1. Select a state health policy reform innovation
2. Discuss the rationale for the policy, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, and (to the extent statistical data are available) its impact. ethical outcome based on evidence.
3. Examples of state innovations include Maryland’s hospital rate setting, Vermont’s single payer system, and Massachusetts’ health reforms

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Struggling with where to start this assignment? Follow this guide to tackle your assignment easily!

Step 1: Read the Assignment Carefully

• You’re asked to select one state health policy reform innovation.

• You must discuss:

  1. The rationale for the policy

  2. How it was adopted (e.g., federal waiver, state law, legislature)

  3. The funding structure (who pays, how revenue flows)

  4. The impact (use statistical or qualitative data if available)

  5. The ethical outcome (based on evidence).

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Step 2: Choose Your Policy

For this assignment, you can choose Maryland’s Hospital Global Budget / All-Payer Model (strong evidence, well documented).

Alternative options include:

• Vermont’s attempt at a single-payer system

• Massachusetts’ early health reforms (precursor to the ACA)

But Maryland’s Global Budget gives you the richest data and case studies.

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Step 3: Structure Your Paper

Here’s a recommended outline:

Introduction (1 paragraph)

• Introduce state health policy innovations.

• Briefly state which policy you chose (e.g., Maryland’s Global Budget Model).

• Mention why it’s important (addresses rising hospital costs, patient access, and quality).

Rationale (1–2 paragraphs)

• Explain the problem Maryland faced (rapidly rising hospital costs, volume-driven incentives).

• Show why reform was needed (align care with population health and reduce readmissions).

Adoption (1 paragraph)

• Describe how Maryland already had an all-payer system since the 1970s.

• Explain the federal waiver with CMS (Medicare included) and the 2014 All-Payer Model agreement.

Funding Structure (1 paragraph)

• Hospitals get a global budget (fixed annual revenue target).

• All payers (Medicare, Medicaid, private insurance) pay under the same rates.

• Tied to economic growth, not service volume.

Impact (2 paragraphs)

• Cite Medicare savings (over $1 billion in first 5 years).

• Mention reduced readmissions and slowed cost growth.

• Note challenges (hard to replicate elsewhere, possible under-provision of care).

Ethical Outcome (1 paragraph)

• Benefits: equity in pricing, fewer unnecessary admissions, better population health focus.

• Risks: possible incentive to reduce services, risk of unequal access if not monitored.

Conclusion (1 paragraph)

• Wrap up by stressing the policy’s innovation, its success in cost control, and ethical implications.

• Suggest lessons for other states.

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Step 4: Style and Formatting

• Length: 2–4 pages (depending on your instructor’s requirement).

• Use APA citations for CMS reports, Health Affairs articles, and HSCRC data.

• Maintain formal academic tone but be concise.

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