Links of Interest
Approved Policies and Reports
Maryland Hospital Acquired Conditions
Readmission Reduction Incentive Program
Quality Based Reimbursement
Maryland Patient Safety Center
GBR-PAU Efficiency Adjustment
PAU Savings Policy
Archived Quality Initiatives
GBR Agreements and Addendums
Annual Update to Unit Rates
Accounting and Budget Manual
Policy Clarifications & Regulation Updates
Approved Hospital Unit Rate Reports
Clinical Data Submission and Requirements
Clinical Public Use Data Requests
Financial Data Submission Tool
Maryland Hospital Audited Financial Statements
Nurse Support Programs I & II
Outpatient Services Survey Results
Hospital IRS 990 Forms
Annual Report of Revenue, Expenses, and Volumes
Community Benefit Program
Trustee Disclosure Information
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. This proposal is currently under consideration by CMMI and is not final until approved.
Marylanders’ Health and Quality of Life
of Maryland is committed to ensuring that all Marylanders have access to the
nation’s best health care and that our critical health needs are met. Our priorities:
that all Marylanders have access to quality health care by the nation’s best
health care providers in every corner of the state – whether rural or urban.
the needs of our senior population, which is expected to increase by 40% over
the next ten years.
Fight the opioid epidemic and other population
health improvements such as diabetes prevention and other chronic conditions.
Health System Limitations
Maryland’s most recent approach to hospital payment was known as
the “Maryland All-Payer Medicare Model Contract,” and ran from January 1, 2014
through December 31, 2018. The All-Payer
Model’s success metrics were based on enhancing quality, improving health
outcomes, and constraining the growth of Medicare costs for hospital inpatient
and outpatient services.
Care will be coordinated across both hospital
and non-hospital settings, including mental health and long term care.
The Model will invest resources in
patient-centered care teams and primary care enhancements.
Maryland will set a range of quality and care
improvement goals. Providers will be
paid more when patient outcomes are better.
Maryland will set a range of population health
goals addressing opioid use and deaths, diabetes, and other chronic conditions.
State flexibility will facilitate programs
centered on the unique needs of Marylanders, the provider community, geographic
settings, and other key demographics.
As part of the federal agreement to put the new Total Cost
of Care Model in place, all-payer hospital cost growth continues to be
limited to 3.58% per capita, a limit that was set in 2014 based on long term
growth in Maryland’s economy. As part of
this Model, Maryland commits to saving $300 million in annual, total Medicare
spending by the end of 2023. The Medicare savings required in the TCOC
All-Payer Model will build off of the ongoing work of Maryland stakeholders,
which began in 2014.
A brief background and summary of the Total Cost
of Care Model with key requirements;
● Announced Terms of the TCOC Model;
● Stakeholder engagement through HSCRC and MDH workgroups;
● All-Payer Model Performance, through
2018 Year-to-Date Results; and
Primary Care Program
Total Cost of Care State Agreement
All-Payer Model Agreement
Amendment 1 (Care Redesign Amendment)
Amendment 2 (MPA MACRAtization)
4160 Patterson Avenue | Baltimore, Maryland 21215 Toll Free: 888-287-3229
Phone: 410.764.2605 | Fax: 410.358.6217