Forget gambling — Prince George’s should go all in on health care

[EdwardA]

As someone that works in healthcare finance I can tell you the situation in healthcare in the state of Maryland is under tremendous pressure. You are going to hear about layoffs, hospital mergers or outright closures in the coming months and years.

It's not a slam dunk that some think it is because of the unique system Maryland works under.

[EdwardA]

Originally Posted by Zimar

This is actually not true, but the rest of your post is on point. My family has a lot of doctors. While they don't make quite as much as they used to, most specialties other than primary care make an average of more than $200,000 a year. Not exactly a bad living. Also, there are more than enough students who want to enter medical school*, and I can tell you that it is exceptionally competitive, and the U.S. has not kept up by opening more medical schools.** What a family member has told me that the trend is where she lives, is instead of owning their own practices, doctors are now increasingly working as employees in their hospitals. That way, the hospital takes care of all the insurance and liability mess and just pays them a salary.

* I am an embittered former pre-med lol.
** I'm from an immigrant community and I have a ton of family and friends who are foreign-educated doctors. Because there is a shortage, America just takes the rest of the world's best and brightest. Go us!

Does your family member work in Maryland? If so that is the trend in the state. Hospitals in Maryland work in a controlled revenue enviroment, the rates that hospital's charge is determinied by the state. Maryland is the only state in the Union that has a waiver for Medicare. It's a complicated method that the Feds work out.

How it works out in practice is because of this waiver Maryland can have an all payer system and set the rates that Insurance, Medicare etc. have to pay. Maryland Hospitals likes it because it can charge more and the insurance companies love it because they don't have to negotiate with each hospital and pay varying rates.

The problem is that the Medicare waiver test is based on Inpatient and there has been a dramatic shift from inpatient to outpatient. For that and other reasons Maryland is in danger of losing the waiver. To prevent that the manage the update factor, or the inflation for revenue. This year it nets to zero. So basically hospitals expenses are increasing but their revenue is not. So you have an immediate shortfall. Also under this system Maryland pays more for inpatient than outpatient and as I mentioned earlier there is a shift to outpatient.

So hospitals in Maryland are scurrying around trying to buy up physician practices in the hope they can offset the decline in inpatient with more outpatient volumes.

Overview of Maryland Regulatory System for Hospital Oversite - Practitioner Guide

[UrbanScholar]

Originally Posted by EdwardA

Does your family member work in Maryland? If so that is the trend in the state. Hospitals in Maryland work in a controlled revenue enviroment, the rates that hospital's charge is determinied by the state. Maryland is the only state in the Union that has a waiver for Medicare. It's a complicated method that the Feds work out.

How it works out in practice is because of this waiver Maryland can have an all payer system and set the rates that Insurance, Medicare etc. have to pay. Maryland Hospitals likes it because it can charge more and the insurance companies love it because they don't have to negotiate with each hospital and pay varying rates.

The problem is that the Medicare waiver test is based on Inpatient and there has been a dramatic shift from inpatient to outpatient. For that and other reasons Maryland is in danger of losing the waiver. To prevent that the manage the update factor, or the inflation for revenue. This year it nets to zero. So basically hospitals expenses are increasing but their revenue is not. So you have an immediate shortfall. Also under this system Maryland pays more for inpatient than outpatient and as I mentioned earlier there is a shift to outpatient.

So hospitals in Maryland are scurrying around trying to buy up physician practices in the hope they can offset the decline in inpatient with more outpatient volumes.

Overview of Maryland Regulatory System for Hospital Oversite - Practitioner Guide

Thanks EdwardA that was very informative.

[Aimewitue]

After seeing whats going on in atlantic city......maybe health care would be the better option for jobs and community investment.

Atlantic City losing to Walmart-style casinos in Pa.

[UrbanScholar]

Originally Posted by Aimewitue

After seeing whats going on in atlantic city......maybe health care would be the better option for jobs and community investment.

Atlantic City losing to Walmart-style casinos in Pa.

From what I have seen over the past few years they are trying to build that industry up within the county. The new regional hospital will serve as a flagship for this effort along with M Square building its research capacity. I believe they are trying to have that area serve as a center for biotech as well. People/media don't mention that as much because its not as "sexy" but there are efforts being made.

[Aimewitue]

Originally Posted by UrbanScholar

From what I have seen over the past few years they are trying to build that industry up within the county. The new regional hospital will serve as a flagship for this effort along with M Square building its research capacity. I believe they are trying to have that area serve as a center for biotech as well. People/media don't mention that as much because its not as "sexy" but there are efforts being made.

Yes i believe the new hospital in LARGO is a big step....

There are only 5 hospitals in the county. With a county this large in population more is needed.

The southern part of the country is underserved with healthcare services, and the north isnt that great either.

If new hospitals are built more people will stay in the county for care.

But you are right efforts are being made and thats a very good sign