Podcast Summary: Dr. David Marcozzi on High Reliability, Access, and the Maryland Model

Podcast: Becker’s Healthcare Podcast
Date: February 5, 2026
Guest: Dr. David Marcozzi, Chief Clinical Officer, University of Maryland Medical Center; Associate Dean of Clinical Affairs, University of Maryland School of Medicine
Host: Laura Deardo

Overview

This episode of the Becker’s Healthcare Podcast spotlights Dr. David Marcozzi’s approach to complex healthcare challenges as Chief Clinical Officer at one of the nation’s premier academic medical centers. The conversation centers on driving high-reliability principles, innovative access strategies, and the state-shaping influence of Maryland’s unique payment and accountability models. Dr. Marcozzi shares key transformation efforts, lessons learned in change management, and his vision for sustainable growth and workforce well-being.

Key Discussion Points & Insights

Dr. Marcozzi’s Role and Health System Structure (01:11–03:08)

• Chief Clinical Officer for the University of Maryland Medical Center, overseeing two hospital campuses, over 800 beds downtown plus 140 at Midtown, and nearly 2,100 learners and physicians.
• Responsible for clinical strategy, operations, safety, graduate medical education, and alignment across an enterprise ranked nationally for high-acuity care and excellence in nursing.
• Emphasis on tight integration of education, research, and care:

  “All of our physicians are faculty within the University of Maryland School of Medicine, tightly linking education, discovery and care.” (02:19)

High Reliability Organization (HRO) Implementation (03:27–06:58)

• Led a comprehensive rollout of HRO principles, embedding them in executive routines, unit governance, and frontline workflows.
• Standardized leader engagement with safety data, rapid escalation of risk, and clear accountability via interdisciplinary “dyad” and “triad” models.
• Introduced “continuous learning for improvement” with applied Lean strategies at the unit level.
• Tangible outcomes:
  • Improved safety reporting.
  • Better interdisciplinary relationships.
  • Higher clarity and ownership of safety issues.

  “We saw improvement in our safety reporting... more consistent leadership at the unit level... very clear ownership of safety issues and faster escalation and resolution of risks.” (06:13)

• Notable phrase:

  “It went from the bedside to the boardroom.” (04:16) — On the pervasiveness of HRO culture.

Innovating Access to Specialized Care (06:59–07:23)

• Tackled access challenges for high-acuity patients via “round trip transfers” (patients transferred for specialized treatment without requiring inpatient admission).
• Created clear standards, disciplined oversight, and tapped telehealth to overcome inpatient bed constraints.
• 70% of requested round trips were completed; others managed differently or deemed unnecessary.

  “We’re really trying to think about a systematic way to get access to high acuity care that our medical center can provide, but not limited by bed capacity.” (06:50)

Change Management: Culture and Decisive Collaboration (08:13–09:33)

• Emphasized clarity of roles and expectations to drive accountability.
• Advocated for a decision-making culture built on "decisive collaboration":

  “We embrace a 'who is the lead for this decision, how are we collaborating to make that decision?' But we will make a decision... we're not paralyzed by indecision." (08:47)

• The HRO model further strengthened the clarity of structure, process, priorities, and outcomes.

The Maryland Model & Future Priorities (09:43–13:03)

• Maryland's unique CMS “Maryland Model” uses global payments and accountability statewide, shifting focus from volume to value.
• Expanded collaboration among hospitals, physicians, and communities, improving quality and curbing costs.
• Maryland as a “beacon” and a model for potential national healthcare reform:

  “The Maryland model has demonstrated also it is starting to bend the cost curve... many states and federal partners now view [it] as a blueprint for national reform.” (10:43)

• Rolling out the new “AHEAD Model” to further expand accountability to total cost of care, population health, and equity.
• Local implications: tighter integration across the care continuum, standardized clinical practice, disciplined use of resources, all amid rising acuity and workforce pressures.

  “I'm not going to say that we don't [have challenges], but the challenge is executing at a high level locally while helping shape a model that could inform healthcare delivery nationally.” (12:39)

Transitioning from Fee-for-Service: Lessons Learned (13:40–15:37)

• The Maryland Model requires a cultural shift, particularly for incoming staff:

  “Supporting health overall outside the four walls of our hospital is really a mind shift change for folks who might be coming in here [from] a typical fee for service model.” (14:22)

• While hospitals are capitated, physicians remain on fee-for-service—necessitating alignment between hospital strategies and physician practice.
• Partnership between providers and hospitals is now fundamental.

2026’s Hardest Challenge: Balancing Innovation with Staff Well-Being (15:50–17:12)

• Facing constant change (clinical, operational, technological) amidst workforce fatigue.
• The chief challenge: driving innovation while sustaining and supporting the healthcare workforce—prioritizing work that truly matters, eliminating low-value tasks, and ensuring innovation enhances rather than burdens staff.

  “Leading through that tension with clarity and empathy will be one of the most important responsibilities this upcoming year.” (16:53)

Growth Opportunities: Workforce, Automation, and AI (17:33–19:31)

• Major growth opportunities at the intersection of workforce sustainability, payment reform (AHEAD), and automation/AI.
• Reimagining care delivery: Right work, right person, right time; automation can reduce administrative burden and burnout.

  “Automation and responsible use of AI could allow us to redesign care so clinicians and staff can operate at the top of their skillset... When team members spend more time delivering care and less time battling administrative systems, our engagement rises, turnover drops, and folks are just happier coming to work.” (18:17)

• Smarter triage, decision support, and improved staff experience are essential for sustaining high performance.

Notable Quotes & Memorable Moments

• On HRO Cultural Penetration:
  “It went from the bedside to the boardroom.” (04:16)
• On Decisive Collaboration:
  “We embrace a 'who is the lead for this decision, how are we collaborating to make that decision?' But we will make a decision... we're not paralyzed by indecision." (08:47)
• On Maryland as an Innovation Beacon:
  “Many states and federal partners now view [Maryland] as a blueprint for national reform.” (10:45)
• On Workforce and Innovation:
  “Leading through that tension with clarity and empathy will be one of the most important responsibilities this upcoming year.” (16:53)
• On AI & Automation Potential:
  “Automation and responsible use of AI could allow us to redesign care so clinicians and staff can operate at the top of their skillset…” (18:17)

Timestamps for Key Segments

• Intro & System Overview: 01:11
• High Reliability Organization Implementation: 03:27
• Expanding Access & Round Trip Transfers: 06:59
• Change Management & Decisive Collaboration: 08:13
• The Maryland Model & Future Priorities: 09:43
• Lessons Transitioning from Fee-for-Service: 13:40
• Biggest Challenge for 2026: 15:50
• Opportunities for Growth – Automation & AI: 17:33

Tone & Language

Dr. Marcozzi’s insights are precise, pragmatic, and forward-thinking—anchored in clinical rigor but with a clear appreciation for team culture and systems leadership. The conversation is energetic, rich with real-world examples, and threaded with an optimistic vision for the future of healthcare transformation.