Dive Brief:
- An initiative spearheaded by Maryland governor Martin O'Malley has had significant success in reducing unnecessary hospital admissions.
- Cumberland-based Western Maryland Regional Medical Center has served as a leading example of what can be accomplished by the new program, cutting admissions by 21% year-over-year.
- Western Maryland's success is part of a larger effort by Gov. O'Malley, whose initiative has seen an overall 11.5% decrease in preventable hospitalizations per 100,000 Marylanders between 2011 and 2013.
Dive Insight:
When transformations like this one occur, it's seldom easy to point to a single reason why they happened. But there are a few factors working in Maryland's favor, notably a robust health information exchange that all 46 acute-care hospitals in the state and more than 150 healthcare providers use.
The exchange, the Chesapeake Regional Information System for our Patients (CRISP), is popular with providers in the state; searches of CRISP have shot up from below 10,000 in November 2012 to 54,489 in July of this year. In addition to helping doctors and hospitals coordinate care, CRISP is allowing health officials do things like map disease hotspots and develop targeted and cost effective responses to these problems.
Yet another factor working in the state's favor is a shift Maryland has made in the way it pays for care across 10 rural hospitals. Three years ago, 10 rural hospitals (including Western Maryland) were given a budget based in a projected patient population rather than traditional fee-for-service compensation. At Western Maryland, this approach has met with great success, supported by its Center for Clinical Resources, which tracks and manages care for patients with high-cost chronic health conditions such as diabetes, COPD or congestive heart failure. The Center doesn't charge patients because it saves so much money for the hospital.
All told, it does seem that some fairly remarkable changes are happening within Maryland's healthcare system. In fact, the governor's office estimates that the new model could save Medicare at least $330 million of the next five years. It looks like the changes happening in the state will bear close watching over the next year or two.