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Priorities and Accomplishments

Commission Informational Brochure

Annual Report to the Governor

Managing For Results

The Maryland General Assembly created the Maryland Health Care Commission (MHCC) in 1999 through the consolidation of two existing commissions to "establish a streamlined health care regulatory system in this state in a manner such that a single state health policy can be better articulated, coordinated, and implemented."

OUR FIVE CENTERS

The commission is organized around the health care systems we seek to evaluate, regulate, or influence, bringing a wide range of tools (data gathering, public reporting, planning and regulation) to bear to improve quality, address costs, or increase access. Two of the centers - the Center for Hospital Services and the Center for Long-term and Community-based Care - are organized around provider organizations, bringing together under one leadership the expertise and tools to address cost, quality, and access in those sectors of our health care system. Two of the centers include both cross-cutting responsibilities and sector specific efforts: The Center for Healthcare Financing and Health Policy deals with broad policy issues relating to the organization and financing of health care and with narrower issues relating to the regulation of the small group health insurance market. The Center for Information Services and Analysis conducts broad studies using both Maryland databases and national surveys, but also has specific responsibilities relating to physician services. The fifth center, the Center for Health Information Technology, has responsibilities that cut across sectors to facilitate the adoption of electronic health records and to enable the private and secure transfer of personal health information among sectors.

A brief description of each of the Centers follows.

THE CENTER FOR HOSPITAL SERVICES

Director, Pamela Barclay

The Center for Hospital Services focuses on improving hospital care, bringing together planning, certificate of need, and public reporting of cost and quality.

• The Center is responsible for planning for hospital services and the drafting of the acute care chapter of the State Health Plan.
• The Certificate of Need program remains within the Center for Hospital Services because hospital certificates of need are the most complex and costly of projects requiring CON action. Maryland hospitals are in the midst of a dramatic rebuilding program, replacing an aging hospital infrastructure through renovation, new construction, and in some cases, consolidation or relocation of facilities.
• The Center oversees specialized inpatient services such as cardiac surgery, obstetrics, neonatal intensive care, organ transplant, and psychiatry, including developing the state health plan chapters, managing certificates of need for these services, and granting appropriate waivers to allow hospitals meeting rigorous criteria to perform emergency angioplasty.
• The Center is committed to providing meaningful information to consumers about the quality and outcomes of care provided in all Maryland acute care hospitals. It publishes the Hospital Guide, containing both general information and specific quality and outcome measures. The Center currently reports on the quality of hospital efforts in surgical infection prevention and is developing strategies to gather and report the rates of key hospital acquired infections. The Center plans to expand public reporting of angioplasty quality and outcomes beyond the current waiver hospitals to include all hospitals performing emergency angioplasty and is examining public reporting of risk-adjusted data on the quality and outcomes of cardiac surgery.
• The Center serves as the lead for studying emergency department crowding.
  

 

THE CENTER FOR LONG-TERM AND COMMUNITY-BASED CARE

Director, Bruce Kozlowski

The Center for Long-term and Community-based Care focuses on improving long-term and community-based care, bringing together planning and public reporting efforts.

• The Center is responsible for health planning regarding long-term and community-based care, including the policies guiding the determination of need in the Certificate of Need process for nursing homes, home health agencies, and hospices.
• The Center is responsible for the Commission’s study of long-term care vision and needs over the coming 25 years, required by legislation during the 2006 session of the General Assembly.
• The Center publishes the Nursing Home Guide for Marylanders, providing an easy way to locate and compare nursing homes on quality and outcomes measures. The Center is also pioneering the public reporting of resident and family satisfaction measures.
• The Center has responsibility for policies and information dissemination related to Maryland assisted living programs.
  

 

THE CENTER FOR HEALTHCARE FINANCING AND HEALTH POLICY

Director, Bruce Kozlowski

The Center for Healthcare Financing and Health Policy (CSHBP) has a specific regulatory responsibility for the small group market for health insurance and a broader responsibility for the analysis of public policy options relating to the organization and financing of health care.

• This Center is responsible for the small group health insurance market, including regulation of the Comprehensive Standard Health Benefit Plan. Specifically, the Commission is responsible for specifying the benefits and covered services included in the core CSHBP offerings, modifying these when necessary to meet statutory affordability requirements.
• The Center reports on trends in the small group market, including the costs of plans and the degree of concentration in the market, suggesting regulatory changes that will improve affordability, innovation, and value through improved competition.
• The Center reports publicly on the performance of and satisfaction with health plans in the HMO Consumer Guide. Traditionally focused on measures of the clinical performance of HMOs, the Guide is expanding in two ways. MHCC will now report on additional measures of health plan quality and value and will soon report on PPOs in addition to HMOs.
• The Center is responsible for the development and analysis of state health policy options affecting the organization and financing of health care. Particular emphasis has been placed on both incremental and non-incremental strategies for expanding health insurance coverage and on strategies to reduce health care expenditures and increase health care value.
• The Center is committed to reporting disparities in health and health care and is responsible for the Commission’s Racial and Ethnic Disparities initiative.
  

 

THE CENTER FOR INFORMATION SERVICES AND ANALYSIS

Director, Ben Steffen

The Center for Information Services and Analysis has expertise in the creation, maintenance, and mining of large databases, in the management of information technology and networks, and in the analysis and interpretation of population surveys.
The Center produces key reports to guide health policy, including reports on health expenditures, health insurance, the uninsured and uncompensated care.

• The Center will be focusing on physician services, including physician reimbursement and reporting on the cost and quality of physician services.
• The Center oversees the Maryland Trauma Physician Services Fund and has responsibility for developing procedures and policy options.
• This Center provides analytic and programming services to other divisions of the Commission and is responsible for the intranet and the Commission’s web site.
• The Center works closely with the Health Services Cost Review Commission, publishing each hospital’s charges for the most common Diagnosis related Groups (DRGs) as part of the Commission’s Price Transparency Initiative.
  

 

THE CENTER FOR HEALTH INFORMATION TECHNOLOGY

Director, David Sharp

Electronic health information exchange promises to bring vital clinical information to the point-of-care, helping to improve the safety and quality of health care while decreasing overall health care costs. Health information technology requires two crucial components to be effective – widespread use of electronic health records and electronic health information exchange. The Center for Health Information Technology is responsible for the Commission’s health information technology initiatives.

• Plan and implement a statewide health information exchange
• Identify challenges to health information technology adoption and use, and formulate solutions and best practices for making health information technology work
• Increase the availability and use of standards-based health information technology through consultative, educational, and outreach activities
• Promote and facilitate the adoption and optimal use of health information technology for the purposes of improving the quality and safety of health care
• Harmonize service area health information exchange efforts throughout the state
• Certify electronic health networks that accept electronic health care transactions originating in Maryland
• Develop programs to promote electronic data interchange between payers and providers

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