Maryland Department of Health
Maryland Primary Care Program

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Maryland's AHEAD Primary Care Programs

Note: As expected, the Total Cos​t Of Care Model will end at the end of 2025. In partnership with CMMI, Maryland will transition to the AHEAD Model beginning January 1, 2026. MDPCP will continue under the AHEAD Model. There are no changes to the current MDPCP.​

On November 1, 2024, Governor Wes Moore and Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure​ signed Maryland’s state agreement to participate in th​e federal States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model​​. Additional detail on the AHEAD Model can be found on th​e HSCRC website​.​​​​​​​

Updates and Announcements

The Maryland Department of Health is excited to share the State vetting application​ to be considered for the AHEAD Medicaid Path beginning 1/1/26 is now available. To apply, please complete the State vetting application as soon as possible, but no later than 5PM Friday, July 11, 2025.​ To be eligible for Cohort 2 of the Medicaid Path, your TIN organization must have at least 250 assigned HealthChoice members, be connected to CRISP or plan to be connected to CRISP by 1/1/26, and be able to report eCQMs. Questions can be directed to mdh.pcmodel@maryland.gov.

Cohort 1: We are excited to announce that the Medicaid Path will launch August 1st, 2025!
Enhanced Evaluation and Management (E&M) fees for all primary care providers participating in the Medicaid program will go into effect on August 1, 2025. Care Management fees for provider organizations contracted to participate in the Medicaid alternative payment model (Medicaid Path or Medicaid Advanced Primary Care) should be disbursed by the end of August, and will account for the full Quarter 3 2025 payment amount (e.g., providers will receive the care management per member per month fees for the months of July through September).

*Please note that Cohort 1 refers to the eligible TIN organizations that will start participation in the Medicaid Path on 8/1/25 and Cohort 2 refers to the eligible TIN organizations that will start participation on 1/1/26

Meetings and Town Halls

Announcing The AHEAD Primary Care Advisory Council, which will advise M​DH on the ongoing development and implementation of Maryland’s AHEAD Primary Care Programs. We encourage you to join the meetings and take the opportunity to submit your questions and comments to this form. For more information on the programs, please see the Overview and FAQs below. 

Upcoming meetings:
Previous events:​

Overview of Programs
Through the AHEAD model, Maryland envisions building a sustainable advanced primary care system that provides high-quality whole person care for all Marylanders and supports strong linkages across the healthcare continuum. Leveraging the success of MDPCP established under the Total Cost of Care Model, AHEAD aims to improve health outcomes for all people in Maryland, while simplifying the administrative burden for providers through all-payer alignment.

Maryland's AHEAD Primary Care Programs includes three main pathways: an infrastructure path, a Medicare path, and a Medicaid path. The Infrastructure path is for a small group of select ​practices that are building new or expanding advanced primary care in underserved areas of the state. The Medicare path includes two options, one for current MDPCP practices (Medicare Path 2/MDPCP) and an entry level option for practices that are not currently participating in MDPCP (Medicare Path 1/PC AHEAD). The Medicaid path is new and will preliminarily only be offered to current MDPCP practices. Practices that are not currently participating in MDPCP will be eligible for this path beginning January 2026. 

Pathways
AHEAD Model Pathways

FAQs