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The Maryland Department of Health and Kaiser Permanente have settled negotiations on a contract that will let the health care company continue as a state Medicaid provider, ensuring that more than 100,000 Medicaid recipients maintain access to their current doctors.
In a joint statement Wednesday, the department and the company said their agreement will increase “accountability and responsibility” among the state’s providers while focusing on the state’s “efforts to achieve health equity and improve health outcomes for Marylanders.”
WYPR reported last week that the department had dropped Kaiser Permanente as one of the managed care organizations that provide Medicaid services through contracted arrangements between the state and health care agencies. Soon after, Kaiser Permanente “reached out to further continue negotiations with the health secretary,” the department said in a statement Tuesday.
At that point, the department had agreed to continue contracts with eight other Medicaid participants: Aetna Better Health, CareFirst Community Health Plan, Jai Medical System, Maryland Physicians Care, MedStar Family Choice, Priority Partners, United Healthcare and Wellpoint.
A department official said that the 2025 contracts include changes that increase accountability and health equity among the managed care organizations. They also require the providers to screen patients for social needs such as food access, transportation, housing and employment, among other requirements.
While it’s not clear if the new requirements led to the initial disagreement with Kaiser Permanente, an official with the department said Wednesday that Kaiser Permanente had agreed to the updated requirements in the new agreement.
Losing Kaiser Permanente as a Medicaid provider could have been a “major crisis” for some 109,000 Medicaid recipients who would have lost access to their physicians, said Gene Ransom, CEO of MedChi, the state’s medical society. He noted that many Kaiser Permanente patients are residents of Prince George’s, Montgomery and Baltimore counties.
“Since these physicians would no longer be eligible to take care of those patients, they would have to go to other physicians. And we just don’t have enough doctors to do that,” Ransom said. “We would essentially, suddenly, have 100,000 people displaced to find new physicians — and the markets just aren’t strong enough to deal with that right now.”
Ransom added that people without access to a physician tend to seek care in Maryland’s already crowded emergency rooms, exacerbating the problem of extended emergency room wait times.
“If those folks got displaced and they didn’t have a doc, would that mean that they end up in the emergency room and other places like that? Where costs are higher and are already backed up?” he said. “We don’t need to make them any worse.”
But the agreement between the health department and Kaiser Permanente means that such a crisis appears to have been avoided, for now.
“This is going to happen occasionally when you have something as complicated as this,” Ransom said. “The most important thing is that everybody calmed down and worked it out.”
Maryland Matters is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Maryland Matters maintains editorial independence. Contact Editor Steve Crane for questions: editor@marylandmatters.org. Follow Maryland Matters on Facebook and X.
