Feds Approve Expanded 'Maryland Model' All-Payer Contract

More than $1 billion in Medicare savings projected as CMS and Maryland state officials sign a five-year agreement to expand the state's value-based payment system into non-hospital settings.

The federal government has given the go ahead for a renewal and expansion of the "Maryland Model," which will take Medicare value-based care beyond hospital walls to include long-term and community-based care, and mental health services.

"The new Maryland Model will expand healthcare access and affordability – and ultimately improve quality of life – for Marylanders, especially those with chronic and complex medical conditions,” Maryland Gov. Larry Hogan said in a media release.

With the existing all-payer model up for renewal at the end of 2018, the Centers for Medicare & Medicaid Services required Maryland to build a new model that encompassed all of the healthcare that patients receive, both in the hospital and the community, including long-term care and mental health services.

The five-year contract signed this week by state and federal officials takes effect on January 1, 2019, and is expected to provide an additional $300 million in savings per year by 2023.

The expanded model will:

• Invest resources in care that is focused on the patient and enhance primary-care teams to improve individual patient outcomes;
   
• Set a range of quality and care improvement goals and provide incentives for providers to meet them;
   
• Concentrate resources on population health goals to help address opioid use and deaths, diabetes, hypertension, and other chronic conditions;
   
• Encourage and facilitate programs focusing on the needs of Medicare recipients across geographic settings and other key demographics.

The current Maryland All-Payer Model Contract started on January 1, 2014, and was set to expire on December 31, 2018. Maryland officials say the current model has already saved Medicare more than $586 million through 2016, compared to national spending, through reduced readmissions, and lower growth in hospital per capita costs.