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05/20 10:00 PM ET; 05/24 5:00 AM ET; 05/25 2:00 PM ET

Colin Donovan, Father Mark Mary, MFVA, and Cindy Cuellar discuss the growing moral crisis related to End of Life medical care.

 

 

 

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What’s stopping you from becoming Catholic? Catholic catechist, writer and speaker, Dr. David Anders talks lovingly but clearly with non-Catholics & fallen-away Catholics in this live call-in show.

 

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FEATURED

The state began piloting the all-payer model for state hospitals in January 2014, in attempts to incentivize keeping people healthy and reducing their need for high-cost hospital care. Essentially, under a federal waiver, the state has been exempt from typical Medicare regulations. The waiver program allowed the state to set budgets for hospitals, and allowed hospitals to try and reduce health care spending and improve community health through universal payment structures. State officials have been working with the federal government over the past two years to explore expansion options.

Now, Maryland has entered a new five-year contract with the Centers for Medicare and Medicaid Services to grow the program to include community providers like nursing homes and primary care physicians' offices. The new model will take effect starting on Jan. 1 and will extend through the end of 2023. The contract can then be extended for an additional five years, pending a review of the terms.

Participation in the model by community providers will be voluntary. Donna Kinzer, executive director of the Health Services Cost Review Commission, said many nursing homes and care offices throughout the state have already signaled their interest.

This expansion, now being called the Maryland Model, will build on some of the successes the all-payer program has already demonstrated. A state report released by the Department of Health last month, noted that state hospitals have reduced readmissions, or the need for someone to come back to the hospital after treatment, by more than 6 percent between 2014 and 2016. And they reduced potentially preventable conditions, or harmful events or negative outcomes that may result from the process of care, rather than from a natural cause, by 30 percent. Rates of complications and infections acquired in hospitals have been reduced by nearly 45 percent since 2014.

Overall, the state said the model has saved Medicare more than 6 million through 2016, compared to national spending. And Maryland officials project the new model could result in an additional 0 million in savings per year by 2023 up to a total of billion over five years.

One of the criticisms of the state model has been that it was limited in its budgeting scope and left out payments to physicians and other care providers. Kinzer said this new contract will address that.

"We had success in saving money over the first five years, but we do recognize the need to get together with community providers and bring this model to full fruition," she said.

The Maryland Model will include:

  • Programs to coordinate care across both hospital and non-hospital settings, including mental health and long-term care
  • A Maryland Primary Care Program to invest resources in care that is focused on improving individual patient outcomes ?
  • Incentives for providers to to meet a range of new quality and care improvement goals
  • Community resources concentrated on population health goals, like addressing the opioid epidemic, and reducing diabetes, hypertension and other chronic conditions

The new Maryland Model will expand health care access and affordability and ultimately improve quality of life for Marylanders, especially those with chronic and complex medical conditions, Gov. Larry Hogan said in a statement. Maryland continues to lead the nation in innovative health care delivery, and the expansion of our successful model is a huge step forward in our efforts to ensure that every Marylander has access to quality care.  

Maryland Sen. Ben Cardin said he hopes the Maryland Model "can show other states how to successfully reward quality over quantity," by moving away from traditional payment models which value high admission rates, and concentrating on better managing patients' overall care.

Bob Atlas, CEO of the Maryland Hospital Association said the state's hospital have already laid a foundation over the past several years for how improving the quality of health care can be linked with cost containment.

During this time, the model has saved Medicare and patients hundreds of millions of dollars and has enabled hospitals to invest in innovative, proactive initiatives," Atlas said in a statement. "Now, Marylands hospitals stand ready and committed to continue our work with the state by engaging our care partners to meet the health care needs of every Marylander. 

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