This report, which was funded by the Robert Wood Johnson Foundation as part of a project to monitor Affordable Care Act (ACA) implementation, examines Maryland’s considerable progress toward implementing health care reform through the ACA.

The report’s authors from the Urban Institute find that while much work remains, a combination of strong leadership, inclusive planning and deliberate but aggressive action by committed state officials and system stakeholders has permitted Maryland to make significant strides in designing its reformed health care system.

The authors point to a number of success factors that have helped Maryland officials to date, including the following:

  • Gubernatorial leadership and support set the tone for rapid and effective implementation.
  • Involvement of a broad range of stakeholders in the reform process, from the beginning, was critical in garnering buy-in and support.
  • Tackling health exchange legislation incrementally was wise.
  • Reform provided an opportunity to assess and transform existing IT systems.
  • A progressive Medicaid program that recently extended public coverage to new groups created a strong foundation upon which to build broader health system reforms.
  • The state’s long-standing Hospital Rate Setting Commission provided valuable experience in controlling costs, promoting quality, spreading risk and innovating with service delivery and payment models.

This report is one of 10 state case study analyses that will be completed in 2012.