TPR Rate Setting Methodology



The Total Patient Revenue System (“TPR”) is a revenue constraint system developed by the Maryland Health Services Cost Review Commission to provide hospitals with a financial incentive to manage their resources efficiently and effectively in order to slow the rate of increase in the cost of health care. The TPR also is consistent with the hospital’s mission to provide the highest value of care possible to the community it serves.

This methodology is available to sole community provider hospitals, and hospitals operating in regions of the State characterized by an absence of densely overlapping services areas. The HSCRC staff reserves the right to exclude any hospital from eligibility for the TPR if it determines that the hospital’s service area characteristics are not conducive to successful implementation and operation of this methodology.

The basic concept embodied in the TPR is the assurance of a certain amount of revenue each year, independent of the number of patients treated and the amount of services provided to these patients. The hospital, therefore, has the incentive to reduce length of stay, ancillary testing, unnecessary admissions and readmissions, as well as improve efficiency in the provision of services while treating patients in a manner consistent with appropriate, high quality medical care.


Ten acute care hospitals participate in the TRP rate setting methodology. One hospital, Garrett County Memorial Hospital has been on this system for over twenty years. A second hospital, The Edward W. McCready Memorial Hospital, transitioned to the TPR methodology in FY 2008. The remaining eight hospitals adopted the TPR rate setting Methodology for FY 2011.

TPR Hospital List

Hospital Location
Calvert Memorial Hospital Prince Frederick, Maryland
Carroll Hospital Center Westminster, Maryland
Chester River Hospital Center Chestertown, Maryland
Dorchester General Hospital Cambridge, Maryland
Edward W. McCready Hospital Crisfield, Maryland
Garrett County Memorial Hospital Oakland, Maryland
Memorial Hospital at Easton Easton, Maryland
Meritus Medical Center Hagerstown, Maryland
Union Hospital of Cecil County Elkton, Maryland
Western Maryland Regional Medical Center Cumberland, Maryland

Agreement Between the HSCRC and the Applicant Hospital

Please click below to review the TPR Agreement template. This document provides extensive detail of the scope of the TPR methodology as well as the requirements and responsibilities of both the hospital and the HSCRC.

Sample TPR Agreement​


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