •Private sector healthcare delivery reforms including access, reimbursement and quality issues •Public health issues including the social determinates of health Listeners are welcomed to share their program comments and suggest programming ideas. Comments made by the interviewees are strictly their own and do not represent those of their affiliated organization/s.
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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.