Maryland

Maryland officials on Monday announced federal approval of a new contract for the state’s unique all-payer health care model.

Maryland is the only state that can set its own rates for hospital services, and all payers must charge the same rate for services at a given hospital. The policy has been in place since the 1970s, though Maryland modernized its one-of-a-kind Medicare waiver four years ago to move away from reimbursing hospitals on a fee-for-service basis to a fixed budget.

It wasn’t medical knowledge or clinical acumen that ultimately helped Catherine M. White, M.D., FAAP, impact the life of a patient with special needs. It was her team’s commitment to building a relationship with the child’s mother, so they could determine why the family was missing the specialist appointments critical to the child’s care.

Tucked into the federal budget law Congress passed in February was a provision that significantly expands the use of telemedicine — long a hyped health care reform, and now poised to go mainstream within five to 10 years.

“There’s much broader recognition of the benefits,” said Mei Wa Kwong, executive director of the Center for Connected Health Policy, a research group that promotes telemedicine in Sacramento, Calif. “The law is the latest to make telemedicine more accessible. But we still have a ways to go before most consumers are aware of the option.”

Baltimore, MD (April 05, 2018) - CareFirst BlueCross BlueShield (CareFirst), the region’s largest not-for-profit insurer, plans to award $1.5 million over two years to programs increasing access to substance use disorder services – including efforts to combat opioid addiction – in Maryland, Washington, D.C., and Northern Virginia.

A couple of years ago, the health insurance exchange in Minnesota – MNsure – was in deep trouble. Health insurance premiums for individual policies had shot up by as much as 67 percent, among the steepest increases in the country.  Insurers were abandoning the market, leaving 116,000 Minnesotans with scant choices.

Saturdays at Mercy Medical Center used to be perversely lucrative. The dialysis clinic across the street was closed on weekends.

That meant the downtown Baltimore hospital would see patients with failing kidneys who should have gone to the dialysis center. So Mercy admitted them, collecting as much as $30,000 for treatment that typically costs hundreds of dollars.

As President Donald Trump and congressional Republicans tirelessly try to dismantle the Affordable Care Act, a number of states are scrambling to enact laws that safeguard its central provisions.

The GOP tax plan approved by Congress in the last days of 2017 repealed the ACA penalty for people who fail to carry health insurance, a provision called the “individual mandate.” On Jan. 30, in Trump’s first State of the Union address, he claimed victory in killing off this part of the health law, saying Obamacare was effectively dead without it.

Maryland is first out of the gate with a plan to replace the individual mandate — an early sign that the states that like Obamacare will be spending a lot of time thinking through what fits best into this gaping health policy hole that the Republican tax bill created.

The Maryland proposal would reinstate financial penalties for those who decide to go without health coverage. Maryland state Sen. Jim Rosapepe, one of the co-sponsors of the plan, tells me they’d like to set the fees similar to where they’ve been under the Affordable Care Act.

What's one of the most effective ways to get doctors to change their referral and drug-prescribing habits, two of best-known drivers of health care costs? Tap into their competitive sides.

That's what CareFirst BlueCross BlueShield CEO Chet Burrell told attendees at the recent Health Datapalooza conference in D.C. as he discussed how data has become a secret weapon for the Owings Mills-based insurer, the region's largest.