The company primarily responsible for operating Maryland's health insurance exchange has agreed to repay the state and federal government $45 million to settle claims that it mishandled its duties, the Maryland attorney general's office announced Tuesday.
For the past 18 months, Maryland has been implementing an all-payer system that shifts away from the fee-for-service reimbursement model and instead focuses on capped payments and rewards to providers who deliver quality healthcare at lower costs.
A Medicare waiver program in Maryland reduced readmissions by 4 percent at 67 hospitals last year, preventing as many as 5,000 readmissions, according to the Maryland Hospital Association.
The Small Business Health Options Program (SHOP) exchanges were meant to drive down costs and boost enrollment. But the program, part of the Affordable Care Act, has yet to reap anticipated rewards.
A Maryland medical center has made substantial progress cutting costs and readmissions, making it a central hub of the effort to revamp healthcare in the Old Line State, according to Business Insider.
If the United States implemented a single-payer health insurance system, small and large businesses would reap the benefits, including seeing their costs go down, according to a new report from Public Citizen.
Several states, including Maryland, Oregon and Massachusetts, suffered major technical difficulties with their health insurance exchanges and now must take actions to improve their websites before the next enrollment period. If they don't, insurers will likely continue to see low enrollment numbers in those states, reported the Los Angeles Times.
Maryland leaders are experimenting with a single-payer system, a plan that could potentially influence other states. In the all-payer system, the state will control and budget hospital costs, giving all hospitals in Maryland an annual budget to manage their total fees for the year.
The state of Maryland and the federal government have come to an agreement that would provide financial incentives to hospitals to keep patients off their premises, Kaiser Health News reported.
California has no limit in the amounts hospitals can bill for services. But Maryland's Health Services Cost Review Commission caps hospital bills. The result: Stark differences in charges but little variation in profit margins, according to the Huffington Post.