Mid-Atlantic Health Law TOPICS

1. In February, the Health Services Cost Review Commission (HSCRC) approved adjustments to the per-admission rate structure to control costs at those Maryland hospitals choosing not to transition to a capped global budget. First, such hospitals may only increase their revenue in regard to volume increases of up to 2% (or 2.5%, in areas of Maryland experiencing population growth) per year. Second, for each admission representing greater than projected growth at such a hospital, the hospital will only be able to increase its revenue by 50% of its per-admission rate, rather than the prior 85%.

2. Also in February, the HSCRC approved two mechanisms for staying under the new 3.58% cap on the growth in Maryland hospital revenue per calendar year. First, the HSCRC could impose a one-time rate reduction on each Maryland hospital. Second, the HSCRC could permit hospitals to raise their rates/budgets by less than the HSCRC would otherwise permit.

3. In March, Maryland's Board of Nursing finalized rules establishing a new advanced practice nurse specialty. The new rules govern nurses who provide care to patients during inter-facility transport.

4. In April, the Maryland Health Care Commission (MHCC) published review schedules for new certificates of need for a variety of health care facilities, such as hospitals and comprehensive care facilities. Notably, the MHCC will begin accepting letters of intent for new hospice providers for Prince George's County (June 5, 2015) and Baltimore City (October 2, 2015), provided that the MHCC publishes updated need projections in the interim, and those projections continue to identify those two counties as having a need for an additional hospice provider.

5. The MHCC also recently published its first annual report on the Maryland Multi-Payor Patient Centered Medical Home Program. The Program is a pilot, and aims to reduce the cost and improve the quality of health care by transforming primary care providers into "medical homes" for patients wherein primary care providers assume greater responsibility for (a) monitoring patients' health and compliance with plans of care, and (b) coordinating care between primary care providers on the one hand and specialists and health care facilities on the other. Medical Homes typically use midlevel practitioners or non-clinicians to monitor or coordinate care. The annual report is the product of a study commissioned by the MHCC to determine whether the Program affected: (i) utilization, (ii) patient and provider satisfaction, (iii) access to care, or (iv) health care disparities. The annual report found that the Program increased survey-reported patient satisfaction (especially among African-American patients) and provider satisfaction. Patients in the Program were also more likely to use primary care services, and less likely to be admitted to the hospital, resulting in an overall decrease in expenditures