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."
Dual Eligible | 2703 SPA | CPC | CPC+ | PCMH QHP | PCMH Legislation | Private Payer |
---|---|---|---|---|---|---|
Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
---|---|---|---|---|
Maryland Multi-payer Patient Centered Medical Home Program | Multi-Payer | Statewide |
Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
---|---|---|---|---|
CHIPRA Quality Demonstration Grant - Maryland | Grant | Maryland, Georgia, Wyoming | CHIPRA Quality Demonstration Grant | |
CMS Health Care Innovation Award: Atlantic General Hospital Corporation | Grant | Worcester County | CMS Health Care Innovation Award (Round 1) | |
CMS Health Care Innovation Award: CareFirst | Grant | Statewide | CMS Health Care Innovation Award (Round 1) | |
CMS Health Care Innovation Award: John Hopkins University | Grant | East Baltimore | CMS Health Care Innovation Award (Round 1) | |
CMS State Innovation Model Design Award - Maryland | Grant | Statewide | CMS State Innovation Model (SIM) | |
Greater Baltimore Medical Center Medical Neighborhood Demonstration - Maryland | Grant | Baltimore | CMS Health Care Innovation Award - PCMN Demonstration | |
Maryland Medicaid Health Homes | Medicaid | Statewide | ACA Section 2703 Health Homes | |
Military Health System PCMH Initiative - Walter Reed National Military Medical Center | Military | Bethesda | U.S. Navy Medical Home Port |
Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
---|---|---|---|---|
CareFirst Patient-Centered Medical Home - Maryland | Commercial | Statewide | Blue Cross Blue Shield Value-Based Care Program | |
Cigna Accountable Care Program - Greater Baltimore Health Alliance | Commercial | Baltimore-area | Cigna Collaborative Care Program | |
UnitedHealthcare Patient-Centered Medical Home Program- Maryland | Commercial | Baltimore-area | UnitedHealthcare PCMH Program |
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 |
SB 734 Requiring the Maryland Health Care Commission to provide a report, beginning December 1, 2024, and each year thereafter, to the Governor and the General Assembly containing an analysis of primary care investment, ways to improve the quality of and access to primary care services, and any findings and recommendations; requiring the Commission to establish a workgroup to develop the report to include an interpretation of the results of the required analysis and to make recommendations; etc. |
Enacted | 2022 |