Mid-Atlantic Health Law TOPICS

1. The Health Services Cost Review Commission (HSCRC) reported that Maryland hospitals' inpatient charge per case rose to $12,847.85 for the twelve months ending November, 2011, an increase of 8.28% against the previous twelve month period. The HSCRC had anticipated a 4.3% increase, and warned that if current trends continue, Maryland's long-standing Medicare waiver would be revoked. The waiver allows Maryland hospitals to charge Medicare for hospital services at rates set under Maryland's unique all-payor case rate system, rather than at Medicare-set rates.

2. Last December, the Maryland Health Care Commission (MHCC) issued its final 2012 reporting requirements for Maryland's commercial health benefit plans. Reports must include data on various measures, including measures related to effectiveness of care and enrollee utilization of services. The MHCC also released its 2011 report. That report showed that Maryland HMOs and Point of Service plans (which are generally Preferred Provider Organizations with assigned primary care providers) on average only outperformed their regional and national counterparts on metrics related to children's health, such as immunization compliance and access to pre-natal care.

3. The MHCC also recently published an analysis of the market for employer-sponsored health insurance in Maryland's private sector workforce. The analysis revealed that over half (53%) of Maryland's private sector workers are enrolled in employer coverage, and that many other private sector workers either purchase coverage on their own, or are perhaps covered under Medicare or a spouse's non-private sector plan. In total, Maryland private sector workers are more likely to have health insurance than the national average (83% vs. 78%).