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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

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
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


Transition january 1 june 30 2014
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


Policy updates and new policies
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


Keys to success
Keys to Success

  • DATA IS KEY !!!!!!!!!!!!!!!!!!!

  • TRANSPARENCY


Other items
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



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