Maryland's Global Hospital Budgets — Preliminary Results from an All-Payer Model

• Published in: The New England journal of medicine Vol. 373; no. 20; pp. 1899 - 1901
• Main Authors: Patel, Ankit, Rajkumar, Rahul, Colmers, John M, Kinzer, Donna, Conway, Patrick H, Sharfstein, Joshua M
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 12.11.2015
• Subjects: Budgets; Centers for Medicare and Medicaid Services (U.S.); Cost Savings; Cost shifting; Economics, Hospital; Health care policy; Health Expenditures; Hospital costs; Hospital Costs - trends; Hospitalization - economics; Hospitalization - statistics & numerical data; Hospitals; Hospitals - standards; Humans; Maryland; Medicare; Medicare - economics; Patient Readmission - statistics & numerical data; Reimbursement Mechanisms; United States; United States; Maryland; United States > US
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMp1508037

In the first year of Maryland's experiment in setting all-payer rates for hospital services, costs were contained and the quality of care improved, though the state still has high rates of hospital admissions and per capita spending for Medicare patients. On January 1, 2014, the Centers for Medicare and Medicaid Services (CMS) Innovation Center and the state of Maryland launched the Maryland All-Payer Model, 1 under which CMS and Maryland agreed that all health care payers, including Medicare, would pay the same rates for inpatient and outpatient hospital services. This rate setting eliminated cost shifting among payers, equitably distributed the costs of uncompensated care and medical education, and limited the growth of per-admission costs. 2 It also meant, however, that Medicare paid higher rates for hospital services in Maryland than under the national payment program. As part of the agreement, Maryland pledged . . .