The impressive gains Maryland's hospitals have made during the first year under the modernized Medicare waiver - $100 million in savings to the Centers for Medicare & Medicaid Services; a 4 percent drop in inpatient admissions and use rates; a 6 percent reduction in potentially avoidable utilization; a 26 percent drop in hospital acquired infections; and more - only begin to tell the story of the tectonic shift that has taken place since the agreement was signed.

Those of you who have stepped up to make these achievements possible know firsthand the challenges of dramatic organizational change, as well as the difficulty of managing that change at such a breakneck pace. And you know how critically important it is that state and federal regulators support your efforts by providing the right tools to do the job - both the resources to invest in delivery system transformation, and the flexibility to tailor those investments to your individual communities.

Earlier this week, the Health Services Cost Review Commission provided hospitals with those much-needed resources, approving a 3.3 percent average per capita global budget increase (before adjusting for uncompensated care and Maryland Health Insurance Program reductions). That means more than $500 million in additional revenue for hospitals in the coming year and represents the largest increase in more than six years.

While a portion of the increase comes in the form of grants that require additional HSCRC reporting, the majority enables hospitals to invest in system delivery transformation as they see fit - flexibility that's needed to ensure long-term success under the waiver.

The increase is the result of close collaboration between MHA and HSCRC staff and commissioners, who worked together to develop an update that accounts for the risk hospitals have assumed in caring for an unknown number of patients with unpredictable care needs within a fixed global budget.