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Spreading Innovations in Health Care Delivery

This website, endorsed by Maryland’s Stakeholder Innovation Group, offers a glimpse at how many of Maryland’s health care providers and community organizations are working together to improve care delivery.

We urge you to use this site to share innovative programs and practices that improve the health of Maryland’s communities.

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Explore our Survey Criteria Submit New Payment Model

Payment Model Form

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The purpose of this form is to collect structured information on stakeholders’ innovative ideas for new payment models to transform and improve the quality of health care delivered in Maryland and meet Total Cost of Care (TCOC) Model savings requirements. New payment models are innovative ideas, outside of traditional provider payment structures, that require approval from the Centers for Medicare & Medicaid Services (CMS) and/or the state of Maryland.

The Stakeholder Innovation Group (SIG) is a provider-led, stakeholder forum to identify innovative ideas and care transformation ideas to advance the goals of the TCOC Model and population health efforts in the state. The SIG discusses and enhances ideas before the state recommends the idea to the Secretary of Health and the Secretary’s Vision Group (SVG) for approval.

Any health care provider or stakeholder in Maryland may submit a new payment model idea through this intake form. You are strongly encouraged to seek technical assistance from the Health Services Cost Review Commission staff prior to form submission at Completed forms will be discussed in SIG meetings.

Submitter Information

Payment Model Overview

What is the objective of this payment model? (Check all that apply)

Target Population

Duration of Performance Period

This duration should match with your methodology for calculating savings and correspond with your timeframe for monitoring of any quality or process measures. The performance period begins when the infrastructure is in place and intervention(s) is active with patients

Quality Impact

Select and describe all measures that apply: Process, Patient outcome, Patient experience or satisfaction.
For each measure, describe its current performance and annual targeted improvement.


Patient Outcome

Patient Experience or Satisfaction

Downside Risk Requirement for TCOC Accountability

Downside financial risk means that if the risk-bearing entity exceeds budgeted costs or incurs losses, then it must refund payers a portion of the difference in costs. To ensure financial accountability under the TCOC Model and promote performance, specify the entity that will bear downside financial risk for the program

Financial Methodology

Anticipated Resource Requirements

Funding Requirements

Describe your primary source of funding for idea development, implementation, and operations

Do you have a secondary source of funding for idea development, implementation, and operations

Advanced Alternative Payment Model (APM) Applicability
Can this idea be developed as an addition to the Care Redesign Program(CRP) or the upcoming Episode Quality Improvement Program (EQIP)?

Select the following criteria that you think would apply to your idea

Legal or Regulatory Barriers

Payer Alignment
Does your payment model idea intend for participation by more than one payer?

Additional Information

If your organization will work with a Partner to furnish services to the Target Population, complete this section for each Partner, if there are multiple. If no Partners, skip this section.

Partner Type (Please select one and describe their responsibility)

Accountability Mechanism (Select all that apply)

Incentive Payment to Partners
Select One:

Types and Source (Select all the apply)

How will you determine the amount of incentive payment that may be distributed to your Partner? (Select one)

Cash Flow Mechanism

Maryland Adoption of Idea

Answer these questions if your idea exists outside the state of Maryland

Upload attachments, e.g. journal articles, evaluation studies, etc.

This field is required

Maximum file size: 10 MB of documents (pdf, doc, docx, ppt, ppsx, xls, xlsx); and images (jpg, jpeg, png, gif, bmp).

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