Maryland

Maryland began a three‐three year pilot study in 2011, the Maryland Multi-Payer Patient-Centered Medical Home Program (MMPP), to test the PCMH model of care, including 52 primary and multi-specialty practices. The practices are comprised of both private and all of the federally‐qualified health centers located across the State. Maryland law SB 855/HB 929 requires the State’s five major carriers of fully insured health benefit products (Aetna, CareFirst, CIGNA, Coventry, and UnitedHealthcare) to participate in the MMPP. The Federal Employees Health Benefit Plan, Maryland State Employees Health Benefit Plan, TRICARE, the health care program serving Uniformed Service members, and plans provided by private employers, such as Maryland hospital systems, have voluntarily elected to offer this program as well.

With the support of a CMS State Innovation grant and participation in the Medicaid Health Homes program, Maryland plans to further strengthen the MMPP through the development of Community-Integrated Medical Home (CIMH) model.  This model of care will integrate patient-centered medical care with community-based resources while enhancing the capacity of local health entities to monitor and improve the health of individuals and their communities as a whole.  

In accordance with Section 31-116 of the Insurance Article of the Annotated Code of Maryland, the Maryland Benchmark Plan sold on the Maryland health insurance Marketplace must include "delivery of benefits through patient centered medical homes for individuals with chronic conditions, serious illnesses or complex health care needs who agree to participate in a patient centered medical home program."
 

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
Yes
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
5,945,000
Uninsured Population:
10%
Total Medicaid Spending FY 2013: 
$7.8 Billion 
Overweight/Obese Adults:
64.1%
Poor Mental Health among Adults: 
33.0%
Medicaid Expansion: 
Yes 

SB 734 - Maryland Health Care Commission - Primary Care Report and Workgroup

Requiring the Maryland Health Care Commission to provide a report, beginning December 1, 2024, and each year thereafter, to the Governor and the General Assembly containing an analysis of primary care investment, ways to improve the quality of and access to primary care services, and any findings and recommendations; requiring the Commission to establish a workgroup to develop the report to include an interpretation of the results of the required analysis and to make recommendations; etc.

Safest States During COVID-19

WalletHub study

As the U.S. continues its efforts to overcome the COVID-19 pandemic amid a surge in cases caused by variant strains, staying safe is one of Americans’ top concerns. Safety is also essential for getting the economy back on track, as the lower COVID-19 transmission and deaths are in a state, the fewer restrictions there will be and the more confidence people will have to shop in person. While almost all states have fully reopened, we’ll only be able to completely get back to life as normal once most of the population is fully vaccinated against coronavirus. The good news is that the U.S.

News Author: 
Adam McCann

COVID Vaccines More Available, but Mostly Not in Doctors' Offices

Maryland one of few states with a distribution program

Even as the supply of COVID-19 vaccines continues to increase, many doctors clamoring to distribute the vaccine directly to their patients are finding their requests go unheeded, experts say.

 

News Author: 
Joyce Frieden

Supreme Court deals a fatal blow to Maryland drug ‘price gouging’ law

The Supreme Court on Tuesday dealt a fatal blow to an expansive Maryland law that aimed to bar drug makers from “price gouging” consumers.

The law, which the Maryland General Assembly passed in 2017, would have prohibited generic drug manufacturers from raising prices in a manner the state deemed “unconscionable.”

News Author: 
Lev Facher

Summary - CareFirst: A Partner in Health

In a briefing on Tuesday February 12th, 2019, CareFirst’s president and CEO, Brian Pieninck discussed the future of healthcare and what role CareFirst will play in actualizing that future. One important part of the conversation was pharmaceutical costs, which is the highest cost category for CareFirst, making up 33 percent of their total spending. These costs are also rising faster than any other category and part of the problem is the opaque supply chain dynamic.

News Author: 
Alyssa Neumann Kane

The Future of Health Care Reform — A View from the States on Where We Go from Here

The future of U.S. health care reform is muddier now than at any point in the past two decades. Health care was one of the most important issues for voters in the 2018 election, but there is little reason to believe that substantive national action is likely any time soon. The Trump administration is taking aggressive steps to undermine the Affordable Care Act (ACA) but is limited in what it can do on health policy absent legislation from Congress. States are poised to fill this vacuum.

News Author: 
David K. Jones, Ph.D.
Christina Pagel, Ph.D.

CareFirst Patient-Centered Medical Home Program Nets $1.2B In Savings Since 2011

 Since it was launched in January 2011, the Patient-Centered Medical Home (PCHM) program operated by CareFirst BlueCross BlueShield (CareFirst) has lowered the expected cost of care for CareFirst members by nearly $1.2 billion.

In 2017 alone, CareFirst’s PCMH program – the largest coordinated care program of its kind in the country – helped save $223 million against the expected cost of care. The savings are fueled primarily by reductions in hospital admissions and readmissions and how long patients stay in the hospital once admitted.

Global Hospital Budgets in Maryland: When Economics and Altruism Align

“We had more imaging facilities than we really needed. Plus our ER was really crowded. So under a global budget we shut down one of our three imaging centers and converted it into a patient-centered medical home to reduce our ER volume.”

I wanted to pinch myself. Was this the fever dream of a crazy-eyed, hopeless delivery system reform devotee or was I really hearing a hospital executive say this? And how could he get away with it? Was he working hard to wreck his hospital’s finances and put himself out of a job?

News Author: 
Christopher Koller

The 8th International Conference on Patient- and Family-Centered Care: Promoting Health Equity and Reducing Disparities

2018-06-11 09:00 to 2018-06-13 15:00

The 8th International Conference on Patient- and Family-Centered Care: Promoting Health Equity and Reducing Disparities, will be held June 11-13, 2018, in Baltimore, MD at the Baltimore Marriott Waterfront Hotel. The Conference will feature programs and strategies that address disparities in health and health care, as well as programs that are dedicated to collaboration among health care professionals, patients, and families to address the challenges in complex health care systems.

Announcement Type: 

Editorial: Expansion, extension of 'Maryland Model' to reduce health care costs a win-win

In medicine, most people would likely agree that the goal should be making sure the patient is healthy and well, not earning revenue. Yet, in many places that isn’t necessarily the case when it comes to hospital admissions.

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