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Maryland’s New Waiver: From Design to Implementation

Maryland’s New Waiver: From Design to Implementation. Michael B. Robbins Senior Vice President, Financial Policy & Advocacy Maryland Hospital Association January 31, 2014. Happy New Year! Are You Ready?. New Financial Tests All-Payer Annual Spending Per Capita Growth of 3.58%

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Maryland’s New Waiver: From Design to Implementation

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  1. Maryland’s New Waiver:From Design to Implementation Michael B. Robbins Senior Vice President, Financial Policy & Advocacy Maryland Hospital Association January 31, 2014

  2. Happy New Year! Are You Ready? • New Financial Tests • All-Payer Annual Spending Per Capita Growth of 3.58% • Medicare Hospital Savings of $330 million between 2014-2018 • Medicare Total Spending Per Beneficiary Guardrails • New Quality Targets • Reducing Readmissions Rate to national rate over next five years • Reducing PPCs under the MHAC program by 30% over the next five years

  3. Transition: January 1-June 30, 2014 • HSCRC Bridge Transition Policy – seeking comments • Two options: global budget or CPE with VCF and volume governor • Issuing of rate orders: interim rate orders for second half of FY 2014? • HSCRC Work Groups • Submission of policy “white papers” • Recommendations to HSCRC for policies to be implemented, most by July 1, 2014

  4. Policy Updates and New Policies • Uncompensated Care Policy • MHAC Policy • Incentives to reduce avoidable utilization, including readmissions • Overages and underages • Annual update factor • Market share changes and population attribution

  5. Keys to Success • DATA IS KEY !!!!!!!!!!!!!!!!!!! • TRANSPARENCY

  6. Other Items? • Expansion of coverage, including transition of MHIP enrollees • OP rate tiering/adjustment of assessments • Governor’s budget/Medicaid assessment • Access to safety net services/malpractice cost issues

  7. QUESTIONS?

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