Maryland All-Payer Model Resulted in $975 Million in Total Savings

On March 2, 2020, CMS released the final evaluation report and a summary of the findings for the Maryland All-Payer Model (MDAPM). The report found that the model helped reduce hospital utilization and lower expenditures for dual-eligible beneficiaries and beneficiaries with multiple chronic conditions. In total, the MDAPM produced $975 million in total savings without shifting expenditures to other parts of the healthcare system. Overall, emergency department visits and inpatient admissions declined for Maryland residents enrolled in commercial insurance, although the decline was not statistically significant for inpatient admissions.

Under the All-Payer Model, Maryland hospitals are exempted from Medicare’s inpatient and outpatient prospective payment systems. Instead, these providers are shifted to an all-payer, annual global budget. This model is intended to eliminate the payment differences across payers present in other states by establishing uniform payment rates for all payers.

On January 1, 2019, the Center for Medicare and Medicaid Innovation (CMMI) began testing the Maryland Total Cost of Care Model, which builds on the MDAPM and incorporates lessons learned on alignment within a state’s healthcare system.

For more information and updates, please visit the Maryland All-Payer Model website.

 

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For more information visit the McDermottPlus Payment Innovation Resource Center or contact Mara McDermott at 202-204-1462 or mmcdermott@mcdermottplus.com.