The State of Maryland has entered into a Total Cost of Care Model contract with the Federal Government that is designed to coordinate care for patients across both hospital and non-hospital settings, improve health outcomes, and constrain the growth of health care costs in Maryland. A key element of the model is the development of the Maryland Primary Care Program (MDPCP). MDPCP is a voluntary program open to all qualifying Maryland primary care providers that provides funding and support for the delivery of advanced primary care throughout the state. The MDPCP supports the overall health care transformation process and allows primary care providers to play an increased role in prevention, management of chronic disease, and preventing unnecessary hospital utilization.
The Maryland Department of Health (MDH) has worked closely with the Centers for Medicare and Medicaid Services (CMS) to establish the MDPCP. The Office of Advanced Primary Care (OAPC) within MDH’s Medicaid Administration is responsible for implementing this innovative health care transformation program in conjunction with the Center for Medicare and Medicaid Innovation (CMMI). The material presented herein provides additional descriptions and resources regarding the MDPCP.
As of January 2020, CareFirst has joined the program as an aligned payer. The following Comparison Table provides a summary of the key differences between Medicare MDPCP and CareFirst's aligned Patient Centered Medical Home (PCMH) program. Please see our MDPCP-CareFirst Alignment FAQs for additional information.
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.
Evaluation of MDPCP (2019-2022) shows cost savings and improved patient care
The Hilltop Institute at the University of Maryland, Baltimore County conducted an evaluation of the MDPCP from 2019-2022 showing cost savings and improved patient care for participating Medicare beneficiaries. The Program’s positive impacts include:
A 4.33% decrease in total Medicare Part A and B expenditures
A 7.18% decrease in inpatient utilization
A 1.70% decrease in emergency department utilization
Total spending was budget neutral (program payments are balanced by cost savings), with suggestive evidence of net cost savings, estimated at $162 million
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