ANNAPOLIS, MD — Governor Wes Moore has announced the appointment of three individuals to Maryland’s Health Services Cost Review Commission. The commission plays a crucial role in controlling healthcare costs and ensuring the financial stability of hospitals in the state.
Governor Moore emphasized the importance of affordable and high-quality healthcare: “To build a state that leaves no one behind, it’s essential that we keep healthcare costs low and protect the financial vitality of our hospitals.” He expressed confidence in the newly appointed members’ wisdom, vision, and expertise, which will guide the commission toward success and enable Maryland to lead the nation in accessible healthcare.
Maryland stands apart from other states as the only one granted a waiver by the federal government in 1977, exempting it from national Medicare and Medicaid reimbursement principles. The goals of the Health Services Cost Review Commission are to restrict hospital cost growth, ensure hospitals can provide efficient and high-quality services to all Marylanders, and promote fairness in hospital financing.
The commission’s primary responsibilities include reviewing and approving reasonable hospital rates, publicly disclosing information on Maryland hospitals’ costs and financial performance, and establishing hospital-specific and service-specific rates for inpatient, hospital-based outpatient, and emergency services. Physician fees, however, fall outside the commission’s regulatory scope, and all payers in Maryland follow the rates established by the commission.
The state has implemented the “Total Cost of Care Model” since January 2019, building upon the successes of the All-Payer Model. This initiative aims to transform care delivery across the healthcare system, focusing on improving health outcomes and quality of care. The Total Cost of Care Model grants Maryland flexibility to tailor healthcare initiatives according to the state’s specific context and encourages providers to drive healthcare innovation.
Governor Moore appointed three individuals to the Health Services Cost Review Commission:
- Ricardo R. Johnson: Ricardo R. Johnson is the Executive Vice President for CareFirst BlueCross BlueShield, the largest not-for-profit healthcare company in the Mid-Atlantic region. In this role, Johnson leads a division focused on aligning CareFirst’s operations to advance accessible, affordable, and equitable healthcare. His responsibilities include overseeing Healthworx, the innovation and investment arm of CareFirst, which supports healthcare solutions. Johnson’s extensive experience in healthcare law, combined with his leadership roles at CareFirst, make him a valuable addition to the commission. He holds a Juris Doctor degree from the University of Maryland and an undergraduate degree from La Salle University.
- Nicki McCann: Nicki McCann has been the vice president of provider/payer transformation for the Johns Hopkins Health System since 2019. Her role involves working with providers and community organizations to develop strategies and programs that enhance patient-centered care, aligning with Maryland’s Total Cost of Care Model. McCann also collaborates with providers, policymakers, and payers to explore value-based models of care. With a background in program development, policy analysis, and leadership advisory work, McCann brings a wealth of experience to the commission. She is actively involved in various committees and organizations, including chairing the Maryland Medicaid Advisory Committee.
- Dr. Joshua M. Sharfstein: Dr. Joshua M. Sharfstein holds the position of Vice Dean for Public Health Practice and Community Engagement and Professor of the Practice in Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. He is also the Director of the Bloomberg American Health Initiative. Dr. Sharfstein previously served as the Secretary of the Maryland Department of Health and Mental Hygiene, where he played a pivotal role in aligning Maryland’s healthcare system with improved health outcomes. His accomplishments include adopting a revised payment model for all hospital care and developing a statewide health improvement process. Dr. Sharfstein’s experience as Principal Deputy Commissioner of the U.S. Food and Drug Administration and Commissioner of Health for Baltimore City further adds to his healthcare policy and management expertise.
The appointments of these three individuals reflect Governor Moore’s commitment to assembling a commission with diverse backgrounds and extensive knowledge in the healthcare sector. Their collective expertise will be instrumental in advancing the commission’s goals of controlling costs, ensuring quality care for all Marylanders, and promoting fair hospital financing.
The Health Services Cost Review Commission plays a crucial role in Maryland’s healthcare landscape, as it reviews and approves hospital rates that directly impact the affordability of healthcare services. Transparency is key to the commission’s work, as it publicly discloses information on hospital costs and financial performance. By establishing hospital-specific and service-specific rates, the commission ensures that healthcare providers are appropriately reimbursed for their services.
It is important to note that the commission does not regulate physician fees, and Maryland hospitals receive payments from all payers based on the rates set by the commission. This system aims to provide consistency and fairness in healthcare pricing across the state.
The newly appointed members bring a wealth of experience and accomplishments to the Health Services Cost Review Commission. Ricardo R. Johnson’s leadership at CareFirst BlueCross BlueShield and his role in driving healthcare innovation through Healthworx make him well-equipped to contribute to the commission’s objectives. Nicki McCann’s work in developing patient-centered care strategies and her expertise in policy analysis will be valuable in advancing Maryland’s healthcare goals. Dr. Joshua M. Sharfstein’s extensive background in public health practice, healthcare policy, and management positions him as a key contributor to the commission’s efforts.
Governor Wes Moore’s appointments demonstrate a commitment to shaping a healthcare system that is accessible, affordable, and high-quality for all Maryland residents. By bringing together individuals with diverse perspectives and expertise, the Health Services Cost Review Commission can achieve its mandates and continue Maryland’s legacy as a leader in affordable and equitable healthcare.
For more information about the Health Services Cost Review Commission, including its current initiatives and public disclosures, visit its official website at hscrc.maryland.gov.