National Leader

• The state of Maryland, hospitals, and insurance companies partnered

• Applied to the federal government for a 5 year “demonstration project”

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Objectives

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Opportunity for Maryland to be a NATIONAL LEADERin health care

CHANGEthe way we pay and provide health care

BUILDon the great system we have and make it even better: • More affordable • Safer • All about you

Starts with Hospital Care

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• Work together to slow growth in spending for hospital care

• Continue Maryland’s unique way of setting hospital prices

• Change how hospitals are paid to reward the right things

Affordable

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$ Slow growth in spending for hospital care

• Track spending in inpatient and outpatient hospital care in Maryland

• Grow no faster than the overall economy (3.58% a year)

• Cut growth in hospital spending in half

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Affordable

$• MARYLAND: only state where

hospitals don’t decide how much to charge for care — the state sets hospital prices

• Hospital prices still set by state

• Utility ‒ like hospital regulation will continue

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Safer

READMISSIONS: patients who return to the hospital within 30 days of hospital discharge

Maryland ranks poorly(almost last)– 49 of 51 states and D.C.

Bring Maryland readmission rates to NATIONALAVERAGE in 5 years

Better and SAFER for YOU

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Safer

INFECTIONS: patients who get infections while in the hospital

Maryland rates of infection HIGHER than nation

REDUCE infections and other “hospital-acquired conditions” by 30% in5 years

Better and SAFER for YOU

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All About YouChange how hospitals are paid to reward the right things

• Hospitals previously paid more to do more

• Can lead to unnecessary procedures, visits, and care

• Hospitals now rewarded for helping people stay healthy, well, and out of the hospital

• Nearly all hospital payments will reward health and wellness in 5 years

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Challenges

• Never been tried; Never been tested

• Hospitals in serious financial condition – 40% losing money today

• New hospitals spending limits tight

• Will require hospitals to redefine themselves

• Will require communities to work together to keep people healthy

• Will require patients and families to truly engage in their care

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Opportunities

• Continue our unique hospital rate-setting system

• More equitable care for low income and uninsured people

• Should lead to slower growth in insurance premiums

• Lead nation in reforming health care

• Statewide focus on quality and safety

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Next Steps

• Federal government must approve state application

• Rate-Setting Commission to put in place all the details

• Hospitals to invest in IT, care coordinators, and more to help manage community health

• All eyes on Maryland