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."
 

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
Maryland Multi-payer Patient Centered Medical Home Program Multi-Payer Statewide

State Legislation

Legislation Status Year
Maryland law Senate Bill 855/House Bill 929

The law requires the State’s five major carriers of fully insured health benefit products (Aetna, CareFirst, CIGNA, Coventry, and UnitedHealthcare) to participate in the Maryland Multi-Payer Patient-Centered Medical Home Program (MMPP).

Enacted 2010

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 

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