The Maryland all-payer approach to hospital payment rate regulation has grown up slowly, and in some ways organically. Indeed, its evolution is so distinct from the rest of the country’s experience ...

The Maryland All-Payer Model was associated with an increase in population-based rates of elective major joint replacements, with a more pronounced effect observed in Maryland-only hospitals.

If the Maryland model has so many advantages, why haven’t other states pursued equivalent reforms? Most importantly, the All-Payer model fundamentally reconfigures health care's supply-demand dynamics ...