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Quality

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Quality Based Reimbursement (QBR)

The purpose of the Quality Based Reimbursement (QBR) Program is to incentivize quality improvement across three patient-centered quality measurement domains:
  1. ​Person and Community Engagement 
  2. Clinical Care 
  3. Patient Safety
The program works by putting two percent (2%) of inpatient hospital revenue at risk (maximum penalty/reward). It uses measures similar to the federal Medicare Value-Based Purchasing (VBP) program but has an all-payer focus and can adjust domain weights to focus on MD-specific improvements.
The HSCRC established the following guiding principles for the QBR through stakeholder input from the Performance Measurement Work Group:​
  • ​The measurements used for performance linked with payment must include all patients, regardless of payer.
  • The measurements must be fair to hospitals.
  • The measurements used should be generally consistent with the CMS VBP measures to support Maryland's annual waiver from the VBP.
  • The approach must include the ability to track progress.​


​Key QBR Policy Documents

Rate Year 2026


​Communications and Memos ​ ​
Document TitleDate
​Final Policy
RY26 Final QBR Recommendation
Dec 13, 2023


Rate Year 2025

​Communications and Memos ​ ​
Document TitleDate
​Final PolicyRY25 Final QBR Recommendation
Nov 9, 2022
Memo​sRY25 QBR Memo
May 3, 2023

Rate Year 2024
​Communications and Memos ​ ​
Document TitleDate
​Final PolicyRY24 Final QBR Recommendation 
Nov 10, 2021
Memo​sRY24 QBR Memo
RY24 TFU Memo
Feb 25, 2022
Oct 10, 2022

​Rate Year 2023

​Communications and Memos ​ ​
Document Title Date
​Final Policy RY23 Final QBR Policy Recommendation
Feb 22, 2021
Memo​s RY23 QBR Memo
Feb 22, 2021
Data Workbooks​​ ​ ​
​Calculation Sheet

Base Period Workbook​

Rate Year 2022

​Communications and Memos ​ ​
Document Title Date
​Final Policy RY 2022 QBR Final Approved QBR Policy
Dec 17, 2019
Memo​s RY 2022 QBR Memo (Updated)

Feb 28, 2020
Data Workbooks​​ ​ ​
​Calculation Sheet RY 2022 QBR Calculation Sheet 
Mar 11, 2020
Base Period Workbook​ RY 2022 QBR Base Period Workbook  ​May 14, 2020
​​Revenue Adjustment RY 2022 QBR Scaling​ ​Jun 30, 2021

Rate Year 2021

​Communications and Memos ​ ​
Document Title Date
​Final Policy RY 2021 Final Approved QBR Policy
Jan 4, 2019
Memo​s RY 2021 QBR Memo (UPDATED)

Mar 05, 2019
Sep 09, 2019
Data Workbooks​​ ​ ​
​Calculation Sheet RY 2021 QBR Calculation Sheet  (UPDATED)
​Mar 11, 2020
​Revenue Adjustments RY 2021 QBR Scaling - Prelim ​June 12, 2020

Rate Year 2020

​Communications and Memos ​ ​
Document Title Date
​Final Policy RY 2020 Final Approved QBR Policy
Dec 13. 2017
Memo​s RY 2020 QBR Memo (UPDATED)
RY 2020 QBR Revenue Adjustments
​Mar 01, 2018
Sep 09, 2019
Data Workbooks​​ ​ ​
​Calculation Sheet RY 2020 QBR Calculation Sheet (UPDATED)
​Apr 11, 2018
​Performance Period Data*
​Revenue Adjustments RY 2020 Final QBR Scaling
​Sep 09, 2019
* Designated hospital employees can access mid-year data through the CRISP Reporting Services (CRS) Portal. For non-hospital interested parties, this data is available upon request, please contact HSCRC Quality at hscrc.quality@maryland.gov.

Rate Year 2019

​Communications and Memos ​ ​
Document Title Date
​Final Policy FINAL Recommendation - QBR - RY 2018 and 201.pdf​ ​Feb 08, 2017
Memo​s RY 2019 QBR Memo Updated 06-02-2017.pdf
RY 2019 QBR Results and Revenue Adjustments.pdf
RY 2019 QBR Memo.pdf
​Jun 02, 2017
Sep 26, 2018
May 22, 2017
Data Workbooks​​ ​ ​
​Performance Period Data*
​Calculation Sheet RY2019 QBR Calculation Sheet (UPDATED)
​Sep 27, 2017
 
* Designated hospital employees can access mid-year data through the CRISP Reporting Services (CRS) Portal. For non-hospital interested parties, this data is available upon request, please contact HSCRC Quality at hscrc.quality@maryland.gov.


​Rate Year 2018

​Communications and Memos ​ ​
Document Title Date
​Final Policy FINAL Recommendation - QBR - RY 2018 and 2019.pdf

RY 2018 Original Final Recommendation QBR.pdf
​Feb 08,2017

Oct 14, 2015
Memo​s RY 2018 QBR Program Results and Revenue Adjustments

2017-06-01 REVISED RY 2018 QBR Memo.pdf

2017-03-27 QBR Memo RY 2018 Revisions.pdf

2016-02-19-QBR-MMO-to-Industry-FY-2018-Final.pdf
Dec 08, 2017

​Jun 01, 2017

Mar 31, 2017

Feb 19, 2016
Data Workbooks​​ ​ ​
​Performance Period Data RY 2018 Safety Data.xlsx ​Jun 01, 2017
​Rate Year Scales
​Calculation Sheet RY 2018 QBR Calculation Sheet (UPDATED) ​Aug 04, 2017

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QBR Workgroup Information

For information regarding the QBR development workgroups, please visit the Archived Quality Initiatives​ page.





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