Brown credits the Maryland legislature with being a key supporter of the effort. "The real action and success of the ACA will happen in state capitals around the country." Because the ACA doesn't guarantee healthcare cost control, one big step is for states to "affirm or strengthen their commitment to implement serious and sustained efforts to bend the cost curve."
For Maryland, that has entailed the development of state and local health improvement plans to identify priorities and set measurable targets, the creation of a model for patient-centered medical homes, and increased adoption of health information technology.
Brown acknowledges that states are right to worry that federal funding, especially for Medicaid expansion, is committed only until 2020. He refers to 2021 as "hitting the cliff" but says that's why bending the cost curve is so important.
He says time is of the essence and states should "use this time to develop programs that benefit their residents."