​​​​​​​​​​​​​​​​​​​​​​​​​​​​

Modernization

​​​​​​​​​
​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

​​Maryland's Care Redesign Program

In response to Maryland stakeholders' requests, care redesign provides tools for greater provider alignment and transformation.  Care redesign aims to support:
  • 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 
  • The next steps toward delivery system transformation

Important Updates Related to the Care Redesign Program

Complex and Chronic Care Improvement Program (CCIP) Ending after 2019
Due to dwindling hospital participation in the CCIP track and the implementation of the Maryland Primary Care Program (MDPCP), the HSCRC has decided to end the CCIP track at the end of 2019.  We appreciate the efforts of hospitals and care partners who participated in this track and are certain their efforts have set them up for continued success under the TCOC Model. The State’s investments into infrastructure for CCIP extend far beyond this particular program track and will continue to be leveraged through CRISP data tools, such as PAVE.

Episode Care Improvement Program (ECIP) - Mid-Year Participation
The HSCRC and CMMI have decided to open up ECIP to existing CRP participants.  Hospitals that already have Participation Agreements with the State and CMS may choose to begin participating in ECIP starting July 1, 2019.  Email care.redesign@crisphealth.org for more information.


Key Care Redesign Documents and Information
Care Redesign Calendar​ (PP4) - updated 12/18/18

Contact care.redesign@crisphealth.org for questions on care redesign.

The voluntary, hospital-led tracks align hospitals and their care partners through common goals and incentives.​  As of January 1, 2019, 42 hospitals are participating in at least one of three active care redesign programs, the Hospital Care Improvement Program (HCIP), the Complex and Chronic Care Improvement Program (CCIP), and the Episode Care Improvement Program (ECIP).
 
Hospital Care Improvement Plan (HCIP)​​
Episode Care Improvement 
Program (ECIP)
​Anne Arundel Medical Center​​
Atlantic General Hospital
CalvertHealth Medical Center 
Carroll Hospital
Charles Regional Medical Center
Doctors Community Hospital
Frederick Memorial Hospital
Greater Baltimore Medical Center
Howard County General Hospital
Johns Hopkins Hospital
Johns Hopkins Bayview Medical Center
Holy Cross Hospital
Holy Cross Hospital - Germantown
Medstar Franklin Square Medical Center
Medstar Good Samaritan Hospital
Medstar Harbor Hospital
Medstar Montgomery Medical Center
Medstar Southern Maryland Hospital Center
Medstar St. Mary's Hospital
Medstar Union Memorial Hospital
Mercy Medical Center
Meritus Medical Center
Northwest Hospital
Peninsula Regional Medical Center
Shady Grove ​Medical Center
Sinai Hospital
Suburban Hospital
University of Maryland Medical Center
University of Maryland - Midtown Campus
UM Baltimore Washington Medical Center
UM Prince George's Hospital Center
UM - Rehabilitation & Orthopaedic Institute
UM Shore Medical Center - Chestertown
UM Shore Medical Center - Easton 
UM Shore Medical Center - Dorchester
UM Upper Chesapeake Medical Center
UM St. Joseph Medical Center
Harford Memorial Hospital
​Washington Adventist Hospital
Western Maryland Health System​ ​
​Anne Arundel Medical Center
Carroll Hospital
Greater Baltimore Medical Center
Holy Cross Hospital
Northwest Hospital
Sinai Hospital
Mercy Medical Center
St. Agnes Hospital
UM Shore Medical Center - Easton


Complex and Chronic Care 
Improvement Program
​ ​​   Garrett Regional Medical Center
St. Agnes Hospital
 ​
 
Hospital Care Improvement Program (HCIP)

The HCIP will be implemented by Participant Hospitals and hospital-based physician care partners.  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
  • Reduced potentially avoidable utilization with a byproduct of reduced cost per acute care event

Examples of categories of care redesign interventions in 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 participating hospitals and community physicians and other 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
  • Facilitate overall practice transformation towards person-centered care that produced improved outcomes and meets or exceed quality standards.

Examples of categories of care redesign interventions in CCIP include: care management, workforce capacity development, and health information technologies. In CCIP, participating hospitals deploy care management resources and technology that align and support community care partners. 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.

For 2019, care partners may not concurrently participate in CCIP and the Maryland Primary Care Program (MDPCP).

Episode Care Improvement Program (ECIP)

The Episode Care Improvement Program (ECIP) is designed to allow a hospital to link payments across providers during an episode of care. Maryland modeled ECIP on CMS’s Bundled Payments for Care Improvement Program Advanced. 

Episode payment models bundle payments to health care providers for certain items and services furnished during an episode of care. ECIP’s bundled payment approach aligns incentives across hospitals, physicians, and post-acute care facilities to generate savings and improve quality through better care management during episodes, eliminating unnecessary care, and reducing post-discharge emergency department visits and hospital readmissions. ECIP provides hospitals with the opportunity to provide incentive payments to care partners that help achieve these goals.  

ECIP intervention categories include clinical care and care redesign; beneficiary and caregiver engagement; and care coordination and care transitions.