2. National Leader The state of Maryland, hospitals, and insurance companies partnered Applied to the federal government for a 5 year “demonstration project” 2

3. Objectives 3 Opportunity for Maryland to be a NATIONAL LEADER in health care CHANGE the way we pay and provide health care BUILD on the great system we have and make it even better: More affordable Safer All about you

4. Starts with Hospital Care 4 Work together to slow growth in spending for hospital care Continue Maryland’s unique way of setting hospital prices Change how hospitals are paid to reward the right things

5. Affordable 5 $ Slow growth in spending for hospital care Track spending in inpatient and outpatient hospital care in Maryland Grow no faster than the overall economy (3.58% a year) Cut growth in hospital spending in half

6. 6 Affordable $ MARYLAND: only state where hospitals don’t decide how much to charge for care — the state sets hospital prices Hospital prices still set by state Utility ‒ like hospital regulation will continue

7. 7 Safer READMISSIONS: patients who return to the hospital within 30 days of hospital discharge Maryland ranks poorly (almost last) – 49 of 51 states and D.C. Bring Maryland readmission rates to NATIONAL AVERAGE in 5 years Better and SAFER for YOU 7

8. 8 Safer INFECTIONS: patients who get infections while in the hospital Maryland rates of infection HIGHER than nation REDUCE infections and other “hospital- acquired conditions” by 30% in 5 years Better and SAFER for YOU 8

9. 9 All About You Change how hospitals are paid to reward the right things Hospitals previously paid more to do more Can lead to unnecessary procedures, visits, and care Hospitals now rewarded for helping people stay healthy, well, and out of the hospital Nearly all hospital payments will reward health and wellness in 5 years 9

10. 10 Challenges Never been tried; Never been tested Hospitals in serious financial condition – 40% losing money today New hospitals spending limits tight Will require hospitals to redefine themselves Will require communities to work together to keep people healthy Will require patients and families to truly engage in their care 10

11. 11 Opportunities Continue our unique hospital rate-setting system More equitable care for low income and uninsured people Should lead to slower growth in insurance premiums Lead nation in reforming health care Statewide focus on quality and safety 11

12. 12 Next Steps Federal government must approve state application Rate-Setting Commission to put in place all the details Hospitals to invest in IT, care coordinators, and more to help manage community health All eyes on Maryland