5 Things in Maryland: Department of Health RFPs, Q&A with Joe Dematos, Hospital Pricing Transparency – Status of Fix

On this month’s e-newsletter, we characteristic two new requests for proposals from the Maryland Division of Well being, a video interview with HFAM CEO and President Joe Dematos, and a dialog about efforts to enhance implementation of CBTs within the state.

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Emily Burger
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1. MDH points two Medicaid-related RFPs

The Maryland Division of Well being issued an RFP this month to hunt a contractor to manage dental advantages for eligible Medicaid beneficiaries. The seek for a Dental Advantages Officer or Dental Administration Companies Group follows Home Move 6/Senate Invoice 150 over the last legislative session, requiring Maryland Medicaid to supply dental companies to eligible adults as of January 1, 2023.

Additionally this month, MDH launched a request for proposal for a statewide non-emergency medical transportation contractor for Medicaid enrollees. The RFP states: “…the first capabilities of the NEMT middleman are to be a single level of contact for the beneficiaries to request help with transportation, and to instantly prepare the bottom price and most applicable sort of transportation for every beneficiary.” Shows are scheduled for November 1 at 4 p.m. ET.

2. Specialists focus on the implementation of CCBHC

In an effort to additional enhance the implementation of accredited group behavioral well being clinics within the state, the Institute for Innovation and Implementation on the College of Maryland held a gathering final week to debate CCBHC high quality enchancment and reporting measures. The assembly introduced collectively representatives from a number of nations to debate classes realized throughout the implementation of CCBHCs.

One of many major classes mentioned was the significance of utilizing knowledge and evidence-based remedies to enhance outcomes. Particularly, consultants highlighted the significance of program evaluations, knowledge sharing, and the event of recent partnerships throughout the well being system. “As we proceed to maneuver ahead with the psychological well being disaster we’re at the moment in, we have to take note of two issues particularly,” stated Kerry Virgo of Tennessee. “The primary is that we’d like to have the ability to associate with anybody and everybody to present individuals what they want. The second is companies and assist which are effectively measured and present the necessity for enchancment to be the usual of our care.”


3. What they’re watching: Joe Dematos, HFAM

As president and CEO of the Maryland Well being Services Affiliation, Joe Dematos focuses on bettering care integration within the state’s long-term care settings. On this version of What They’re Watching, DeMattos discusses what could be finished to enhance entry to care, particularly for underserved communities.

“Right here in Maryland, we have now wonderful instructing hospitals and medical facilities of excellence,” Dematus says. “We now have nice nursing properties and sponsored residing facilities, however these dots are sometimes not linked. Typically they’re linked – in probably the most difficult communities – with dotted traces that should be stuffed in. A giant a part of our work now’s about connecting the dots, but in addition recognizing the work that needs to be finished. We now have to do to achieve the deprived, probably the most weak communities.”

4. Hilltop researchers to start out hospital pricing research

Researchers on the Hilltop Institute at UMBC have obtained a $282,412 grant from the Nationwide Science Basis to launch a complete challenge to gather knowledge on hospital pricing behaviors. Since 2021, hospitals have been required by federal regulation to supply normal charges for his or her companies, along with negotiated charges for every payer. By gathering and evaluating this new knowledge from a nationwide pattern of hospitals, the researchers hope to open up a brand new space of ​​analysis on hospital pricing and payer negotiation.

“We really feel that being in Maryland (with a payer-all mannequin) provides us this completely distinctive and goal benefit, as a result of in nearly each different state, we have seen big variation in pricing for a similar process throughout hospital taxpayers,” says Hilltop Principal Information Scientist Dr. Morgan Henderson. “…there may be numerous fascinating analysis to be finished taking a look at hospitals on each side of Maryland and different state borders. That in and of itself could be an awesome research.”


5. Maryland excels at Medicaid reset

States proceed to organize for the repeal of the federal public well being emergency and the next re-determination of Medicaid eligibility that should happen. A brand new report from CMS examined every state’s capability to course of MAGI purposes below Medicaid and CHIP, and located that Maryland processed practically all purposes in lower than 24 hours, second solely to Oklahoma.

Maryland has ready to unravel PHE all through the pandemic, partly by persevering with outreach with managed care organizations, native well being departments and group organizations. After the report was printed, a spokesperson for the Maryland Division of Medication stated they’re ready for extra steering on PHE dismantling from the US Division of Well being and Human Companies.

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