Strategies to improve healthcare delivery, sustain coverage, and manage growing cost pressures resulting from federal policy changes and state budget dynamics were key topics of discussion at this year’s Maryland health policy conference, May 21, 2026, in Baltimore, MD. Hosted by State of Reform (SOR), an HMA Company, the program convened state policymakers and leaders of health plans, provider groups, and community-based organizations to examine the most pressing healthcare issues in Maryland.
Across sessions, participants explored key policy priorities, including Maryland’s implementation of the Rural Health Transformation Program (RHTP), efforts to stabilize and expand health insurance coverage, and early lessons from implementing the AHEAD (Achieving Healthcare Efficiency through Accountable Design) total cost of care (TCOC) model.
Sustaining Medicaid and Marketplace Accessibility Amid Federal Policy Changes
Throughout the conference speakers and attendees engaged on myriad issues and concerns resulting from the 2025 budget reconciliation act, now referred to as the Working Families Tax Cuts (WFTC) Act, and its potential impact on state Medicaid programs and coverage stability. Maryland Deputy Secretary for Healthcare Financing and Medicaid Director Perrie Briskin joined Johanna Fabian-Marks, Deputy Executive Director of the Maryland Health Benefit Exchange (MHBE), and Melissa Horn, Director of State Legislative Affairs at the Arthritis Foundation, to examine strategies for mitigating coverage loss and maintaining affordability.
Speakers emphasized the need for improved coordination between Medicaid and the MHBE, including clear and consistent consumer communications and targeted outreach in counties most affected by federal policy changes.
For example, Maryland leaders described several innovative approaches the MHBE is using to help people in the state maintain Marketplace coverage, including state-funded subsidies to offset the expiration of enhanced premium tax credits, streamlined auto-renewals, and simplified enrollment pathways for individuals identified as uninsured based on their tax and employment records. The state reported an 8 percent decline in enrollment in April 2026, noting that without these mitigation strategies, enrollment could have dropped by as much as one-third.
The MHBE is using artificial intelligence (AI) to support document verification and is deploying a chatbot to help consumers navigate common questions.
On the Medicaid side, the state is consulting multiple data sources—including CRISP (Chesapeake Regional Information System for our Patients), labor, and education data—to verify eligibility and, compliance with community engagement requirements to reduce administrative burdens.
Rural Health Transformation Program Implementation and Early Priorities
Maryland’s RHTP, supported by nearly $168.2 million in first-year funding from the Centers for Medicare & Medicaid Services (CMS), was a hot topic at the conference. State leaders and implementation partners emphasized the program’s role in addressing rural health disparities, strengthening care delivery infrastructure, and improving chronic disease outcomes.
Elizabeth Kromm, PhD, Assistant Secretary, Maryland Department of Health, outlined the three pillars of the state’s RHTP plan:
- Expand the rural healthcare workforce
- Increase access to integrated primary, specialty, and behavioral health services
- Address the underlying drivers of chronic disease through nutrition and food system interventions
Together, these initiatives highlight Maryland’s focus on both clinical care delivery and broader population health strategies.
State officials also discussed the funding opportunities announced in April 2026, one of which seeks to support care delivery innovation, improve chronic condition management, and advance value-based care models. Speakers emphasized that connection is central to the program’s success—both the strength of community relationships, the connections enabled through technology, and the integration of clinical and nonclinical services.
AHEAD Model: Advancing Total Cost of Care and Population Health
Maryland’s participation in CMS’s AHEAD Model represents a significant shift toward healthcare cost containment and system transformation. As one of the first states to implement the framework, Maryland is testing a statewide approach to managing TCOC while improving quality and population health outcomes.
A panel discussion including leaders from the MedChi, Johns Hopkins, CareFirst Blue Shield, and Kaiser Permanente, addressed implementation considerations, open policy implications, and how providers and payers were approaching these changes in payment for healthcare services. Reimbursement strategies for primary care services were still uncertain and may differ significantly from those used under the Maryland TCOC model. Panelists also discussed what this model means in the broader healthcare environment of reductions in Medicaid payments resulting from the reconciliation legislation and additional funding coming from the Rural Health Transformation Fund. They also described how Maryland could serve as an example for other states working to implement AHEAD in the coming years.
Speakers noted that successful implementation will require strong coordination among providers, payers, and state agencies, and more details are necessary to fulfill the requirements. The model’s 10-year timeline positions Maryland as a leading test case for future federal and state efforts to scale TCOC approaches.
AI in Healthcare: From Innovation to Real-World Impact
AI’s role in healthcare delivery and policy continues to evolve, with growing attention on its practical applications and regulatory implications. A session led by Health Management Associates (HMA) Principal Brandon Greife, JD, and speakers from Microsoft AI, the Pair Team, the Center for Virtual Care, and b.well Connected Health explored how healthcare organizations conceptualize AI use cases to deploy solutions that demonstrate measurable impact.
AI holds promise for improving care delivery, but realizing that potential requires navigating ethical, regulatory, and operational challenges. Mr. Greife led a panel discussion on how the healthcare industry is transitioning from abstract use cases for AI toward evaluating the real-world impact of deployed solutions.
Session speakers also explored how healthcare is advancing from AI tools that support clinicians and payers to patient-facing AI that supports care navigation, chronic disease management, and community outreach. They rounded out the session with a focus on fundamentals of healthcare—concepts like data quality, clinical trust, patient safety, and demonstrated value at the point of care.
Looking Ahead
If you are looking for strategies and solutions to address urgent healthcare policy and operational challenges, HMA experts are available to help you navigate these complex changes and identify practical paths forward.
Through the HMA National Conference, State of Reform partnership events, and other HMA convenings across the country, we connect state leaders, providers, health plans, and community stakeholders to share insights, elevate lessons, and advance solutions. Join us at an upcoming event—including our next HMA National Conference in New Orleans, LA on October 5-7, 2026—or explore additional opportunities to engage with HMA and access the full schedule of conferences and resources.
State of Reform develops its conference agendas through collaboration with HMA subject matter experts/market leads and stakeholders across the public and private sectors, including state officials, community-based organizations, providers, payers, and more.