CMS and MDH have envisioned a new type of entity, a Care Transformation Organization (CTO). For purposes of the Maryland Primary Care Program (MDPCP), a CTO is defined as an entity that hires and manages an interdisciplinary care management team capable of furnishing an array of care coordination ​services to Maryland Medicare beneficiaries attributed to Participant Practices. The interdisciplinary care management team may furnish care coordination services such as: pharmacist services, health and nutrition counseling services, behavioral health specialist services, referrals and linkages to social services, and support from health educators and Community Health Workers (CHWs). Many different types of entities may submit a CTO application, including health plans, Accountable Care Organizations (ACOs), managed service organizations (MSOs), Clinically Integrated Networks (CINs), hospitals, and other practice support organizations.​ 

There are no additional application periods for practices, FQHCs, and CTOs scheduled at this time. Please visit the CMS Total Cost of Care Model page​ for more information.​