Forum Session

Moving Toward Global Payment: Maryland’s New All-Payer Model
May 30, 2014


Sally Coberly, PhD


In collaboration with the Centers for Medicare & Medicaid Services, the state of Maryland has made significant changes to its 40-year-old all-payer rate-setting system for inpatient and outpatient hospital services. The new model is designed to move the state from fee-for-service reimbursement to population-based global budgeting for hospital services. This Forum session provided an overview of the new all-payer model, including its goals and the factors that led to its development. Executives from two hospitals, one rural and one urban, described their experiences adopting or moving toward global budgeting. The session concluded with comments from a long-time observer of Maryland's all-payer system.


Joshua M. Sharfstein, MD (bio)
Maryland Department of Health and Mental Hygiene

Kimberly Repac, MBA (bio)
Senior Vice President & Chief Financial Officer
Western Maryland Health System (Cumberland, Maryland)

Thomas R. Mullen, MA (bio
President & Chief Executive Officer
Mercy Health System (Baltimore, Maryland)

With comments from:

Gerard Anderson, PhD (bio)
Professor & Director
Center for Hospital Finance and Management
Bloomberg School of Public Health
Johns Hopkins University

Related Materials

Robert Murray, "Maryland's Bold Experiment in  Reversing Fee-For-Service Incentives," Health Affairs Blog, January 28, 2014.

State of Maryland, Department of Health and Mental Hygiene, "Maryland's All-Payer Model," a proposal submitted to the Center for Medicare and Medicaid Innovation, October 11, 2013.

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