Maryland Hospital Association President and CEO Carmela Coyle will step down from her job this fall to take the same position with the California Hospital Association, the Maryland group announced Thursday.
Coyle has served as president and CEO of the hospital association since 2008. During her tenure, the state rolled its Medicare waiver program into the Affordable Care Act, accelerating the state’s move to global budgets for hospitals instead of a fee-for-service system.
“Maryland is such a unique state in terms of its innovative health care policy,” Coyle said. “It’s what brought me here from the national stage. I think Maryland’s hospitals are really doing a terrific job in what is a leading-edge model for hospital payment in the United States.”
When Coyle took over the hospital association, the state’s hospital system required a Medicare waiver. But under the Affordable Care Act, these types of state projects became demonstration projects run out of the Center for Medicare and Medicaid Services.
Under both the waiver and the demonstration project, the state’s Health Services Cost Review Commission sets budgets for the state’s hospitals. Under the agreement with the Center for Medicare and Medicaid Services, the hospitals were given goals to meet covering cost savings and rehospitalizations. As of last month, the state was on track to meet most of those goals.
Maryland’s agreement with the federal government had a five-year term, set to expire in 2019. The state is currently in the midst of negotiating a new five-year agreement.
“We’re heading down the process here of negotiating the second phase of this waiver so it’s a crucial time in the life of the hospital industry,” said Robert Chrencik, president and CEO of the University of Maryland Medical System. “It’s not the best time to be losing your spokesperson.”
But the state’s medical community said the state should still be in good shape following Coyle’s departure.
“I think it won’t have any effect,” said Gene Ransom, executive director of MedChi, Maryland’s medical society. “We’ll march through it. The state’s negotiating it and we’ll figure it out.”
MedChi, like the hospital association, has kept the state’s all-payer system at the top of its list of things to be watchful of during discussions around amending or repealing and replacing the Affordable Care Act.
Current proposals offered in the House and Senate would not affect the statutory authority for the program. But full repeal, which President Donald Trump suggested last month, could remove the authority and require the state to return to the waiver process it used before 2014.
“I think all of the key stakeholders understand the importance of this system,” Coyle said. “While the MHA is certainly at the forefront of working to maintain this unique model, I really think it’s a statewide effort.”
The hospital association and the medical society have worked together on a number of other issues in the state, including tort reform and workforce issues. Ransom called the hospital association under Coyle, a “good partner.”
“The hospital association and medical society have a much closer relationship than in other jurisdictions,” he said. “That’s a credit to Carmela and her personality.”
Chrencik also credited Coyle for helping the industry adapt to changes under the Affordable Care Act.
“There was no guarantee that the Maryland hospital industry was going to adapt to this new way of doing things,” he said. “To her credit, she helped the industry through an enormous period of change as we adapted to this new waiver and the requirements of the Affordable Care Act.”
Prior to joining the Maryland Hospital Association, Coyle had spent 20 years at the American Hospital Association. Before that, she worked for the Congressional Budget Office.
The hospital association said it would begin work to conduct a nationwide search for the next president.