HSCRC incorporates stakeholder feedback into all of its decision-making, ensuring Marylanders are at the center of each of its policies. HSCRC gathers input in several ways, including:
- Allowing for public comment in all Commission meetings
- Convening regular workgroups, which are open to the public
- Meeting directly with stakeholders as staff develop new policy ideas
Workgroups are meant to support staff in advancing the mission of the HSCRC and serve as advisory bodies. HSCRC operates three standing workgroups: Payment Models, Performance Measurement, and Total Cost of Care. There are also a number of sub-workgroup meetings and task forces to discuss technical, data-driven matters related to specific policies, which report back to the larger standing workgroups.
In addition, HSCRC occasionally has ad hoc workgroups on topics that are not covered in the standing workgroups. Information about current ad hoc workgroups is available in the menu on this page.
Meeting dates & registrations, rosters, and decriptions for each standing workgroup and subgroup are listed below.
Standing Workgroups:
All-Payer rate setting is an integral part of the Total Cost of Care Model. Under the TCOC Model, the State committed to continue to limit the growth in hospital costs in line with economic growth, reach an annual Medicare total cost of care savings rate outlined in the agreement, continue quality improvements, and improve the health of the population. To meet the ongoing requirements of the Model, HSCRC will need to continue to ensure that state-wide hospital revenue growth is in line with the growth of the economy. The HSCRC will also need to continue to ensure that the Medicare TCOC savings requirement is met.
The main charge of the Payment Models workgroup is to develop the update factor provided to hospitals on July 1 of each year that ensures reasonable growth of revenue relative to cost while also balancing the needs/tests of the TCOC Model outlined above. The update factor typically provides an increase of 500-900 million across the State each fiscal year, making it the most substantial policy (in dollar value) developed each year.
Payment Models Workgroup Membership
- March 5, 2024 (1:00PM - 3:00PM)
- Aprill 3, 2024 (10:00AM - 12:00PM)
- April 30, 2024 (1:00PM - 3:00PM)
- May 30, 2024 (1:00PM - 3:00PM)
- September 23, 2024 (1:00 - 3:00PM)
- October 24, 2024 (10:00 - 11:00AM)
The Performance Measurement Workgroup, generally convened monthly, is charged with vetting measures and methodology options and making recommendations for the Commission on measures and measurement approaches that are reliable, informative, and practical for assessing hospital quality and safety. The PMWG work is generally focused on areas and programs for implementation in hospital performance-based payments. Guiding principles include the following:
Areas of PMWG focus include:
- Value-based payment (integration of cost, quality, population health and outcomes)
- Patient Experience and Patient-centered Outcome measures
- Potentially Avoidable Utilization (PAU)
- Development of Statewide Targets and Hospital Performance Measurement
- Maryland’s quality programs should monitor for unintended consequences of, and maximize the population health improvement opportunities made possible by, the TCOC Model;
- Goals, measures, and targets should be specific to Maryland and established through a collaborative public process;
- Goals, measures and targets should reflect an all-patient (regardless of payer) perspective;
- Performance measurement should include predetermined performance targets and monitoring reports of hospital-level and statewide improvements, including improved health equity;
- Goals of the programs should be synergistic and mutually reinforcing with other state health improvement goals and efforts;
- Measures should be focused on outcomes whenever possible but also include process and structure measures where appropriate.
The Commission appoints and maintains a diverse group of Workgroup members that includes but is not limited to representatives in the following areas:
- Clinical/medical specialties/subspecialties
- Clinical quality measurement (physician, nurse, quality measurement, QIO, digital measures)
- Nursing care (hospital leadership, academia, nursing sensitive measures)
- Consumer advocacy/ representatives (Families USA, community behavioral health)
- Hospital operations leadership (fiscal, quality, population health, CEO)
- Payer (Medicaid managed care, Medicaid, commercial)
- Public policy (state policy makers, academic health policy and business)
- Health equity
- Diverse hospital types (MHA, academic, teaching, community, urban, rural)
- Diverse provider settings (hospital, primary care, specialty care, OBGYN care, community behavioral health)
Subgroups of the PMWG are convened as needed to elicit additional critical expertise in targeted areas such as the Readmissions subgroup and the Quality Based Reimbursement subgroups.
Meeting Schedule:
- March 20, 2024
- April 17, 2024
- September 18, 2024
- October 16, 2024
- November 20, 2024
Please visit the
Performance Measurement Webpage for more 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 initial 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.
- November 20, 2024 - 8:00AM - 9:30AM
- December - Cancelled
- January 22, 2025 - 8:00AM - 10:00AM
Subgroups:
The initial focus of this technical subgroup will be to advise on the development of the Annual Filing supplemental schedule to capture clinician (provider) costs (2-3 meetings).
Later, the subgroup’s work will shift to updating indirect cost center definitions and selected allocation metrics within the Annual Filing and establishing a cost center framework for reporting population health costs and revenues (2-3 meetings).
The first 2-3 workgroup meetings will require individuals familiar with the Annual Filing and knowledge of their hospital’s clinician operations, contracting, and costs. Subsequent meetings will require individuals with working knowledge of the Annual Filing allocation methodology and their hospital’s population health initiatives. The group will convene in March with workgroup meetings occurring every 4 to 6 weeks.
Meeting Schedule and Webinar Registration:
As part of the Rate Year 2026 Quality-based Reimbursement program the Commission approved the addition of an Emergency Department (ED) length of stay measure specifical for patients admitted to the hospital, weighted at 10 percent of the program. In collaboration with key hospital, payer, consumer and other stakeholders, HSCRC is convening two subgroups of the Performance Measurement Workgroup to develop data collection, measure specifications, and incentive methodology.
ED Length of Stay Data Subgroup 1:
This technical subgroup will advise on the best way to collect data on ED length of stay. Options for data collection include: 1) addition of timestamps to the HSCRC case-mix data; 2) submission of summary metrics by the hospital; 3) and use of electronic clinical quality measure infrastructure for data submission. The workgroup will need to include those who are familiar with EHR capabilities, emergency department/hospital operations for patient flow, and quality measurement. This group will also be asked to provide recommendations for auditing/validating the data. The group will convene starting in late-January and should complete the assignment within 3-4 workgroup meetings occurring every 2-4 weeks.
- February 2, 2024 (10:00AM - 11:30AM)
- March 1, 2024 (10:00AM - 11:30AM)
- April 12, 2024 (10:00AM - 11:30AM)
ED Measure and Incentive Methodology Subgroup 2:
This technical subgroup will advise on the development of ED length of stay measure, including any risk-adjustment or stratification based on hospital specific factors (i.e., occupancy, discharge disposition). The workgroup will need to include those who are familiar with quality measurement, risk-adjustment, emergency department/hospital operations, and pay-for-performance/value-based payments. The group will convene starting in March and should complete the assignment within 3-4 workgroup meetings occurring every 2-4 weeks.
Meeting Schedule and Webinar Registration:
- April 26, 2024 (10:00AM - 11:30AM) - Registration Link (Meeting ID: 410 764 2605 Passcode: 9Hm89B)
- May 17, 2024 (10:00AM - 11:30AM) - Registration Link (Meeting ID: 410 764 2605 Passcode: 9Hm89B)
The Sexual Orientation and Gender Identity (SOGI) workgroup is dedicated to addressing the critical need for comprehensive data collection regarding the health status of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals. Recognizing the significance of accurate and reliable data, coupled with robust confidentiality safeguards, the workgroup aims to bridge existing gaps in understanding public health and healthcare disparities.
The workgroup seeks to enhance hospitals' patient-level data submission requirements (DSR) by requiring three SOGI data fields beginning October 1, 2025. These efforts are pivotal in ensuring that healthcare providers have access to the necessary information to deliver quality care tailored to the diverse needs of LGBTQ+ individuals. Through this initiative, the workgroup endeavors to foster a more inclusive and responsive healthcare system, promoting equitable access to healthcare for all members of the community, regardless of sexual orientation or gender identity.
Sexual Orientation and Gender Identity Membership
To ensure this data in a culturally competent manner, the HSCRC has provided training sessions for hospital staff responsible for primary data collection. Please use the link below to access the training asynchronous training session. This session will require you to register and create an account. If you have any issues accessing the training link or questions on the training content, please email the HSCRC Quality Team:
hscrc.quality@maryland.govSOGI Data Collection Asynchronous Training Meeting Link:
Course Title: Health Services Cost Review Commission (HSCRC) Sexual Orientation and Gender Identity (SOGI) Data Collection Training for Hospitals
Meeting Schedule and Webinar Registration:
The Population Health Innovations Subgroup will advise HSCRC on the development and evolution of the following HSCRC population health programs and initiatives, offering input on overall strategy and practical considerations impacting design and implementation These programs are all enabled under other HSCRC policies and seek to focus hospital efforts on strategies that maximize the effectiveness of Maryland's investments in the care delivery system:
- Revenue for Reform - FY 2026 Revisions
- High-Value Care / Population Health Management Plans
- Innovations in Clinical Delivery Program
HSCRC is currently seeking volunteers with a broad range of expertise to participate in the subgroup as members. Interested stakeholders should email hscrc.grants@maryland.gov by July 25, 2024. HSCRC encourages non-hospital stakeholders to participate.
Please visit the Population Health Innovations Subgroup webpage for more information and tentative meetings.
HSCRC is required consult with multiple State Agencies and other stakeholders on a study on facility fees. The purpose of the study is to address and enhance transparency regarding hospital outpatient facility fees. HSCRC is convening this workgroup to provide advice to the HSCRC on the study and any related recommendations to the legislature.
Meeting Schedule and Webinar Registration:
Public Forums:
The HSCRC Data Forum is an industry wide meeting that meets quarterly to discuss hospital data-related topics. The purpose is to facilitate collaboration and information exchange regarding hospital clinical and financial data submission requirements, collection, auditing and dissemination. Meetings cover a wide range of topics, including emerging quality measures that the HSCRC is implementing, new financial data collection activities, and best practices in data quality. The outcomes of these meetings may include insights, recommendations, and best practices for improving HSCRC data. Overall, the Data Forum serves as a valuable resource for industry stakeholders to stay abreast of the latest information related to HSCRC data.
- Q4 - June 7, 2024 (10:00AM)
Please visit the Clinical Data Webpage for more information and past meeting recordings.
