Download individual appendices

• Appendix A: Eligible providers and provider delivery locations for AE
• Appendix B: TMaH VBP Frequently Asked Questions
• Appendix C: TMaH Required Milestones and Activities
• Appendix D: Provider Infrastructure Payments (PIP)
• Appendix E: CMS Standard and TMaH Program Terms and conditions
• Appendix F: Sample Minnesota Department of Human Services Grant Contract Template
• Appendix G: CMS VBP Webinar Slides
• Appendix H: TMaH VBP Glossary Terms
• Appendix I: Sample Data Sharing and Business Associate Agreement terms and conditions

Download individual attachments

• Attachment A: Signed Attestation for TMaH Participation
• Attachment B: Letters of Agreement (LOA) for all participating organizations in AE
• Attachment C: Documentation to Establish Financial Stability – Grants

What will selected applicants receive?

• Technical assistance and training (throughout contract)
• Provider Infrastructure Payments to prepare for value-based payment transformation (Model Year 3, 2027)

With options for contract renewal for:

• Provider Infrastructure Payments (Model Year 4, 2028)
• Upside-only performance incentives (Model Year 4 starting no later than March 2028)
• Value-based payment transformation (Model Year 5 starting in 2029)

This value-based payment model will change the way organizations are paid for certain perinatal MA patients. Final payment specifications are forthcoming from CMS.

Who is eligible to participate?

• Eligible Partner Delivery Locations may include but are not limited to hospitals, Birth Centers, obstetrician-gynecology practices, mental and behavioral health practices, FQHCs/clinics, Tribal sites, and other points of maternal care.
• Eligible Partner Providers may include but are not limited to obstetrician-gynecologists, all types of midwives, physicians, fetal medicine specialists, nurses, mental and behavioral health practitioners, and other clinical and support staff, such as doulas, home visiting staff, lactation consultants, and Community Health Workers.
• Locations and Providers must provide maternal care and services to Medical Assistance (MA) beneficiaries in Hennepin County, where the model is piloting.

At the time of application, providers at applying organizations must meet one of the following conditions:

• enrolled as a Minnesota Medicaid provider,
• contracted with a Minnesota managed care plan, or
• employed with an organization supporting Medicaid beneficiaries.

Providers must be licensed and/or credentialed and in good standing with applicable state and federal oversight bodies and must have or obtain a National Provider Identifier through the National Plan and Provider Enumeration System to bill for services.

What is a TMaH Accountable Entity?

A TMaH Accountable Entity (AE) is the practice(s) accountable for care in the TMaH model. These are clinics or practices providing maternal health services, including OB-GYN practices, FQHCs, and birth centers.

The AE must provide the full range of perinatal care (prenatal, delivery, and postpartum care), which can be provided among different organizations within the AE. Partners come together as an “Accountable Entity” (AE) to apply.

Inclusion of safety net providers and community organizations is strongly encouraged.

Hospitals may serve as participants in the AE but are restricted from serving as the primary AE organization unless they provide the full range of perinatal care (prenatal, labor/delivery, and postpartum care) AND contractual assurances that at least 80% of the AE’s portion of the shared savings payment will be given to the individuals who provided a majority of the prenatal and postpartum care.

Who cannot be an AE?

• Individual clinicians without organizational infrastructure
• Hospitals that do not provide prenatal or postpartum services cannot be an AE on their own but can join with others
• Practices/FQHCs where providers do not perform labor/delivery cannot be an AE on their own but can join with others
• AEs below minimum delivery volume requirement of 30-50 births/year*

*CMS has proposed 30-50 births as the minimum delivery number for AE eligibility. This number is subject to change based on CMS guidance.