Enhancing Healthcare Quality and Cost Savings Through Maryland's Value-Based Episode Quality Improvement Program

Maryland's Episode Quality Improvement Program (EQIP) incentivizes nonhospital practitioners to improve care quality and reduce healthcare costs through an episode-based payment framework.

Results from EQIP's performance year one (January 1, 2022 to December 31, 2022) were published by the Maryland Chesapeake Regional Information System and the Maryland Health Services Cost Review Commission. Savings for every clinical episode category and type were determined by comparing an entity's 2022 spending to target prices.

Fifty entities enrolled in EQIP in 2022 and experienced a total savings of $11,763,026. Entities reported 37,758 clinical episodes and payments totaling $385,701,806, which was less than the target price of $397,464,832. Entities participated in 15 clinical episode types divided into three categories: Orthopedics (50%, 25 entities), Cardiology (40%, 20 entities), and Gastroenterology (34%, 17 entities). Orthopedics was the only clinical episode category with savings at a rate of 5.9%. Cardiology episodes had savings at a rate of -0.3%, and gastroenterology episodes had a rate of -1.8%.

Episode Quality Improvement Program yielded cost savings in Maryland. Other states could learn from this model when implementing their own value-based care models. Policies that create an enabling environment for value-based care programs like EQIP should be supported.