Maryland Primary Care Program: Apply by July 14, 2020

The Maryland Primary Care Program (MDPCP) is in its second Performance Year and now recruiting for the 2021 Performance Year Three. The MDPCP is a voluntary program open to all qualifying Maryland primary care practices. It provides funding and support for the delivery of advanced primary care throughout the state. The MDPCP supports the overall health care transformation process and allows primary care providers to play an expanded role in prevention, management of chronic disease, and preventing unnecessary hospital utilization.

Practice Eligibility:

  • Primary Care practices in Maryland comprised of physicians, clinical nurse specialists, nurse practitioners, and physician assistants
  • Provider Specialty designations include: General Practice, Family Medicine, Internal Medicine, Obstetrics and Gynecology, Pediatric Medicine, Preventive Medicine, Geriatric Medicine, and co-located Psychiatry.
  • Use a certified electronic health record (EHR)
  • Provide services to a minimum of 125 attributed Medicare fee-for-service beneficiaries

Improved Health

The MDPCP is dedicated to improving health outcomes for all patients, focusing on the five primary care functions:

  1. Access to Care
  2. Care Management
  3. Comprehensiveness and Coordination
  4. Patient and Caregiver Experience
  5. Planned Care and Population Health

Partners and Supports

All participating practices have access to a Practice Coach, who provides ongoing assistance in meeting program requirements. Practices may also choose to partner with a Care Transformation Organization (CTO), an entity which can provide additional supports and fulfill staffing needs. Practices also receive many resources, such as via support meetings and webinars, an interactive Learning System, and data-driven tools to support functions like risk stratification, social needs screening, and behavioral health integration.

MedChi CTO

Provides support to practices via care management personnel, infrastructure, and technical assistance. Offers services related to Diabetes Management, Transitional Care Management, Patient Transportation and Secure Patient Messaging and Telehealth. Learn more.

Enhanced Payments

The MDPCP redesigned payments reward value-based, comprehensive care. CMS will provide funding directly to Practices (and Care Transformation Organizations by practice designation) to strengthen and transform the delivery of primary care. The typical primary care practice in the program can expect to receive $100k or more in annual payments depending on size and program options selected.

The payment structure is based on Medicare fee-for-service. In the advanced track of the program (Track 2), the typical Medicare fee-for-service payment system gradually transforms to a partial prepayment system, with practices receiving quarterly Comprehensive Primary Care Payments (CPCP) in advance.

Patient Attribution

The attribution algorithm emphasizes the importance of an ongoing and substantive relationship with a primary care practice. This can be a three step process that analyzes the most common TIN, claims data, CCM fees, WTM and AWV services. Payments are based on attribution. Practice attribution is adjusted quarterly.

Timeline

The MDPCP will have an annual enrollment period each spring/summer during which interested practices and CTOs can apply. Enrollment is open now through midnight on July 14, 2020.

Updates related to program application can be found on the MDPCP website at health.maryland.gov/MDPCP.

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