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
The HSCRC, MDH, CMS, and CMMI recently signed a
Memorandum of Understanding to support the implementation of a statewide
strategy to address key health priorities, also referred to as the Statewide
Integrated Health Improvement Strategy. HSCRC
and MDH have worked collaboratively to identify opportunities provided by the
Total Cost of Care Model to not only lower costs but also to improve population
health across the State. The Model encourages
the development of programs and provides financial credit for improvement on
key health priorities. HSCRC and MDH
have begun to identify key health priorities including diabetes and opioid use
that are well suited for a statewide approach that mobilizes and integrates
public and private resources to reduce the impact these conditions have on
Marylanders. The Memorandum of Understanding can be found here.
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 current approach to hospital payment is known as
the “Maryland All-Payer Medicare Model Contract,” and runs from January 1, 2014
through December 31, 2018. The All-Payer
Model’s success metrics are 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 will continue 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.
The State of Maryland remains
committed to a robust process for input and feedback during the implementation of the TCOC Model. Maryland
stakeholders will continue to provide feedback through participation in workgroups, councils, and provider-led innovation groups.
Additional information is available in the following
resources and the list of documents below:
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)
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