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Md. Medicare model works

The recent commentary, "Maryland's Medicare experiment needs to end" (Aug. 31), got it wrong. Maryland's all-payer model for health care delivery improvement is on the right track. In January of 2014, Maryland partnered with the federal government to transform health care in the state, emphasizing higher quality of care that provides more value for our dollars. Since then, there have been life-changing improvements in the quality of health care provided to Marylanders. Hospital-acquired infections and conditions are down nearly 30 percent. Hospital readmissions, which increase the cost of care, are dropping significantly. Maryland hospitals are deeply engaged with their communities and local physicians to provide effective and efficient health care that meets the needs of patients. Hospital payment demonstrations that have been in place for years at Maryland's rural hospitals — and which are the foundation for early value-based payment models being implemented across the state today — have shown success through improved care for patients and a stabilization of resources for hospitals.

In other states, Medicare and Medicaid payments to hospitals are substantially below market price. As a result, private patients outside Maryland frequently pay, in what amounts to a hidden tax, more than 75 percent above Medicare prices. With the aging of the population, the situation gets worse. As the graying of America accelerates, more of the cost of hospital care nationally will be shifted to employers and individuals with insurance coverage to make up for low Medicare and Medicaid payments. In contrast, Maryland avoids that pitfall by ensuring that all payers pay the same rate for the same service at the same hospital.

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Despite spiraling health care costs, the United States falls short on some comparative quality measures. Congress recently passed a law that changes the way Medicare pays physicians to promote quality of service rather than quantity. The all-payer model aligns with the new federal strategy and is being supported by providers, consumers and public health agencies, all working collaboratively. This is why Princeton University health care economist Uwe Reinhardt called the new agreement, "the boldest proposal in the United States in the last half century to grab the problem of cost growth by the horns."

Maryland is placing the interests of the patient first while serving as an important model for the country in tackling challenges on a broad scale to improve outcomes and control costs. More information on the progression of Maryland's all-payer model may found on the Health Services Cost Review Commission website.

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Nelson Sabatini and Donna Kinzer, Baltimore

The writers are, respectively, chairman and executive director of the Maryland Health Services Cost Review Commission.

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