It seems to me, that missing in the discussion of healthcare coverage and controlling healthcare costs is the ability of hospitals to charge the payers differently, making private payers off set the losses associated with Medicare and Medicaid, both of which have reimbursement caps per diagnosis. Maryland has an all-payer system, meaning hospitals negotiate their charges with the HSCRC and charge all payers the same. Quality indicators such as mortality, readmission, and complication rates are factored in determining each hospital's rates.

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Suzanne Butterbaugh