An episode-based payment program for non-hospital providers designed to:
- Help the State meet the financial targets of Total Cost of Care (TCOC) Model
- Include more providers in a value-based payment framework (that is, to have responsibility and share in rewards for reducing Medicare TCOC spending)
- Encourage multi-payer alignment in a value-based payment framework
- Include more episodes than in Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI) models
- Broaden access to Medicare’s 5% Advanced APM (AAPM) MACRA opportunity
Healthcare Payment Glossary
The Healthcare Payment Glossary is intended to facilitate a better understanding of the terminology used in healthcare payment systems and to create a foundation for all stakeholders — patients, providers, employers, health plans, and government agencies — to reach consensus on how to reform healthcare payment.
Maryland Primary Care Program
An advanced payment model for adult primary care physician’s created under Maryland’s Total Cost of Care All Payer contract. Learn more by clicking here.
Medicare Access and Summary CHIP Reauthorization Act of 2015 (MACRA)
Legislation that repealed the Sustainable Growth Rate formula and replaced it with the “Quality Payment Program." This proposed rule requires physicians to participate in either the Merit-based Incentive Payment System (MIPS) or the Advanced Alternative Payment Models (APMs).