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Maryland Health Services Cost Review Commission announces Federal Approval of New Program for Specialist Physicians

June 23, 2021

The Maryland Health Services Cost Review Commission is announcing federal approval of the Episode Quality Improvement Program (EQIP). This new program provides incentive payments to specialist physicians who improve quality of care and reduce the cost of the care that they provide to Medicare patients.

“We are excited to announce the development and launch of the Episode Quality Improvement Program”, said Maryland Department of Health Secretary Dennis R. Schrader.

The Episode Quality Improvement Program is the first value-based payment program designed for specialty physicians under Maryland’s unique Total Cost of Care Model. HSCRC Commissioner James Elliott, M.D., said “Specialty physicians are a critical component of our healthcare system, without their participation in our Model and statewide efforts, we cannot be successful long term. This program is an important step in the right direction both for Maryland physicians and their patients.”

For 2022, the program is open to doctors who specialize in gastroenterology, orthopaedics, and cardiology. Physician participation in the program is voluntary. Gene Ransom, CEO and Executive Director of MEDCHI, said “Maryland is incredibly lucky to be able to design Medicare value-based payment programs that meet unique needs of the State’s physicians. EQIP presents an opportunity for Maryland physicians to lead their own payment program while engaging with our broader efforts statewide to improve the cost and quality of healthcare”. The State plans to add specialities to the Episode Quality Improvement Program in future years. While this program is limited to Medicare patients, the State is encouraging health insurers to implement similar programs to bring the benefits of this program to a broader group of physicians and patients.

The program pays incentives based on physician performance on treatment of 15 specific medical conditions, procedures, or other health care events. Examples include hip replacements, knee replacements, spinal fusion, gallbladder surgery, colonoscopies, pacemaker/defibrillator procedures, and heart attacks. This list will grow in future years.

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