The Health Services Cost Review Commission's (HSCRC) decision on a global budget update for fiscal year 2017 is just a few weeks away, and it is important for hospital leaders to help commissioners understand why the current HSCRC staff recommendation is, to put it simply, not only inadequate but damaging. In a Member Alert earlier this week we asked you to counter a perception among some commissioners that hospitals aren't doing enough to reduce utilization and save costs, by sharing all the ways you are investing in care coordination and management, your work with non-hospital community partners, and your commitment to the state's all-payer experiment - an experiment that is already paying dividends by containing costs and improving quality.

Commissioners are hearing a steady drumbeat from payers who are saying that hospitals are not focused enough on avoidable utilization and reining in Medicare's total cost of care, thus jeopardizing the model itself. You know better than anyone that what they're saying is questionable, and the data back you up. Cumulative Medicare savings are five times the target, there's ample cushion for the Total Cost of Care guardrail, and the Centers for Medicare & Medicaid Services is taking nationwide its argument that the Maryland model can work.

 

Yet, here in Maryland, despite all the data that indicate more investment, not less, is needed to maintain and build on the progress so far, the HSCRC staff proposal is far below acceptable. The more that commissioners hear from hospitals throughout the state, the more they should understand that hospitals' request for an appropriate global budget update is an act of necessity for organizations that have taken on all the risk associated with caring for unknown numbers of patients with uncertain health needs, and are incurring the vast expenses associated with care delivery transformation.

 

The current HSCRC staff proposal would allot, on average, a 0.60 percent per capita increase. In a letter to commissioners earlier this week, which we attached to the Alert, MHA detailed its recommendation that a modest 1.12 percentage point increase to that number would allow the success we've achieved already to be continued. In your letter to commissioners, along with the description of your organization's activities, please note your support for MHA's proposed increase. We recommend having your chief medical officer co-sign along with you. 

 

As a reminder, here are the email addresses for the commissioners: 

Please copy Mike Robbins, MHA's Senior Vice President, Rate Setting, at mrobbins@mhaonline.org with your letter, and contact him with any questions.