Mid-Atlantic Health Law TOPICS

A version of this article was published in The Daily Record on June 4, 2015.

1.   This spring, the Health Services Cost Review Commission (HSCRC) adopted a number of significant changes to rate-setting policy for Maryland hospitals. First, continuing its response to the decline in the uninsured coinciding with Medicaid expansion and the individual mandate, the HSCRC reduced, as of the start of the next yearly rate cycle (July 1), the built-in cushion to hospital rates to cover uncompensated hospital care. The HSCRC also permanently eliminated the cushion for charity hospital care. Second, responding to Obamacare's ban on health plan discrimination on the basis of pre-existing health conditions, the HSCRC approved regulations to eliminate hospital assessments tied to funding the phased-out Maryland health insurance plan (MHIP), Maryland's historic high-risk pool. Third, the HSCRC set a new readmission reduction benchmark and approved a rate boost (of up to 1% of rates) and a penalty (of up to 2% of rates) to reward individual hospitals for meeting these benchmarks, and to punish those that do not. Finally, to fund statewide care coordination initiatives, the HSCRC approved two hospital rate assessments for the next yearly rate cycle: $3.25 Million to support the health information exchange (HIE) of the Chesapeake Regional Information System for our Patients (CRISP); and up to $15 Million to fund grants to create further regional and statewide care coordination infrastructure.

2.   In February, the Maryland Health Care Commission recommended that the legislature curtail Maryland's experiment with freestanding emergency rooms.