Providing a Health Policy Think Tank for Maryland

The Commission plays a key role in developing health policy options, both for the Administration and for the General Assembly.

Reports that Help Guide Policy

• A report on health care expenditures in Maryland, particularly on spending by the privately insured and uninsured
• An analysis of access of insurance coverage for Maryland residents
• An analysis of the insurance coverage offered by private employers
• Special studies of importance to policymakers, including prescription drug spending, uncompensated care, and primary care services

Supporting health care reform by working collaboratively to implement the major recommendations of the Health Care Reform Coordinating Council (Chair Moon serves on the Council)

• Establish the basic structure and governance of Maryland’s Health Benefit Exchange;
• Continue development of the state’s plan for seamless entry into coverage to meet federal implementation deadlines and to maximize federal funding for information technology (IT) systems and infrastructure;
• Institute comprehensive workforce development planning;
• Achieve cost savings and quality improvements through payment reform and innovation in health care delivery models;
• Promote improved access to primary care;
• Achieve reduction and elimination of health disparities through exploration of financial, performance-based incentives and incorporation of other strategies;
• Preserve Maryland’s strong base of employer-sponsored insurance.

Monitoring and reforming the Small Group Market

• MHCC, the MIA, carriers, producers, and employers have worked together to make insurance accessible in this market. Recent rapid increases in premiums in the small group market, coupled with the economic downturn, pose a challenge to small businesses and their employees.
• As premiums continue to rise, MHCC has made hard choices to slow cost growth for the product. Legislation in 2009 broadened the rate bands, introduced protections against adverse risk selection (preexisting condition exclusion for previously uninsured and rating adjustments for health status on the group’s initial entry into the small group market).
• MHCC will redefine its role in the oversight of the small group market as a result of the ACA.

Making Certificate of Need Work for the Citizens of Maryland

• The Commission is in the midst of revising State Health Plans for Hospice, Home Health, and Nursing Home Services. In each major area, we will bring health economics expertise to bear on this often controversial area and identify the options that best serve the citizens of Maryland.
• Maryland hospitals are in the midst of a multi-billion dollar program of construction and renovation, replacing and modernizing aging hospital facilities throughout the state.
• Major hospital modernizations authorized by MHCC are nearing completion including major projects at Johns Hopkins, University of Maryland, MEDSTAR, and numerous other systems.
• In January 2011, the MHCC issued a certificate of need for construction of a new hospital in Germantown Maryland.
• Hearings are underway on an application to build a replacement hospital for Washington Adventist Hospital in the White Oak area of Silver Spring Maryland.

In the controversial areas of percutaneous coronary interventions and cardiac surgery, the Commission:

• Oversaw and evaluated the C-PORT clinical trial of primary PCI and developed a waiver process to assure access to high-quality emergency angioplasty; and
• Establish and oversee a waiver process that is aligned with the clinical trial of non-primary angioplastywithout back-up on-site open heart surgery.

Promoting Electronic Health Records and Secure Health Information Exchange (HIE)

Health information technology is essential to improve quality, reduce medical errors, and control health care costs by assuring appropriate, high value care.

MHCC is:

• Overseeing the diffusion of technology and directing the expenditure of federal and state funds for the establishment of state HIE and the adoption of electronic medical record systems by providers.
• Defining policies for HIE operation and information sharing.

Providing Consumers with Better Information to Make Better Choices

Quality Reporting Using Objective Measures

• MHCC is a leader in quality reporting for hospitals, nursing homes, and HMOs;
• MHCC is expanding the collection of quality measures and collaborating with other organizations in linking performance on quality measures to payment;
• Measures on hospital and nursing home worker influenza rates are now measures used in STATESTAT.

Price Transparency Project

• Hospital prices for specific diagnoses adjusted for case mix are now posted;
• The MHCC’s Medical Care Data Base contains sufficient information to enable consumers to determine the total costs of care for certain commonly performed services. We will debate the resources we should invest in making this information widely available.