​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

​​Modernization

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​​​​​Workgroups

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Total Cost of Care Workgroup Information

The success of the Total Cost of Care Model and the Care Redesign programs will be measured, in part, by reductions in potentially avoidable utilization, readmissions, and ultimately reduced costs due to higher quality healthcare and improvements in patient health. Understanding and managing the drivers of total cost of care and establishing sound approaches to incenting and measuring care transformation activities across the State is essential to ensuring overall success.​

The charge of the TCOC workgroup is to provide technical feedback to HSCRC on the methodologies and calculations that underpin care transformation and total cost of care management activities.

Total Cost of Care Workgroup Membership

The Health Services Cost Review Commission (HSCRC) has appointed a diverse group of individuals to serve on the Total Cost of Care Workgroup. The list of workgroup members is available at the following link:

Total Cost of Care Workgroup Membership Roster​ - Updated March 2024

Meeting Schedule and Documents​

The Total Cost of Care Workgroup schedule is provided in the table below. Additional meetings will be ​added to the schedule. All meetings are virtual and recordings are provided. Questions related to the schedule and location of meetings should be directed to: hscrc.tcoc@maryland.gov.​

2016-2019

 

Dates and Location Meeting Materials
January 25, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605
  1. Agenda
  2. Slides
  3. Data
  4. CCIP/HCIP Calendar

  5. Webinar Recording
March 1, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605
  1. Agenda
  2. Slides

  3. Webinar Recording
March 29, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605
  1. Agenda
  2. Workgroup Presentation
  3. Episodes
  4. PSA by Hospital

  5. Webinar Recording
April 26, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605
  1. Agenda
  2. HSCRC Slides
  3. MHA Slides
  4. PSA-Episode Examples

  5. Webinar Registration
May 24, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605
  1. Agenda
  2. HSCRC Presentation
  3. Total Cost of Care Beneficiary Attribution Results
  4. Hospital Primary Service Area Results

           Webinar Recording 
June 28, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605
​   
      1. Agenda
      2. HSCRC Presentation
      3. TCOC Attribution Methodologies 
      4. Key for Hospital-Specific PSA Maps 
      5. Maps - Part 1
      6. Maps - Part 2

           Webinar Recording​
July 26, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605
      1. Agenda
      2. HSCRC Presentation
      3. TCOC Workbook
      4. Regional Maps Part 1
      5. Regional Maps Part 2​

        Webinar Recording
September 27, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605
​      1. Agenda 
      2. HSCRC Presentation 
      3. MPA by Hopsital Spreadsheet


        Webinar Recording​

 
November  29, 2017
8:00 - 10:00 a.m.

HSCRC
4160 Patterson Ave.
Baltimore, MD 21215
410-764-2605​​
     ​1. Agenda
     2. HSCRC Presentation 11.29.2017
     3. Final Recommendation​ on MPA


     Webinar Recording​​
​January 17, 2018  
8:00 - 10:00 a.m.
  1. Agenda 
  2. January 2018 TCOC Slides
  3. Webinar Recording
February 28, 2018  ​
8:00 - 10:00 a.m. 
  1. Agenda
  2. February 2018 TCOC Presentation
​****MARCH MEETING (3/28) RESCHEDULED***

April 4, 2018
10 a.m - 12 p.m.
​1. Agenda
2. April 2018 TCOC Presentation
April 25, 2018  ​
8:00 - 10:00 a.m. 
  1. Registration Link/Webinar Recording​
  2. Agenda​
  3. April 25 TCOC Presentation
  4. April 25 CRISP Reporting Presentation​
May 23, 2018  ​
8:00 - 10:00 a.m. 
  1. ​​Registration Link/Webinar Recording​
  2. Agenda​
  3. May 23 TCOC Presentation​
June 27, 2018  ​
8:00 - 10:00 a.m. 
  1. Registration Link/Webinar Recording​​
  2. Agenda​
  3. Jun​e 27 TCOC Presentation
​​July 25, 2018  
8:00 - 10:00 a.m. 
  1. Registration Link/Webinar Recording​
  2. Agenda
  3. July 25 TCOC Presentation​
​​September 26, 2018
8:00 - 10:00 a.m.  ​
  1. ​​Registration Link/Webinar Recording​
  2. RY2021 MPA Policy Discussion Draft​
​October 24, 2018
8:00 - 10:00 a.m. ​
​CANCELLED
​​November 28, 2018
8:00 - 10:00 a.m. ​​
  1. Registration Link/Webinar Recording​​
  2. Agenda
  3. Nov 28 TCOC Presentation​​

January 30, 2019 
 
8:00 - 10:00 a.m. 
  1. ​​​​Meeting Recording
  2. Agenda​
  3. Slides

Febuary 27, 2019
9:00 - 10:00 a.m. 
CALL ONLY​
  1. Meeting Recording
  2. Agenda
  3. Slides​

March 27, 2019
8:00 - 10:00 a.m. 
  1. Meeting Recording
  2. Agenda
  3. Slides
  4. Handout​

​April 24, 2019
8:00 - 10:00 a.m. 
  1. Meeting Recording
  2. Agenda
  3. Slides
  4. Handout​

May 29, 2019
8:00 - 10:00 a.m. 
  1. Meeting Recording
  2. Agenda
  3. Slides​
  4. Additional Slides​

June 26, 2019
9:00 - 10:00 a.m. 
WEBINAR ONLY

July 31, 2019

8:00 - 10:00 a.m.
  1. ​Meeting Recording
  2. Agenda​
  3. Slides​
  4. Handout​​

September 25, 2019
8:00 - 10:00 a.m.
  1. Meeting Recording​
  2. Agenda
  3. Slides​

October 30, 2019

8:00 - 10:00 a.m.
  1. Meeting Recording​
  2. Agenda
  3. Slides​

December 4, 2019
8:00 - 11:00 a.m.
  1. ​​Meeting Recording​
  2. Agenda​
  3. Slides​

2020

 
Dates and Times Meeting Documents

January 29, 2020 
 
8:00 - 10:00 a.m. 
 

Febuary 26, 2020
8:00 - 10:00 a.m. 


March 25, 2020
8:00 - 10:00 a.m. 

         
        ​
CANCELLED

​April 29, 2020
8:00 - 10:00 a.m. 

        ​​
        ​​CANCELLED

May 27, 2020
8:00 - 10:00 a.m. 

        ​
        ​​​CANCELLED

June 24, 2020
8:00 - 10:00 a.m. 

        ​​​​
        ​​​​CANCELLED

July 29, 2020
8:00 - 10:00 a.m.

August 26, 2020

8:00 - 10:00 a.m.​
  1. Meeting Recording​
  2. Slides

September 23, 2020
8:00 - 10:00 a.m.
  1. Meeting Recording
  2. Slides

  • September 30, 2020
    8:00 - 10:00 a.m.


    October 28, 2020
    8:00 - 10:00 a.m.


    December 2, 2020
    8:00 - 11:00 a.m.

    2021

     

    Dates​
    ​​Meeting Materials
    ​July 28, 2021
    8:00 - 10:00AM
    1. Slides
    ​August 25, 2021
    8:00 - 10:00AM
    1. ​​Slides​​
    ​November 24, 2021
    8:00 - 10:00AM
    1. Slides​​

    2022

     

    ​Dates
    ​Meeting Materials
    ​May 25, 2022
    8:00 - 10:00AM
    1. Slides

    ​July 27, 2022
    8:00 - 10:00AM
    1. Slides
    2. MPA Y5 
    3. MPA Y6
    ​August 31, 2022
    8:00 - 10:00AM
    1. Slides
    ​October 26, 2022
    8:00 - 10:00AM
    1. Slides
    ​November 30, 2022
    8:00 - 10:00AM
    1. ​Slides

    2023

     


    ​Dates
    ​Meeting Materials
    ​January 25, 2023
    8:00 - 10:00AM
    1. Slides
    2. Webinar Recording​​​​​
    ​April 26, 2023
    8:00 - 10:00AM
    1. Slides
    2. Other Meeting Materials
    3. Webinar Recoding
     May 31, 2023
    8:00 - 10:00AM
    1. ​Slides
    2. Other Meeting Materials
    3. Webinar Recording
     June 28, 2023
    8:00 - 10:00AM
    1. ​Slides
    2. Webinar Recording​​
    September 27, 2023
    8:00 - 10:00AM

    1. Slides
    2. Webinar Recording​​
    October 25, 2023
    8:00 - 10:00AM
    1. Slides
    2. Other Meeting Materials
    3. Webinar Recording​​
    November 29, 2023
    8:00 - 10:00AM
    1. ​Meeting Registration Link
    2. Slides
    3. MPA Adjustment Worksheet 12-15-23
    4. ​​MPA Adjustment Worksheet 1-1-24
    5. Webinar Recording​
    ​No December Meeting

    2024

     
    January 24, 2024

    8:00 - 10:00AM

    1. Meeting Registration Link
    2. Slides
    3. Webinar Recording​

    February 28, 2024

    8:00 - 10:00AM

    1. Meeting Registration Link
    2. Slides
    3. Webinar Recording​
    March 27, 2024 - CANCELED

    8:00 - 10:00AM



    April 24, 2024

    8:00 - 10:00AM

    1. Meeting Registr​ation Link​
    2. Slides
    3. AHEAD Target Calculation
    4. Meeting Recording​​  - Passcode: xH&7iN.*​ 
    May 22, 2024

    8:00 - 10:00AM

    1. Meeting Registration Link​
    2. Slides
    3. Meeting Recording - Passcode: y8.7Ccn!​​

     June 26, 2024

    8:00 - 10:00AM​

    1. Meeting Registration Link​
    2. Slides
    3. Meeting Recording - Passcode: Ax2qZf&1​​
      ​​
     July 24, 2024

    8:00 - 10:00AM​

    1. Meeting Registration Link
    2. Slides​​​

    Resources
    Y3 MPA and MPA Framework Final Recommendations: 
    Please find the Year 3 Medicare Performance Final Recommendation, which was approved during the November 2019 HSCRC Commission Meeting, and the MPA Framework Final Recommendation, which was approved during the October 2019 HSCRC Commission Meeting. The HSCRC sent additional guidance to hospitals on the 2020 MPA attribution process and new MPA Attribution Tracking Tool (MATT), linked below.

    Y2 MPA Final Recommendation: 
    Please find the Year 2 Medicare Performance Final Recommendation which was approved during the November 2018 HSCRC Commission Meeting. The HSCRC sent additional guidance to hospital CFO's on sumbitting data for provider-to-hospital linkages. The memo to CFOs and data submission template are linked below.

    MPA Results: 
    Below are hospital-level summaries of MPA performance during MPA Y1 and MPA Y2. The accompanying memos provide an overview of the Excel files. 

    MPA Attribution Guides and FAQs: 
    Below is the draft Attribution Guide and Frequently Asked Questions (FAQ) for the Year 3 (RY 2022) Medicare Performance Adjustment (MPA), along with prior Y1 and Y2 versions. This document is not final and may be updated with edits or additional questions. Questions about this document should be directed to hscrc.tcoc@maryland.gov. Versions of this document will be posted below. 

    MPA Y3 Attribution Guide and FAQ​ - last updated 4/16/2020​​

    QP Score: 
    Below is a combination of two memos -- from HSCRC to CMS, and a response from CMS to HSCRC.  These memos describe how CMS will calculate the Threshold Score for assessing whether or not clinicians who are certified care partners in a Maryland Care Redesign Program (CRP) are Qualified Advanced Alternative Payment Model Participants (QPs), for purposes of the federal MACRA law and its 5% APM Incentive Payment. Additionally, please find the list of approved Alternative Payment Models (APMs) below. 

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