Maryland has recently become the first state to join a federal program aimed at improving health care quality and equity while lowering costs for all health care payers, including Medicare, Medicaid, and private insurers. The state’s Total Cost of Care Model, which sets a per capita limit on Medicare’s total cost of care and includes an all-payer hospital payment system, has paved the way for this new federal framework known as the AHEAD model. Governor Wes Moore, a Democrat, expressed pride in Maryland leading the way in this new chapter of health care.
Since the 1970s, Maryland has operated a hospital all-payer system that allows the state to set its own rates for hospital services, ensuring equitable access to care and treatment regardless of insurance status. The system eliminates the need for charity hospitals and ensures that all patients are treated the same. Senator Chris Van Hollen highlighted the benefits of this system, emphasizing the importance of equity, quality, and affordability in health care. The agreement with the federal government further solidifies Maryland’s commitment to these priorities.
The Maryland Department of Health is now tasked with planning the implementation of the AHEAD model, set to begin on January 1, 2025. This will involve establishing targets for cost growth, quality improvements, and equity, as well as investing in population health and primary care. Senator Ben Cardin stressed the importance of ensuring that health care providers receive equal pay for services, regardless of insurance type. This commitment to equitable care and quality improvement will drive the state’s efforts to transform health care and address disparities in the system.
In addition to Maryland, five other states and regions — Vermont, Connecticut, Hawaii, Rhode Island, and parts of New York — have been selected by the Centers for Medicare and Medicaid Services to participate in the AHEAD Model. State participation is seen as a critical step in improving the overall health of residents, supporting primary care, and transforming health care in communities. U.S. Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure praised Maryland’s commitment to the AHEAD model, highlighting the state’s efforts to address health disparities and promote high-quality, coordinated care.
The AHEAD model places a strong emphasis on health equity and addressing the social needs of underserved patients. By focusing on greater coordination and investing in primary care, early detection, and prevention, the goal is to keep individuals healthier and reduce overall health care costs. The agreement between Maryland and the federal government underscores the state’s dedication to improving health outcomes for all residents and creating a more efficient and effective health care system. With this new model in place, Maryland is poised to lead the way in delivering high-quality, affordable care for all.
