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Maryland's All-Payer Hospital System Modernization

Call for White Papers

The HSCRC is requesting assistance from interested parties in the form of technical papers on several different topics. The purpose of the papers is to provide data analyses, policy analyses and background information to inform implementation decisions. The call for papers is for interested stakeholders, members of the research community and the general public who want to voluntarily contribute to the implementation planning. Parties may respond to one or more of the topics described in the linked document below.

Call for Papers: HSCRC Implementation of Population-Based and Patient-Centered Payment Systems - Revised 11-08-13

Papers Received To Date

The HSCRC identified eleven topics for technical papers and set an initial deadline for four paper topics of January 10, 2014. The HSCRC has begun receiving papers on these and other topics. Links to the papers received are provided in the table below.

Author White Papers
Kaiser Permanente and Holy Cross Hospital Consumer Preference Driven Market Share Measurement - November 6, 2014
CareFirst Market Share Adjustments
CareFirst Volume Allowances
CareFirst Potentially Avoidable Volumes
CareFirst Annual Update Allowance
CareFirst Total Cost of Care
John Hopkins Health System Gain Sharing and Other Physician Alignment Programs
John Hopkins Health System Potentially Avoidable Volumes
John Hopkins Health System Methods for Monitoring Total Cost of Care
Maryland Hospital Association Gain Sharing Document
Maryland Hospital Association Volume and Potentially Avoidable Utilization
Maryland Hospital Association Total Cost of Care
KPMG Methods for Monitoring Total Cost of Care Maryland's All-Payer Model
Applied Medical Software Gain Sharing: Aligning Provider Incentives
MedChi Gain Sharing and Other Physician Alignment Programs
Segal et al., John Hopkins School of Public Health Potentially Avoidable Utilization
Maryland Hospital Association Quality Based Reimbursement - March, 2014
Health Care for All Market Share Adjustment - May, 2014
Health Care for All Hospital Collaboration to Avoid PAU - June, 2014

Market Share Sub-Workgroup Meeting Cancelled 10-07-14

Market Share Data Sets

The HSCRC is providing access of special Statewide Research-level Inpatient and Outpatient data files to interested parties seeking to perform market share analyses to contribute to the policy determinations of the payment work group. In particular, FY2013 and FY2014 inpatient and outpatient data files are provided and contain the following enhancements:

  • Streamlined Inpatient and Outpatient data grouped by the latest grouper versions:
  • Inpatient: 3M APR-DRG, version 31
  • Outpatient: 3M EAPGs, version 3.8

  • Inpatient data file includes data elements from the 3M (APR_DRG) grouper, 3M product lines structure modified to segment specific categories (transplants, ventilator support, vascular surgery, and normal newborns), AHRQ PQI indicators, Re-admissions indicators, Maryland-specific CMI weights, and outpatient observation cases with stays greater than 24 hours.

  • Outpatient data files includes data elements from the 3M (EAPG) grouper, 3M service line structure modified to segment major/minor surgeries, pathology, etc., ECMAD weights, rate-center classifications to identify ED with/without observation, and clinic resources.

  • Data files are available in flat (.txt) and SAS (.sas7bdat) file formats.

  • Both Inpatient and Outpatient datasets include patient master ids to model patient-based measures of market share.

Connect to the links below for more information regarding the specific variables included in the data files:

  • IP Non-Confidential Market Share Data Dictionary -*link to be provided soon
  • OP Non-Confidential Market Share Data Dictionary -*link to be provided soon

To gain access to the data files, please complete the following two documents using the links:

Please submit both completed forms, and a copy of the white paper letter of intent to

All requests are reviewed by the HSCRC Review Board, which makes the final decisions on the release of the Market Share datasets. The review process may take up to 1 week from submission of the complete letter of request and supporting materials to the Commission for consideration.

Prior Target Dates and Submission Information for Papers

The HSCRC has established target dates for submission of papers to correspond to the tentative schedule of the workgroups. The dates are presented below. The HSCRC will continue to receive papers on all the topics. Interested parties may share papers at any time.

Due Date White Paper Topics to be Submitted
TBD Attribution
May 9 Variable Cost Factor
March 10 Efficiency and Value Measurement
March 3 Payment Incentives for Quality-Based Reimbursement
March 24 Predictive Models for Uncompensated Care
TBD Payment Models for Population Based Approaches
April 30 Financing Major Capital Projects
March 3 Balanced Update

This paper should offer recommendations on setting the overall Rate Update Target in a manner that assures successful performance within the All-Payer requirements in the Maryland / CMMI Agreement. The paper should consider the recommendations for both Global Budget, TPR, as well as CPC hospitals, including the interplay between the models in order to meet the inflation requirements of the new model.