Managing for Results

4. Innovation

Does the state use innovation to improve results?

The state uses innovation to achieve its priority goals and improve results for residents.

Maryland

Leading Example

In 2021, Governor Hogan created the Maryland Vaccine Equity Task Force (VETF) to focus COVID-19 vaccination efforts on underserved, vulnerable, and hard-to-reach populations to ensure the equitable delivery of vaccines, including for minorities and non-English speaking populations. These efforts align with the innovations and evidence described in the U.S. Department of Health and Human Services, Presidential COVID-19 Health Equity Task Force, Proposed Implementation Plan and Accountability Framework, Recommendation #1: Partner with communities to expand vaccination to underserved groups.

Throughout the state, Health Equity Resource Communities (HERCs) help to engage communities and to prioritize programs for equitable public health. Evidence-based activities include establishment of an inventory of health disparities and a clearinghouse / database to manage them. In 2022, a new “Pathways to Health Equity” grant program targets health disparities including diabetes, asthma, heart disease and hypertension, mental health, substance use disorder, maternal and child health, and Sickle Cell Disease. These efforts align with the innovations and evidence described in the U.S. Department of Health and Human Services, Presidential COVID-19 Health Equity Task Force, Proposed Implementation Plan and Accountability Framework.

Innovative / unique among American states, Maryland requires that hospitals receive the same payment for specific treatments delivered to Medicare, Medicaid, commercially insured, or self-pay patients under a global budget covering all hospital and non-hospital costs. An analysis of the first two years of the Total Cost of Care (TCOC) found some significant improvements particularly in the areas of care management, access (a measure of equity), and continuity. In the first performance year of Maryland’s TCOC model, the state reduced spending by $365 million, relative to national trends, according to a Mathematica implementation report. In a recent report by Fair Health, among all 50 states Maryland had the lowest average costs for complex COVID-19 hospitalizations. At $49,127, Maryland’s cost was just under half the national average of $98,139 and over $20,00 less than the next lowest-cost state (Arkansas).