Health care reform is full of pilots that sound promising. Far fewer can point to a straightforward result: saving taxpayers money, year after year, while giving physicians a meaningful role in improving care.

Maryland’s Episode Quality Improvement Program, or EQIP, is one of those programs.

The numbers are increasingly difficult to ignore. EQIP generated $20.2 million in Medicare savings in 2022. In 2023, savings increased to $36.7 million, an 81.6 percent increase. In 2024, EQIP generated $62.6 million in gross savings, another 70.6 percent increase. Of the 117 EQIP entities participating that year, 67 earned shared savings, resulting in $29.1 million being distributed to participating practitioners.

That means EQIP has saved Medicare money in every performance year for which results are available, while helping Maryland meet the Medicare savings requirements of its Total Cost of Care Model.

What is the trick?

I believe it is the partnership behind the program.

The Maryland Health Services Cost Review Commission created EQIP in 2022, but it was developed in conjunction with MedChi, The Maryland State Medical Society; CRISP, Maryland’s state-designated Health Information Exchange; the Maryland Hospital Association; and physicians and other practitioners across the state. CRISP administers the program under HSCRC’s guidance.

Over time, a particularly important three-part partnership has emerged among HSCRC, CRISP and MedChi.

HSCRC provides the policy framework and sets the rules. CRISP provides the data, analytics, and infrastructure.

MedChi provides physician engagement, education, outreach, and the trusted connection to practices. HSCRC itself has described this collaborative structure as central to EQIP’s success.

That last part should not be underestimated. You cannot simply create a value-based payment model in Washington, publish a rule and expect physicians to participate. Someone has to explain it, answer questions, help practices navigate enrollment and work with physicians to make the model function in the real world.

That is where organized medicine can make a tremendous difference.

It is also why I believe the Center for Medicare and Medicaid Innovation should look seriously at expanding the EQIP concept beyond Maryland.

CMMI does not need to copy every technical detail of Maryland’s program. Every state is different. Instead, it should replicate the architecture: a public agency setting smart incentives, a strong health information exchange providing usable data, and a state medical society serving as the trusted physician partner.

Maryland has already run the experiment.

The savings are real. Participation is growing. Physicians are benefiting.

Now CMMI should take the lesson from Maryland and see whether EQIP can work across the country.

Gene Ransom

CEO MedChi, the Maryland State Medical Society