The Future is Here in Maryland – hospitals sign up for capitation, and need a network of MH professionals to make it work!

As reported in an NPR article published on 10-23-15, “In Maryland, A Change In How Hospitals Are Paid Boosts Public Health,” Maryland hospitals have been offered a voluntary capitated payment system, and, remarkably, every hospital in the state has signed up. The program has saved an estimated hundred million dollars in the first year of the program. The program is a collaboration with the Centers for Medicare and Medicaid Services (CMS). The program emphasizes a flexible approach, rules that promote fairness and access to healthcare, establishing uniform policies and processes across hospital systems, support for the social mission of hospitals, and, in particular, a focus on costs that are potentially under the control of hospital systems.

One primary area of focus is addressing problems with “high utilizer’s”, many of whom have significant mental health problems which can contribute to repeated visits to emergency departments and hospital admissions. Another area of focus is reducing readmissions to hospitals, which often relies on behavioral change after discharge, such as improving patients’ treatment compliance and self-care. The NPR article briefly touches on the fact that hospitals will need to coordinate with mental health professionals, and will need a network of mental health professionals and programs in order to help them with the behavioral components that are necessary for this program to succeed.

mhconcierge’s take: given that the program has already had substantial savings, and has the backing of CMS, it is likely that this program will be expanded to other states.

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