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Quality Improvement | Complications (MHAC)

Process Measures: Quality Based Reimbursement (QBR)

Overview

HSCRC has implemented payment adjustments to hospital rates for the Quality-Based Reimbursement Initiative for hospitals in July 2009 based on hospital performance on the identified measures for calendar year 2008. In the QBR Initiative, hospital reimbursement rates will vary depending on each hospital's achievement on specified quality-of-care measures. For the initial year, nineteen Hospital Quality Alliance (HQA) process measures for heart attack, heart failure, pneumonia, and surgical infection prevention were used in the Initiative. Going forward, additional process measures will be added consistent with the measures added the Maryland Hospital Performance Evaluation Guide maintained by the Maryland Health Care Commission.

Key development elements and features of the QBR Model Include:

  • A multi-stakeholder Initiation Work Group that convened from 2004 to 2008 and made recommendations on appropriate set of quality measures, and a composite scoring system.
  • Evaluation Work Group is established to make recommendations to the Commission on changes and additions to the QBR in June 2008.
  • QBR Work Group convened to compare and align QBR program with Centers for Medicare & Medicaid Services’ (CMS) Value Based Purchasing (VBP) program in 2011.
  • Funding for rewards for hospitals performing the best, and penalties for poor performers; the maximum amount of penalties/rewards is 0.5% of the total revenue of the hospital, translating to a total amount at risk of $7.1 million for FY2012.
  • A data collection policy that stresses accomplishing the goals of the Initiative but, when practicable, limits the additional collection and reporting burden on hospitals.
  • A composite system of scoring performance on quality measures, which is expanded to appropriateness of care measure in FY2011 and patients experience of care measures in FY2012.

For full details of the QBR Initiative, click on the links below for the Final Approved QBR Staff Recommendations for 2008 and 2009.

Policy Papers and Presentations

Quality Reports and Analyses

Workgroup Meeting Information


Please click here to email questions or inquiries about HSCRC’s Quality Improvement Initiatives or contact Dianne Feeney by telephone at 410-764-2605.
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