Module Components

• Overview
• Assignments

Topics

• MD: The ONLY State without DRGs
• Current Challenges
• Moving Forward

NDNP 803 - Executive Leadership and Healthcare Economics

Module 12: Reforming Health Care in Maryland

Behind the HRCSC “Curtain”

There is a famous scene in the movie "The Wizard of Oz" when Toto opens a curtain and exposes a little man who is pulling levers and pushing buttons that appear to be controlling the image of the great and wonderful Wizard of Oz. After the curtain is drawn, the great and powerful Wizard commands Dorothy and her friends to ignore the man behind the curtain.

For many, there is a curtain at Maryland’s HRCSC.

For decades Maryland has maintained a hospital payment system in which all payers—public and private—pay the same rates. This paper describes Maryland’s all-payer hospital payment system—the legislative goals and principles that directed regulatory efforts in the state; how well the system performs in meeting these goals; and current initiatives on payment design, quality-based reimbursement, and their application elsewhere in the health sector. Maryland’s rate-setting system is one of the most enduring and successful cost containment programs in the United States. Lessons learned are relevant to other states and provide useful bases for consideration of future health reform strategies.