Former Health Secretary Joshua Sharfstein to lead Md. hospital cost review commission

Former Maryland Secretary of Health Joshua Sharfstein will be the new chair of the Maryland Health Services Cost Review Commission, a powerful board tasked with constraining hospital rates in the state.

Sharfstein, the commission’s newest member, was appointed by Gov. Wes Moore (D) to take over as chair starting at the upcoming November meeting, according to the outgoing HSCRC Chair Adam Kane at a Tuesday meeting.

“This will be my last meeting as chair. The governor has selected Dr. Sharfstein to be our new chair, which will be in very good hands,” Kane said, during a meeting held in Baltimore.

Sharfstein was Maryland’s Secretary of the Maryland Department of Health from 2011 to 2014 and is currently a vice dean at Johns Hopkins Bloomberg School of Public Health.

But his new leadership position reignites unanswered questions related to recent appointments on the commission.

In June, Gov. Moore announced the appointment of three new members to the HSCRC, including Sharfstein and Nicki McCann, vice president of provider/payer transformation for the Johns Hopkins Health System.

The Health Services Cost Review Commission sets hospital rates across the state, and Maryland law places a limit on how many individuals on the commission can be a part of a regulated entity to avoid potential conflicts of interest: There cannot be more than three commissioners who have connections “with the management or policy of any facility.”

The question is whether Sharfstein and McCann’s appointments violate that provision with their connections with Hopkins, as there are already two commissioners involved with state medical institutions — Commissioner Maulik Joshi, who is president and CEO of Meritus Health, and Commissioner James Elliot, a physician at Luminis Health Doctors Community Medical Center.

At the time of their appointments, McCann and Sharfstein’s connections to Johns Hopkins raised questions on their ability to sit on the board together and remain compliant with Maryland law.

The Moore administration asserted that the appointees “meet all the statutory requirements to serve on the Commission” but have not publicly explained how the appointments comply with the state law or with a decades-old State Ethics Commission opinion which concluded that a commission employee’s affiliation with Johns Hopkins University violated a state employment conflict-of-interest law, given the close relationships between the university and Johns Hopkins Health System.

The governor’s office did not respond to questions about what led into the change in leadership or whether Sharfstein’s duties as chair may be affected because of his connection with Johns Hopkins.

The commission has also seen other leadership changes in recent months.

Over the summer, Katie Wunderlich stepped down as executive director, serving at her last meeting in July.

Jonathan Kromm attended his first meeting as executive director in September. Wunderlich’s departure was controversial for a separate reason. Some advocates are concerned that the commission lacks enough female voices, especially at a time when reproductive rights are on the line.

McCann is currently the only woman serving as commissioner on the seven-person board.

Health Services Cost Review Commissioner Adam Kane attends a meeting in Baltimore on Oct. 11, 2023. Photo by Danielle J. Brown

Kane will continue to serve on the board as a commissioner. He started as chair in 2020 and has been at the head of the commission throughout the COVID-19 pandemic.

“Come next meeting, I now get to vote again — for which I apologize in advance,” he joked. The chair does not vote in most decision-making but will cast a tie-breaking vote.

Sharfstein gave Kane a “moment of appreciation,” before the meeting ended and thanked Kane for his work with the commission during COVID.

“I am glad personally and professionally that you’re going to be serving on the commission,” Sharfstein said.

After the meeting, Sharfstein did not respond to questions about his appointment, but told Maryland Matters that he is “looking forward to being a part” of the commission in his new role as chair.

“It’s an incredibly important commission, a really important time for Maryland,” he said.

Sharfstein said that since he’s started with the commission in September, the learning curve has been “fascinating.”

“I mean, there’s so much good work happening in Maryland…Adam and the other commissioners and staff have been very generous in teaching about the different programs that are underway,” he said.

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