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 Statewide Integrated Health Improvement Strategy

​In 2019, the State of Maryland collaborated with the Center for Medicare and Medicaid Innovation (CMMI) to establish the domains of health care quality and delivery that the State could impact under the Total Cost of Care (TCOC) Model.  The collaboration also included an agreed-upon process and timeline by which the State would submit proposed goals, measures, milestones, and targets to CMMI. As a result of the collaboration with CMMI, the State entered into a Memorandum of Understanding (MOU)​ that required Maryland to provide a proposal for the Statewide Integrated Health Improvement Strategy (SIHIS) to CMMI by December 31, 2020.  The SIHIS aligns statewide efforts across three domains that are interrelated and, if addressed successfully, have the potential to make significant improvement in not just Maryland’s healthcare system, but in the health outcomes of Marylanders.

Read the State's SIHIS proposal to CMMI here.​ ​ ​​

SIHIS Domain ​Goals


Domain Area​            Go​al(s)​
Domain 1 – Hospital Quality​
  • ​Reduce avoidable admissions and readmissions
Domain 2 -Care Transformation 
Across the System​
  • ​Increase the amount of Medicare TCOC or number of Medicare beneficiaries under Care Transformation Initiatives (CTIs), Care Redesign Program, or successor payment model
  • Improve care coordination for patients with chronic conditions 
Domain 3 – Total Population Health Diabetes
  • ​Reduce the mean Body Mass Index (BMI) for adult Maryland residents 
​Domain 3 - Total Population Health Opioid Use Disorder
  • ​Improve overdose mortality 
Domain 3 - Total Population Health Maternal and Child Health                       
  • ​Reduce severe maternal morbidity rate 
  • Decrease asthma-related emergency department visit rates for ages 2-17


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