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."
 

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
Yes
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
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 

Maryland announces agreement on all-payer health model

Maryland officials on Monday announced federal approval of a new contract for the state’s unique all-payer health care model.

Maryland is the only state that can set its own rates for hospital services, and all payers must charge the same rate for services at a given hospital. The policy has been in place since the 1970s, though Maryland modernized its one-of-a-kind Medicare waiver four years ago to move away from reimbursing hospitals on a fee-for-service basis to a fixed budget.

News Author: 
Brian Witte 

Primary care teams discover benefits of improving family communication

It wasn’t medical knowledge or clinical acumen that ultimately helped Catherine M. White, M.D., FAAP, impact the life of a patient with special needs. It was her team’s commitment to building a relationship with the child’s mother, so they could determine why the family was missing the specialist appointments critical to the child’s care.

News Author: 
Jessica Pupillo

Hoping To See Your Doctor Via Telemedicine? Here’s A Quick Guide.

Tucked into the federal budget law Congress passed in February was a provision that significantly expands the use of telemedicine — long a hyped health care reform, and now poised to go mainstream within five to 10 years.

“There’s much broader recognition of the benefits,” said Mei Wa Kwong, executive director of the Center for Connected Health Policy, a research group that promotes telemedicine in Sacramento, Calif. “The law is the latest to make telemedicine more accessible. But we still have a ways to go before most consumers are aware of the option.”

News Author: 
Steven Findlay

CareFirst to Invest $1.5 Million to Increase Substance Use Disorder Services

Baltimore, MD (April 05, 2018) - CareFirst BlueCross BlueShield (CareFirst), the region’s largest not-for-profit insurer, plans to award $1.5 million over two years to programs increasing access to substance use disorder services – including efforts to combat opioid addiction – in Maryland, Washington, D.C., and Northern Virginia.

To Curb Rising Health Insurance Costs, Some States Try 'Reinsurance Pools'

A couple of years ago, the health insurance exchange in Minnesota – MNsure – was in deep trouble. Health insurance premiums for individual policies had shot up by as much as 67 percent, among the steepest increases in the country.  Insurers were abandoning the market, leaving 116,000 Minnesotans with scant choices.

News Author: 
Michael Ollove

Paying Hospitals To Keep People Out Of Hospitals? It Works In Maryland

Saturdays at Mercy Medical Center used to be perversely lucrative. The dialysis clinic across the street was closed on weekends.

That meant the downtown Baltimore hospital would see patients with failing kidneys who should have gone to the dialysis center. So Mercy admitted them, collecting as much as $30,000 for treatment that typically costs hundreds of dollars.

News Author: 
Jay Hancock

A Health Plan ‘Down Payment’ Is One Way States Try Retooling Individual Mandate

As President Donald Trump and congressional Republicans tirelessly try to dismantle the Affordable Care Act, a number of states are scrambling to enact laws that safeguard its central provisions.

The GOP tax plan approved by Congress in the last days of 2017 repealed the ACA penalty for people who fail to carry health insurance, a provision called the “individual mandate.” On Jan. 30, in Trump’s first State of the Union address, he claimed victory in killing off this part of the health law, saying Obamacare was effectively dead without it.

News Author: 
Rachel Bluth

Maryland’s plan to save Obamacare from individual mandate repeal

Maryland is first out of the gate with a plan to replace the individual mandate — an early sign that the states that like Obamacare will be spending a lot of time thinking through what fits best into this gaping health policy hole that the Republican tax bill created.

The Maryland proposal would reinstate financial penalties for those who decide to go without health coverage. Maryland state Sen. Jim Rosapepe, one of the co-sponsors of the plan, tells me they’d like to set the fees similar to where they’ve been under the Affordable Care Act.

News Author: 

Doctors are a naturally competitive bunch. CareFirst has tapped into that to tackle health costs.

What's one of the most effective ways to get doctors to change their referral and drug-prescribing habits, two of best-known drivers of health care costs? Tap into their competitive sides.

That's what CareFirst BlueCross BlueShield CEO Chet Burrell told attendees at the recent Health Datapalooza conference in D.C. as he discussed how data has become a secret weapon for the Owings Mills-based insurer, the region's largest.

Mary's Center - Ontario Rd

Practice Type: 
FQHC
Multispecialty practice
Not-for-profit practice
Practice Setting: 
Urban
Practice Address: 
2333 Ontario Rd, NW
Adelphi, MD 20009

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