CMS State Innovation Model Design Award - Maryland

Program Location: 
Annapolis, MD
Payer Type: 
Grant
Payers: 
Medicaid
Description: 

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 of individuals and their communities as a whole. The state of Maryland is committed to designing the CIMH based on input from a wide range of health care stakeholders. Through this initiative, participating Maryland primary care providers will lead a team of health professionals focused on coordinating personalized care that meets the complex needs of patients.  It will allow physicians to focus more on treating a patient’s overall health, as opposed to just treating illnesses when they arise. In addition to services provided in the physician’s office, Community Integrated Medical Homes will coordinate with public health resources in local communities across Maryland.  This connection to community health resources will provide complementary supports for patients between their office visits. 

Through a stakeholder engagement process, Maryland developed the details of the model and devised an innovation plan to guide its implementation.  ​A payer and provider engagement process was used to develop programmatic standards and administrative structures for the CIMH. Second, local health improvement coalitions (LHICs), which are panels of local health departments, hospitals, physicians, community organizations, and other local entities, were engaged to develop plans for the integration of  community health with medical care and build capacities at the local level for health planning and hot-spotting of areas with inefficient use of health services.

The state was awarded a Model design award in Round 1, but CMS required the state to make adjustments to the proposed SHIP. In December of 2014, CMS awarded Maryland an additional Model Design award of $2.5 million and required the state to resubmit the proposal after making revisions. 

The state's plan focuses on a "Dual Eligible ACO" pilot that will incorporate a shared savings model, a quality alignment and measurement plan, a provider organization engagement strategy, and an enrollment strategy. The model will be a Medicaid Integrated Delivery Network. Click here to read more.

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Payment Model: 

 During the Model Design period, the state will engage both public and private payers to establish the governance structure for the CIMHs and set programmatic standards

Last updated July 2015
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