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 

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

A review of the year’s academic and industry-generated PCMH evaluations finds significant impact across a number of clinical and financial outcomes.

Embargoed Until Monday, January 13th, 4PM

PCPCC: Michelle Shaljian, 347-754-1692, michelle@pcpcc.net

Milbank: Tara Strome, 212-355-8400, tstrome@milbank.org

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

Military Health System PCMH Initiative - Walter Reed National Military Medical Center

The basic concepts and tenets of the integrated patient-centered medical home at Walter Reed National Military Medical Center includes Stable Primary Care Manager, Team Based Healthcare, Improved Access, Proactive Healthcare, Coordination with Medical and Surgical Specialists and Improved Communication and Information Systems. Medical Home patients have an entire team responsible for their healthcare which includes the Primary Care Manager, a Registered Nurse (RN), a Licensed Practical Nurse (LPN), and/or a Hospital Corpsman.

CHIPRA Quality Demonstration Grant

[ENDED IN 2015] In February 2010, the Centers for Medicare & Medicaid Services (CMS) awarded 10 grants, funding 18 States, to improve health care quality and delivery systems for children enrolled in Medicaid and the Children's Health Insurance Program (CHIP).

Medicare Shared Savings Program

The Centers for Medicare & Medicaid Services (CMS) has established a Medicare Shared Savings Program (Shared Savings Program) to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs.

CMS Health Care Innovation Award (Round 1)

 [ENDED IN 2014] The Health Care Innovation Awards are funding up to $1 billion in awards to organizations that are implementing the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children's Health Insurance Program (CHIP), particularly those with the highest health care needs.

Maryland Multi-payer Patient Centered Medical Home Program

The Maryland Multi-payer Patient-Centered Medical Home Program (MMPP) began a three‐three year pilot study in 2011 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 requires the State’s five major carriers of fully insured health benefit products (Aetna, CareFirst, CIGNA, Coventry, and UnitedHealthcare) to participate in the MMPP.

CareFirst Patient-Centered Medical Home - Maryland

As the region’s largest private payer, CareFirst undertook the Total Cost and Care Improvement (TCCI) and PatientCentered Medical Home (PCMH) Programs at the start of 2011 as a way to tackle the continuing steep increases in health care costs occurring in its service area which includes Maryland, the District of Columbia and Northern Virginia. 

CMS State Innovation Model Design Award - Maryland

As part of the State Innovation Model funding opportunity from the Centers for Medicare & Medicaid Innovation (CMMI), the state of Maryland received funding to engage in a planning process to develop the Community-Integrated Medical Homes (CIMH) model based on their State Healthcare Innovation Plan.  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

CMS Health Care Innovation Award: Atlantic General Hospital Corporation

Atlantic General Hospital Corporation, which serves largely rural Worcester County, Maryland, is receiving a grant to improve care for Medicare beneficiaries with either a primary or admitting diagnosis of congestive heart failure, chronic obstructive pulmonary disease, or diabetes, who currently rely on high cost ER visits and Acute Care admissions.

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