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Maryland Regulatory News Fall 2001

1. In June, the Maryland Health Care Commission (HCC) released its Practitioner Utilization Trends within Privately Insured Patients Report, based on data from the HCC's 1998 and 1999 Medical Care Data Base. The report shows the experience of 2.2 million Marylanders who received practitioner health care services provided by private HMOs and non-HMOs. (The data base does not include HMO capitated primary care data.) From 1998 to 1999, per patient utilization of practitioner services increased for non-HMO and HMO patients. Non-HMO expenditures for a typical patient increased 11.7% from 1998 to 1999. Median work relative value units per HMO patient, including all fee-for-service and capitated specialty care services, increased by 3.5%. However, the average payment per standardized unit of care fell by 1.8% for non-HMOs, and remained steady for HMO fee-for-service care. In every region of the State, the average reimbursement by non-HMOs and by HMOs fell significantly for services that were provided to infants and children. 2. In July, the HCC released its annual report titled "Licensed Acute Care Hospital Bed Capacity FY 2002." The Department of Health and Mental Hygiene (DHMH) annually calculates the average daily census of each hospital for a 12-month reporting period, and the licensed bed capacity for each hospital is established at 140% of that hospital's average daily census. For the year beginning July 1, 2001, the number of licensed beds in Maryland acute care general hospitals is 9,791 beds - an increase of 229 beds. Medical/surgical beds increased by 256 beds, and acute psychiatric beds increased by 6 beds, while obstetric beds and pediatric beds declined by 25 beds and 8 beds respectively. The Eastern Shore experienced the largest relative increase in bed capacity since last year, 4.9%, followed by Central Maryland at 3.6%. 3. In August, the HCC released its new web-based Nursing Home Performance Guide that presents information on the quality of care, and the comparative performance, of Maryland nursing facilities. The Guide will be updated twice a year, and contains information on over 200 nursing homes in the State. It features the characteristics of each nursing home and its residents, and describes any deficiencies that were found at the facility by State inspectors. The HCC will release a similar comparative performance report on hospitals and ambulatory surgical facilities later this year. 4. In July, the Health Services Cost Review Commission approved an average increase of 3.97% to hospital rates effective July 1, 2001. All hospitals will not receive the same rate increase, but the increase will be between 3.6 - 4.2%.

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Date

09.22.01

Type

Publications

Authors

Rosen, Barry F.

Teams

Health Care