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 form of U.S. healthcare saves money, improves quality, one insurer finds

on Thu, 2014-07-10 00:00   staci

In one of the largest tests of a novel way to deliver and pay for healthcare, insurer CareFirst BlueCross BlueShield announced on Thursday that 1.1 million people receiving care through its "patient-centered medical homes" last year were hospitalized less often and stayed for fewer days compared to patients in traditional fee-for-service care.

Story Date: 
July 10, 2014
News Author: 
Sharon Begley
Source Link: 
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Will Health Reform Bring New Role, Respect To Primary Care Physicians?

on Thu, 2014-07-10 00:00   lisabeth

A few years ago it struck the D.C. region’s biggest medical insurer that the doctors who saw its members most often and knew them best got the smallest piece of the healthcare dollar. CareFirst BlueCross BlueShield spent billions on hospital procedures, drugs and specialty physicians to treat sick patients. Only one dollar in 20 went to the family-care doctors and other primary caregivers trained to keep people healthy.

The company’s move to shift that balance tells a lesser-known story of the Affordable Care Act and efforts to change the health system.

Story Date: 
July 10, 2014
News Author: 
Jay Hancock
Source Link: 
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Hospital Readmissions: Impact of Mental Illness

2014-12-02 08:00 to 13:00

Workshop Presentations:

Maryland Statewide Transitions to Care Steering Committee- Maryland Hospital Association

Project RED: Mental Illness and Hospital Readmissions
Larry Culpepper, MD, Chief, Department of Family Medicine, Boston University

M3 Clinician
Steve Daviss, MD, Medical Director, M3 Clinician

Health Information Technology and Data Security
William O'Byrne, Executive Director, NJHITEC

Please RSVP to Chris@m3information.com. Phone: (301)444-4400

Announcement Type: 
Partner
Seminar

Leveraging Multiple State Data Sources to Drive Improvement in Population Health Outcomes

2014-07-10 15:30 to 17:00

States have a variety of metrics and data sources that potentially can be used to assess and improve population health outcomes. In order to maximize this potential, states need effective strategies to collect, analyze, integrate, and use data from various sources, and to share it across multiple agencies and health care organizations for activities that drive improvement for all populations. This webinar will feature an overview of provisions in the Affordable Care Act (ACA) that place new emphasis on data to promote health equity and improve health outcomes.

Register Here
Announcement Type: 
Webinar

CMS Dual Eligible Demonstration

A longstanding barrier to coordinating care for Medicare-Medicaid enrollees has been the financial misalignment between Medicare and Medicaid. To begin to address this issue, the Centers for Medicare & Medicaid Services (CMS) is testing models with States to better align the financing of these two programs and integrate primary, acute, behavioral health and long-term services and supports for their Medicare-Medicaid enrollees. 

Maryland’s patient-centered medical homes, lowering costs, improving care

on Wed, 2014-04-23 00:00   staci

In past generations, it wasn’t unusual for a family doctor to make a house call, perform a broad range of medical services and offer emotional as well as clinical support. While the traditional house call may be a thing of the past, patients today are taking advantage of a return to cooperative hands-on care in the form of patient-centered medical homes, including many in Maryland. Data shows that this care model is not only lowering costs but also improving care.

Story Date: 
April 23, 2014
News Author: 
Brian Castleberry
Source Link: 
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Greater Baltimore Medical Center Medical Neighborhood Demonstration - Maryland

This award is part of the Health Care Innovation Awards program, a Department of Health and Human Services initiative investing up to $1 billion to test promising new approaches that aim to improve health care and lower program costs for recipients of Medicare, Medicaid and the Children's Health Insurance Program (CHIP).

CMS Health Care Innovation Award - PCMN Demonstration

[ENDED] About 157,000 Medicare and Medicaid beneficiaries in 15 health systems and provider organizations across the nation are participating in a Patient-Centered Medical Neighborhood (PCMN) demonstration project as part of a collaboration among TransforMED, Phytel and VHA Inc.  Funded by a three-year, $20.75 million cooperative agreement awarded by the Center for Medicare and Medicaid Innovation (Innovation Center), the PCMN project began implementation in 2013.

Maryland Medicaid Health Homes

Maryland was approved for a 2703 Health Home State Plan Amendment in September of 2013. Health Homes for individuals with chronic conditions will augment the State's broader efforts to integrate somatic and behavioral health services.  The program will target populations with behavioral health needs who are at high risk for additional chronic conditions, including those with serious persistent mental illness, serious emotional disturbance, and opioid substance use diso

Hospital Readmissions: Impact of Mental Illness

2014-02-18 08:00 to 13:00

Workshop Presentations:

Maryland Hospital Association Care Transitions Steering Committee Update
Jeff Richardson, MBA, Executive Director, Mosiac Community

Project RED: Mental Illness and Hospital Readmissions
Larry Culpepper, MD, Chief, Department of Family Medicine, Boston University

mHealth: Why It Matters Here and Now
Pete P. Celano, Director Consumer Initiatives, MedStar Health

Announcement Type: 
Partner
Seminar

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