Maryland All-Payer Model Performance Results Donna Kinzer, - PowerPoint PPT Presentation

Maryland All-Payer Model Performance Results Donna Kinzer, Executive Director Health Services Cost Review Commission

Maryland’s All-Payer Model Agreement with CMS: Results to Date Current Hospital Model Features (2014-2018) Maryland hospital growth contained for all payers ✔ Per capita, value-based payment framework for hospitals ✔ Provider-led efforts to reduce avoidable use, and improve quality and 3.58% 3.58% 3.58% coordination MD Per Capita ✔ Savings to Medicare without cost shifting Revenue Growth ✔ Sustains rural health care with stable revenue base 2.31% MD Per Capita Revenue Ceiling 1.47% Future Model Features (2019 and beyond) 0.80% ✔ Complex and chronic care improvement, population health ✔ Provider-led innovations in primary care, nursing homes, other care settings, fostering State innovation and flexibility CY 2014 CY 2015 CY 2016 ✔ Limit growth in Medicare Total Cost of Care (A&B) for 800k FFS benes SOURCE State of Maryland . Medicare savings of $500+ million in hospital payments in 3 years, Total Cost of Care and Quality Results relative to national growth rates ✔ Medicare total cost of care $538 CUMULATIVE SAVINGS $287 2016 $364 million savings ✔ Readmissions (-11%) $135 2015 ✔ Hospital Acquired $116 2014 Millions Conditionss (-48%) $0 $200 $400 $600 SOURCE State of Maryland analysis of data from CMS. 2

Maryland’s Strategy for Medicare TCOC Based on Use 100% 13% 90% 80% 70% 65% No hospital utilization 60% All encouters out of state 50% No apparent single hosp/system Plurality pmts & visits 40% 79% Majority pmts & plurality visits 30% Same hospital/system 20% 31% 10% 0% TCOC payments Beneficiaries SOURCE State of Maryland analysis of Medicare FFS claims data. Source: Draft methodology presented by MHA to TCOC Work Group, April 26, 2017 3