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:

Balanced Updates
Guardrails for Model Performance
Market Share
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: hscrc.payment@maryland.gov

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	Review Workgroup charge and draft work plan Discussion of New Model and Global Budget Methodology (HSCRC staff presentation and discussion) Discussion of Factors to be Considered in Updates (HSCRC staff presentation and discussion) Discussion of Factors to be considered in short term adjustments (HSCRC staff presentation and discussion)	Agenda 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	Discuss Performance Measurement Work Group Recommendations and Payment Approaches (staff presentation and discussion) Discussion on Balanced Update Discussion of components, approach and principles for update factor and short term adjustments	Agenda 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. HSCRC	Synthesis of Additional Papers on Balanced Update Discussion of components, approach and principles for update factor and short term adjustments Presentation of Initial Uncompensated Care Analysis (HSCRC staff or contractor presentation and discussion)	Agenda Workplan 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 HSCRC	Finalize recommendation on components, approach and principles for update factor and short term adjustments Discussion of balanced update and short term adjustments recommendations	Agenda 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 HSCRC	Finalize Uncompensated Care Policy Discussion of balanced update and short term adjustments recommendations	Agenda 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 HSCRC	Finalize balanced update and short term adjustments recommendations (May 7 Draft recommendation to Commission) Report from Performance Measurement Workgroup on Efficiency	Agenda 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 HSCRC	Discussion of guardrails for model Report from Physician Alignment Work Group on Shared Savings/Gain sharing Discussion of Market Share Papers 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: CareFirst Health Care for All Webinar Recording

June Deliverable

Report on balanced update and short term adjustments recommendations

June 2 2:00 – 5:00 HSCRC	Presentation on major capital projects from MHCC Comments on contract recommendations Update from Physician Alignment Workgroup on shared savings/gain sharing Initial discussion of future role and work plan for workgroup 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 Cancelled	Discussion of Tranfers Analysis and Policy Finalize Recommendation on Future Role and Work Plan for Workgroup
July 30 Cancelled	To be updated Discussion of Tranfers Adjustment Methodology Global Budget Revenue/Volume Corridors
August 6 1:00-4:00 HSCRC 4160 Patterson Ave. Baltimore, MD 21215 410-764-2605	Review Transfers Sub-Workgroup Report Review GBR Revenue Corridor Sub-Workgroup Report Review Modifications to the GBR Agreement template Review Phase 2 work plan	Complete Presentation Packet Agenda Transfer Cases Description Addendum to Section 5 of Global Budget Agreements -Hospital System Addendum to Section 5 of Global Budget Agreements -Single Hospital Addendum to Compliance of TPR Agreements Payment Models Workgroup Phase 2 Draft Workplan Draft Charge Corridors within TPR and GBR Agreements Webinar Recording

August Deliverable

Finalize Methodology on Transfers

October 1 1:00 – 4:00 HSCRC	Finalize Transfer Approach Finalize GBR Revenue Corridor Approach Review Total Cost of Care Template Review Guiding Principles for Market Share Policy Review Data Analytics for Market Share	Complete Presentation Packet Agenda Total Cost of Care Update Slides Draft: Charge Corridors within TPR and GBR Agreements Transfer Cases Description Transfer GBR Adjustment Slides Market Share Adjustment Principles Webinar Recording
October 29 9:00 – 12:00 a.m. Webinar Only No In-person Meeting	Presentation from Ken Thorpe on Market Share Review Market Share Sub-Workgroup Calculations Finalize Total Cost of Care Template Review GBR Infrastructure and Investment Sub-Workgroup Report Review and Finalize Medicaid Savings Sub-Workgroup Report	Agenda Phase II Draft Work Plan Market Share Adjustment Principles Market Share Examples Presentation State Wide Product Line Summary GBR Infrastructure Investment Report Presentation Global Budget Revenue Reporting Draft Report Webinar Recording
December 15 9:00 – 12:00 a.m.	Review of Market Share Subgroup Calculations Aggregate Revenue At Risk in Maryland Value-Based Programs Update on Uncompensated Care Update on Medicaid Savings Calculations	Agenda Draft Aggregate At Risk for Quality Recommendation Payment Scales Market Share Adjustment Principles Potential Considerations for Off-Cycle Adjustments Midyear Update Request 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 hscrc.payment@maryland.gov. Below are the comments received by the Workgroup to date.

​​Modernization