Year 1 of Maryland’s New Waiver: What Are We Learning?

1. Year 1 of Maryland’s New Waiver:What Are We Learning? Michael B. Robbins Senior Vice President Maryland Hospital Association August 22, 2014

2. First Impressions • Data remains key • Policies, policies, policies • Communicate and collaborate • Educate, educate, educate • Where are we: dash-boarding results to date

3. Data Remains Key • CMS calculates Medicare targets: access to data and verification of calculations • Hospitals submit data: MD vs. Non-MD, Medicare FFS vs. Medicare HMO, Preliminary vs. Final • Adhering to timeframes for submitting and finalizing data as well as “cleaning data” are critical • Turning data into information: hot-spotting, where to focus resources, trending and modeling results

4. Policies, Policies, Policies • Uncompensated Care Policy • MHAC Policy • Readmissions and shared savings • Balanced Update • Demographic/population growth adjustment methodology • Adoption of global budgets

5. Policies, Policies, Policies • Total revenue budget and unit rate compliance • Adjustments to global budgets: transfers, market share, regulated to unregulated, and potentially avoidable utilization • Capital funding • Overages and underages • Infrastructure funding and reporting • Global budget reporting

6. Communication and collaboration • HSCRC Workgroup and sub-group process • Readmissions reduction efforts: working with new partners • Transparency: sharing of data and information

7. Educate, educate, educate • HSCRC Webinars began before waiver was approved • MHA Education series: MHAC policy changes, Readmissions, UCC, Demographic methodology • Engaging hospitals, community-based and professional society organizations on the waiver and their role in its success • Maryland Chapter of HFMA

8. So Where Are We? • Financial Tests: On target • MHAC Reduction: On target • Readmission: Short of target • Other metrics being monitored • HSCRC and MHA dashboards: Targeting areas for improvement

9. QUESTIONS?