Maryland is on the cusp of a unique opportunity to lead the nation in health care innovation while improving access and affordability for patients and clinicians alike.
Just recently, Gov. Larry Hogan (R), together with the Maryland Department of Health and the Centers for Medicare and Medicaid Services, announced the federal approval of Maryland’s Total Cost of Care All-Payer Model, known as the “Maryland Model” contract. This innovative approach to health care clinician payment is unique to Maryland and made possible via a contract between CMS and the state. The Maryland Model dramatically shifts how we pay for and deliver health care in Maryland. Going forward, the health care system in Maryland will transition away from encouraging more services and higher costs to one that rewards efficiency, value and better health outcomes.
A central part of the Maryland Model is the Maryland Primary Care Program. MDPCP provides the foundation for Marylanders to have their health managed by a dedicated, interdisciplinary care team led by a primary care clinician. Voluntary for all eligible Maryland primary care practices, MDPCP provides substantial funding to support practice transformation to advanced primary care. Advanced primary care is a way of delivering care that broadens the care provided by the practice and allows the patient to have the confidence of always knowing that their health care team is there to support their needs. MDPCP will enhance practices’ ability to deliver needed supports for Marylanders both within the office setting and in the community. This program offers primary care clinicians an opportunity to greatly expand the services provided to their patients through the addition of care managers, behavioral health specialists, pharmacists, community health workers and others working in a team approach to provide measurably high-quality health care.
In accordance with the Maryland Model, the MDPCP also alters the payment system from a pure fee for-service, volume-based system to value-based payments, allowing the practices to be rewarded by focusing their attention on those with the greatest need rather than being forced to see more patients over shorter visits.
Patients will benefit, too. MDPCP is designed to foster holistic care, addressing the physical, behavioral and social needs of Marylanders. Patients can expect a better patient experience, tailored care and lower costs. The MDPCP will provide financial incentives to primary care clinicians to support significant improvements in the way health care is delivered to patients, requiring extended hours, 24/7 availability, prompt follow-ups to emergency department and hospital visits and meticulous and consistent attention to the needs of patients. This is exactly what our primary care clinicians already want to do. With the introduction of MDPCP, the long wait for a better way to meet the needs of Marylanders is finally here.
The program is also open to newly formed, private entities called care transformation organizations. CTOs will support the practices’ movement along the continuum to advanced primary care by offering care management resources to practices on request.
The Maryland health care community has the unique opportunity to significantly improve the lives of every Maryland resident, enhancing the vitality of Maryland as a whole. The MDPCP is a tremendous benefit to both patients and clinicians in Maryland and will ensure the highest level of care for patients who have the greatest need.