Maryland's Care Redesign Programs under the All-Payer Model Amendment

Program Information and Webinar Series

Maryland’s Care Redesign Amendment to the All-Payer Model

In response to Maryland stakeholders’ requests for greater provider alignment and transformation tools under the All-Payer Model, the State proposed a Care Redesign Amendment (“Amendment”) to the All-Payer Model Agreement. The Amendment aims to modify the All-Payer Model by supporting:

Effective care management and population health activities;
Improvement in care for high and rising risk populations;
Efforts to provide high quality, efficient, well-coordinated episodes of care;
Hospitals and their Care Partners in monitoring and controlling Medicare beneficiaries’ Total Cost of Care (TCOC) growth; and
The next steps toward delivery system transformation.

The Amendment gives Maryland hospitals the opportunity to implement Care Redesign Programs, through which they can access comprehensive Medicare data, share resources and offer incentives to Care Partners – including hospital-based and community-based providers. CMS approved the proposed Care Redesign Programs under the Care Redesign Amendment in September 2016.

Care Redesign Programs

The Amendment proposes two voluntary, hospital-led programs, which align hospitals and their Care Partners through common goals and incentives: The Hospital Care Improvement Program (HCIP) and Complex and Chronic Care Improvement Program (CCIP).

Hospital Care Improvement Program (HCIP)

The HCIP will be implemented by Participant Hospitals and hospital-based providers. The HCIP aims to:

Improve inpatient medical and surgical care delivery;
Provide effective transitions of care;
Ensure an effective delivery of care during acute care events, beyond hospital walls;
Encourage the effective management of inpatient resources; and
Reduce potentially avoidable utilization with a byproduct of reduced cost per acute care event.

Examples of categories of Care Redesign Interventions in the HCIP include: care coordination, discharge planning, clinical care, patient safety, patient and caregiver experience, population health, and efficiency and cost reduction. Care Partners who choose to participate may receive incentive payments based on reducing internal costs through a reduction in unnecessary utilization and resources, efficient practice patterns, and improved quality.

Complex and Chronic Care Improvement Program (CCIP)

The CCIP will be implemented by Participant Hospitals and community providers and practitioners. The CCIP aims to:

Strengthen primary care supports for complex and chronic patients in order to reduce avoidable hospital utilization
Enhance care management through tools such as effective risk stratification, health risk assessments, and patient-driven care profiles and plans; and
Facilitate overall practice transformation towards person-centered care that produces improved outcomes and meets or exceeds quality standards.

Examples of categories of Care Redesign Interventions in the CCIP include: care management, workforce capacity development, and health information technologies. In the CCIP, Participant Hospitals deploy care management resources and technology that align and support community-providers who work with the Participant Hospital. Care Partners who choose to participate will have access to care management tools and resources targeted to high utilizer and rising risk patients that will support implementation of care plans, provide care coordination, and help manage care transitions. Participation in the CCIP is also tailored to leverage the Medicare Chronic Care Management (CCM) fee. Care Partners who choose to participate may receive incentive payments from hospitals based on defined activities that improve quality of care and reduce potentially avoidable utilization of hospitals.

Both Programs (HCIP & CCIP)

Care Partners: To the extent possible, the Care Redesign Programs will be tailored to support the Medicare Access and CHIP Reauthorization Act (MACRA) requirements, which CMS plans to finalize in November 2016.

Hospitals who choose to participate in HCIP and/or CCIP will: have access to patient identified Medicare claims data; achieve closer alignment with their Care Partners, focus on common goals; enhance their person-centered focus of care; increase quality scores and improve outcomes; and generate greater savings and reductions of potentially avoidable utilization under global budgets.

Webinar Series

The Webinar Series on the All-Payer Model Amendment's Care Redesign Programs, as outlined below, will provide hospitals and stakeholders with critical information on the Care Redesign Programs. A total of seven webinars have been scheduled from October 2016 through January 2017, which will be co-hosted by the Center for Medicare and Medicaid Innovation (CMMI), the Maryland Hospital Association (MHA), and the Chesapeake Regional Information System for our Patients (CRISP) to help prepare hospitals to implement one or both of the proposed Care Redesign Programs under the All-Payer Model Amendment.

During each webinar, participants will have the opportunity to ask questions of the State, CMMI, MHA, and CRISP. We strongly encourage hospital participation in the webinars as information discussed will be critical for successful implementation of the Care Redesign Programs. For those who cannot attend, webinar recordings will be posted below.

Webinar Schedule:

2016 Webinar Dates (Online Only, EST)	Webinar Communication Calendar for Implementation of Care Redesign Programs	Webinar Information
October 21 1:00 - 2:00pm Friday	Webinar 1: Amendment Overview and Implementation Timeline of Care Redesign Programs	Webinar 1 Slides Webinar 1 Recording
October 25 9:00-10:00am Tuesday	Webinar 2: Care Partner Approval Process	Webinar 2 Slides Webinar 2 Recording- Audio starts at 18:15 minute mark
November 2 9:00-10:00am Wednesday	Webinar 3: Complex and Chronic Care Improvement Program	Webinar 3 Slides Webinar 3 Recording
November 18 9:00-10:00am Friday	Webinar 4: Hospital Care Improvement Program	Webinar 4 Slides Webinar 4 Recording
November 30 9:00-10:00am Wednesday	Webinar 5: Comprehensive Medicare Data Process and Use	Webinar 5 Registration
December 7 9:00-10:00am Wednesday	Webinar 6: Care Redesign Program Monitoring	Webinar 6 Registration
2017 Webinar Dates (Online Only, EST)	Webinar Communication Calendar for Implementation of Care Redesign Programs	Webinar Information
January 13 9:00-10:00am Friday	Webinar 7: Care Partner Agreements	Webinar 7 Registration

Required Documents

Hospital Letter of Intent (LOI) for Participation in Care Redesign Programs – Due to HSCRC by November 18, 2016 - Updated Oct. 18

The template for the Hospital Letter of Intent, listed above, is a non-binding agreement hospitals are required to complete and submit to HSCRC to indicate interest in participating in one or both of the care redesign programs. Submission Instructions and Requirements

Interested parties should submit the attached Letter of Intent (LOI) via email by November 18, 2016

Letters should be submitted to hscrc.care-redesign@maryland.gov and include in the subject line “LOI.” All letters should be submitted in either Microsoft Word or .pdf format.

Questions related to the Care Redesign Programs or specific to the LOI should be directed to hscrc.care-redesign@maryland.gov.