- Maryland Announces Agreement on All-Payer Health Model Associated Press by Brian Witte — Maryland officials on Monday announced federal approval of a new contract for the state's unique all-payer health care model. Maryland is the only state that can set its own rates for hospital services, and all payers must charge the same rate for services at a given hospital. The policy has been in place since the 1970s, though Maryland modernized its one-of-a-kind Medicare waiver four years ago to move away from reimbursing hospitals on a fee-for-service basis to a fixed budget. "The new Maryland Model will expand health care access and affordability — and ultimately improve quality of life — for Marylanders, especially those with chronic and complex medical conditions," said Gov. Larry Hogan, a Republican.