Maryland's All-Payer Hospital System Modernization

Payment Models Workgroup

In general, this workgroup will develop recommendations for the HSCRC on the structure of payment models and how to balance its approach to updates. The Workgroup will address topics that include:

  1. Balanced Updates
  2. Guardrails for Model Performance
  3. Market Share
  4. Initial and Future Models
HSCRC Workgroups Descriptions

Payment Models Workgroup Membership

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

Payment Models Workgroup Appointments

Schedule, Goals, and Documents

The Payment Models Workgroup work plan is provided in the table below. Additional meetings will be added to the schedule. Please check back for the location and schedule of future meetings. Questions related to the schedule and location of meetings should be directed to:

Workgroup and Sub-workgroup Master Schedule - Updated 10-13-15​

2014 Meetings

2014 Dates and Location Meeting Goals Meeting Documents
February 21 
3:00 - 5:00
  1. Review Workgroup charge and draft work plan

  2. Discussion of New Model and Global Budget Methodology (HSCRC staff presentation and discussion)

  3. Discussion of Factors to be Considered in Updates (HSCRC staff presentation and discussion)

  4. Discussion of Factors to be considered in short term adjustments (HSCRC staff presentation and discussion)

Payment Models Workgroup Workplan 

Presentation Slides 

Approved Transitional Rate Setting Policies 

Global Revenue Budget Template Single 

Webinar Recording
March 13 
1:00 pm – 4:00 pm 

  1. Discuss Performance Measurement Work Group Recommendations and Payment Approaches (staff presentation and discussion)

  2. Discussion on Balanced Update

  3. Discussion of components, approach and principles for update factor and short term adjustments

Workgroup Workplan 3-11-14 

Payment Workgroup Performance Based Programs 

Global Budget Update 

New All-Payer Model for Maryland - considerations for payment update 

Balanced Update 

Webinar Recording - 3 hours (large file)
March 20 
9:00 - 11:00 a.m.

  1. Synthesis of Additional Papers on Balanced Update

  2. Discussion of components, approach and principles for update factor and short term adjustments

  3. Presentation of Initial Uncompensated Care Analysis (HSCRC staff or contractor presentation and discussion)



UCC Methodology Trend and PAC Analysis Slides 

PAC Data FY 2013 

UCC and PAC Analysis Document 

CareFirst - Proposed Process - Dual Waiver Tests Slides

CareFirst Paper - Annual Update Allowance 

Goals - Desirable Features 

Webinar Recording
April 3 
3:00 – 6:00

  1. Finalize recommendation on components, approach and principles for update factor and short term adjustments

  2. Discussion of balanced update and short term adjustments recommendations

Work Plan 

Demographic Adjustment Slides 

Report on Balanced Update and Short-term Adjustments

Webinar Recording - Mainly Audio. Demographic Adjustment Slides presented. Agenda shown otherwise and majority of discussion is on the Report on Balanced Update.
April 23 
9:00 – 12:00

  1. Finalize Uncompensated Care Policy

  2. Discussion of balanced update and short term adjustments recommendations

Work Plan - updated 4-18-14 

PAU Slides 

Webinar Recording - Complete, 3:15 hrs. 

*ARR Shared Savings Methodology FY2015 - PDF 

*ARR Shared Savings Methodology FY2015 - Excel
April Deliverable Report on components, approach and principles for Balanced Update and Short-Term Adjustments for May Draft Recommendation to HSCRC
May Deliverable Report on uncompensated care policy recommendations
May 5 
2:00 – 5:00 


  1. Finalize balanced update and short term adjustments recommendations 
    (May 7 Draft recommendation to Commission)

  2. Report from Performance Measurement Workgroup on Efficiency


HSCRC Efficiency Measures and Issues 

UCC Recommendations Slides 

Draft Report - UCC Recommendations 

Webinar Recording - Part 1 

Webinar Recording - Part 2 - starts at 1:25 minute mark, audio lost for last 6 minutes, at 21:40 mark.
May 19 
2:00 – 5:00

  1. Discussion of guardrails for model

  2. Report from Physician Alignment Work Group on Shared Savings/Gain sharing

  3. Discussion of Market Share Papers

  4. Discussion of post acute care bundling
1- Agenda 

1- Work Plan - updated 5-19-14 

2- Demographic Adjustment Slides 

3- Contract Review Recommendations 

4- Draft Discussions: Market Share Adjustments 

5- CareFirst Market Share Adjustments Presentation 

Complete Meeting Packet - compiling above listed items 

Market Share Adjustment White Papers: 


Health Care for All 

Webinar Recording
June Deliverable Report on balanced update and short term adjustments recommendations
June 2 
2:00 – 5:00

  1. Presentation on major capital projects from MHCC

  2. Comments on contract recommendations

  3. Update from Physician Alignment Workgroup on shared savings/gain sharing

  4. Initial discussion of future role and work plan for workgroup

  5. Status of sub-groups
Complete Presentation 

Additional Documents: 

Hospital CAP Projects 

Hospital CAPEX B 

Hospital CAPEX C 

Hospital CAPEX D 

Hospital CAPEX E 

Hospital CAPEX 2009 and 2013 

CON Reform Nov 2013 

Webinar Recording
June 23 
  1. Discussion of Tranfers Analysis and Policy
  2. Finalize Recommendation on Future Role and Work Plan for Workgroup
July 30 
To be updated
  1. Discussion of Tranfers Adjustment Methodology
  2. Global Budget Revenue/Volume Corridors
August 6 

4160 Patterson Ave.
Baltimore, MD 21215
  1. Review Transfers Sub-Workgroup Report

  2. Review GBR Revenue Corridor Sub-Workgroup Report

  3. Review Modifications to the GBR Agreement template

  4. Review Phase 2 work plan
Complete Presentation Packet
  1. Agenda

  2. Transfer Cases Description

  3. Addendum to Section 5 of Global Budget Agreements -Hospital System

  4. Addendum to Section 5 of Global Budget Agreements -Single Hospital

  5. Addendum to Compliance of TPR Agreements

  6. Payment Models Workgroup Phase 2 Draft Workplan

  7. Draft Charge Corridors within TPR and GBR Agreements
Webinar Recording
August Deliverable
  • Finalize Methodology on Transfers
October 1 
1:00 – 4:00 

  1. Finalize Transfer Approach

  2. Finalize GBR Revenue Corridor Approach

  3. Review Total Cost of Care Template

  4. Review Guiding Principles for Market Share Policy

  5. Review Data Analytics for Market Share

Complete Presentation Packet

  1. Agenda

  2. Total Cost of Care Update Slides

  3. Draft: Charge Corridors within TPR and GBR Agreements

  4. Transfer Cases Description

  5. Transfer GBR Adjustment Slides

  6. Market Share Adjustment Principles

Webinar Recording
October 29 
9:00 – 12:00 a.m.

Webinar Only
No In-person Meeting

  1. Presentation from Ken Thorpe on Market Share

  2. Review Market Share Sub-Workgroup Calculations 

  3. Finalize Total Cost of Care Template

  4. Review GBR Infrastructure and Investment Sub-Workgroup Report
  5. Review and Finalize Medicaid Savings Sub-Workgroup Report
  1. Agenda

  2. Phase II Draft Work Plan

  3. Market Share Adjustment Principles

  4. Market Share Examples Presentation

  5. State Wide Product Line Summary

  6. GBR Infrastructure Investment Report Presentation

  7. Global Budget Revenue Reporting Draft Report

December 15 
9:00 – 12:00 a.m.

  1. Review of Market Share Subgroup Calculations

  2. Aggregate Revenue At Risk in Maryland Value-Based Programs

  3. Update on Uncompensated Care

  4. Update on Medicaid Savings Calculations
  1. Draft Aggregate At Risk for Quality Recommendation

  2. Payment Scales

  3. Market Share Adjustment Principles

  4. Potential Considerations for Off-Cycle Adjustments

  5. Midyear Update Request

  6. Transfer Cases Description​

Public Comments Submitted to the Workgroups

The Workgroup will reserve time at the end of each meeting for brief comments and questions from the public. The public is also encouraged to submit written comments related to Workgroups at any time. Comments may be sent via email to Below are the comments received by the Workgroup to date.​