Outcomes-Based Credits

Diabetes Outcomes-Based Credit

HSCRC announces federal approval of ​the first methodology to credit Maryland for population health improvements achieved during the Total Cost of Care Model.

The Centers for Medicare & Medicaid Services (CMS) and the State of Maryland are partnering to test the Maryland Total Cost of Care (TCOC) Model. Under TCOC, the State is able to receive credit for savings generated by addressing health conditions, like diabetes, that affect Marylanders in large numbers.  By improving the health of our population, the State can also reduce all-payer healthcare spending, a key goal in TCOC. This unique opportunity recognizes that the State is now investing in programs that prevent/delay diabetes onset over the long term, but that may not immediately result in cost savings. Under the Model, if Maryland is able to prevent or delay diabetes onset, the State will receive credit to offset federal investment in Maryland.  Any credit earned increases TCOC Model Savings, which may benefit hospital global budgets. In this way, Maryland aims to further incentivize health system transformation and public health intervention alignment.​ 

Additional Materials

Diabetes OBC Methodology Summary

Approval Letter from CMMI

Approved Proposal to CMMI​

For more information, please email Laura.Mandel@maryland.gov