Maryland: The first state CMS will hold fully at risk for total healthcare costs

Morgan Haefner - Print  | 

CMS' Innovation Center revealed June 8 that Maryland will become the first state fully at risk for the total cost of healthcare for Medicare beneficiaries.

Here are five things to know about the Maryland Total Cost of Care Model:

1. The model sets a per capita limit on the total cost of care Medicare beneficiaries receive in Maryland. It is founded on Maryland's current all-payer model, launched in 2014, which limits the state's per capita hospital expenses.

2, The performance period of the TCOC Model begins Jan. 1, 2019, and runs through Dec. 31, 2026.

3. The Maryland TCOC Model aims to save $1 billion-plus on Medicare beneficiaries' care by the end of 2023, the model's fifth performance year.

4. Three programs will operate under the TCOC Model:

5. Maryland will choose its own measures and targets it wants to hit across six population health areas. The measures require CMS approval.

Find more information on the Maryland TCOC Model here.

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