(This was previously named the 'Maryland Comprehensive Primary Care Model.)
Overview
Maryland, under agreement with the Centers for Medicare & Medicaid Services (CMS), launched the All-Payer Model in 2014 to transform the health care delivery system. The All-Payer Model is changing the way Maryland hospitals provide care, shifting from a financing system based on volume of services to a system of hospital-specific global revenues and value-based incentives.
Further health transformation in Maryland means transitioning to an All-Payer Model that limits the growth in total cost of care for Medicare beneficiaries in a second term that will begin on January 1, 2019. In the “Progression Plan” document, Maryland outlines its proposal to accomplish the expanded system-wide goals and address the State’s goal of including the Medicaid costs for Medicare beneficiaries who are also covered by Medicaid.
A key component of the Progression Plan is system-wide primary care transformation. Primary care is essential for patients with chronic diseases that progress over time, to prevent them from having to seek care in higher acuity care settings. However, many primary care settings lack the resources to meet the full range of needs of the growing number of patients with multiple chronic conditions. Necessary resources include care management, care coordination, and connections to behavioral health and social services.
Maryland, equipped with experience and expertise in primary care transformation, now proposes a Maryland-specific program: The Maryland Primary Care Program (MDPCP). This foundational payment and delivery system reform is designed to transcend the silos that separate the many professionals who are seeing patients, by providing the technical assistance, learning systems and the funding streams to support care delivery transformation.
The MDPCP is based upon the Center for Medicare and Medicaid Innovation Comprehensive Primary Care Plus Model. An innovation under MDPCP is the provision of entities called Care Transformation Organization that provide resources and assistance to practices to support care management, care coordination, and connections to behavioral health and social services.
Maryland is currently negotiating approval of the MDPCP with CMS. Pending approval, here is a timetable of key dates:
|
Activity |
Timeframe |
|
Submit Model to CMS for Approval |
Summer 2017 |
|
Stand up Program Management Office |
Fall 2017 |
|
Release Applications |
Spring/Summer 2018 |
|
Select CTOs and Practices |
Summer/Fall 2018 |
|
Initiate Program |
January 2019 |
General Information
Practices
Care Transformation Organizations
Questions or comments may be directed to the Program Management Office for the Primary Care Program: mdh.pcmodel@maryland.gov.
------------------------------------------
Last updated: 2017 October 13
