Maryland’s All-Payer Health Reform—A Promising Work in Progress

In January 2014, the State of Maryland and the Centers for Medicare and Medicaid Services (CMS) came to terms on an ambitious approach to improve care for Marylanders and to slow the growth of health care costs. The state shifted from its historic approach of limiting price growth by setting hospital rates for all payers to limiting overall hospital expenditures by establishing global hospital budgets.¹ A second phase that broadens the policy scope to the total cost of care, including hospital and nonhospital spending, is expected to begin in 2019.