Opportunities to Maximize the Maryland Waiver Model – State of Reform

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Michael Goldberg | May 26, 2021

Maryland’s waiver of care model – the “Maryland model” – is well regarded by a range of stakeholders, but that doesn’t mean there is more work to be done. At the 2021 Maryland Reform State Health Policy Conference, a panel of experts discussed how to continue to improve Maryland’s model of care and where system improvement efforts will work best.

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The panel included:

Bob Atlas (CEO, Maryland Hospital Association), Maria Harris Tildon (Executive Vice President, Public Policy and Government Affairs, CareFirst BlueCross BlueShield), Joe DeMattos, Jr. (CEO, Health Facilities Association of Maryland) and Joshua Sharfstein, MD (associate dean of public health practice and community engagement, Johns Hopkins Bloomberg School of Public Health).

Panelists discussed everything about the Maryland model, from why it was developed, to how it was adopted, to how it plays out today.

Around 2011-2012, there was a small crisis in the Maryland health care system. It was in this context that the Maryland model was born, Sharfstein said.

We had this hospital pricing system that had been in place for 30 years and had done a lot of good things for the state, but it was on a shaky basis. The fragile foundation was caused by some general health care trends and challenges in Maryland. This led to a review with the Federal Government’s Centers for Medicare and Medicaid Services of how things were going and whether the system that had been developed could be developed. This led to an opportunity for the state of Maryland.

The federal government was prepared to support Maryland if the state stayed true to the “threefold goal” – better health, lower costs, and a better patient experience.

From that starting point, Atlas and DeMattos discussed what the data says about the Maryland model. The group looked at the savings targets of the Maryland model, Maryland’s outperformance relative to other states in hospital spending in employer-sponsored plans, key quality metrics, and more.

Watch the full conversation above or at this link.



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