Maine

Maine has had an impressive history and continued commitment to improve the health of its citizens through strengthening its system of primary care across the State. In the fall of 2007, the Maine Legislature convened the Commission to Study Primary Care Practice to examine the issues facing primary care and ways to stabilize and support it. In the 2008-2009 State Health Plan, the Governor’s Office for Health Policy and Finance identified the need to promote primary care as the foundation for our state’s health system.

Formed in 2003 and incorporated in 2006, Maine Quality Counts (QC) has provided leadership, advocacy and support for improving primary care in partnership with the State through several multi-stakeholder initiatives including PCMH learning collaboratives, a Multi-payer Advanced Primary Care Practice program, Coordinated Care Teams, Quality Counts for Kids, and Integrated Behavioral-Physical Health, to name a few. Maine Quality Counts, as one of the State’s designated partners in the State Innovation Model (SIM) Initiative, is working to ensure all State health improvement measures build upon the success of these and other established PCMH programs. Quality Counts is leading the learning collaborative to implement the new Maine Behavioral Health Home Initiative. 

Primary Care Innovations and PCMH Activity

Dual Eligible 2703 SPA CPC CPC+ PCMH QHP PCMH Legislation Private Payer

Multi-Payer Programs

Program Name Payer Type Coverage Area Parent Program Outcomes
Maine Patient-Centered Medical Home Pilot Multi-Payer Statewide Multi-Payer Advanced Primary Care Practice (MAPCP)

State Legislation

Legislation Status Year
Appropriation for patient-centered medical home pilot

In the FY2010 budget, the Maine legislature appropriated $500,000 to partially fund a PCMH pilot in partnership with Maine Quality Forum (MQF), Maine Quality Counts, and the Maine Health Management Coalition with additional funding from an RWJ Foundation Aligning Forces for Quality grant.  

Active 2010
SP 421: An Act To Establish Transparency in Primary Health Care Spending

This bill requires insurers to report primary care expenditures to the Maine Health Data Organization and for the Maine Quality Forum to use this data to report annually to the Department of Health and Human Services and the Legislature the percentage of total medical expenditures paid for primary care by commercial insurers, the MaineCare program, Medicare, the organization that administers health insurance for state employees and the Maine Education Association benefits trust respectively, the average of the percentage of total medical expenses paid for primary care across all organizations and the methods used by these organizations to pay for primary care. This bill also requires the Maine Quality Forum to conduct a study on best practices in health care spending reporting and submit its findings to the Department of Health and Human Services and the Joint Standing Committee on Health and Human Services.

Pending 2019

State Facts:

Population:
1,312,200
Uninsured Population:
10%
Total Medicaid Spending FY 2013: 
$2.9 Billion 
Overweight/Obese Adults:
64.8%
Poor Mental Health among Adults: 
34.2%
Medicaid Expansion: 
No

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