Legal Bulletins

Recently, the State of Maryland and the Centers for Medicare and Medicaid Services announced a new initiative, the Maryland Primary Care Program (MDPCP) which aims to reduce overall spending for Medicare beneficiaries in Maryland by offering care coordination to keep patients healthier and out of hospitals.

This is a unique opportunity for primary care providers to partner with larger organizations, referred to as Care Transformation Organizations (CTOs), with both groups earning financial incentives. The MDPCP is open to those in general practice, family medicine, internal medicine, obstetrics and gynecology, pediatrics, geriatrics and co-located psychiatry.

The MDPCP will partner participating practices with a CTO. The CTO’s services may vary, and could include pharmacy services, nutrition counseling, behavioral health, and referrals to social services or other community health programs. Though each CTO may deploy different services, the CTO must be able to provide five key functions: (1) care coordination; (2) care transitions; (3) standardized beneficiary screening; (4) data tools and informatics; and (5) practice transformation assistance.

In exchange, participating providers will receive from 50% to 70% of a care management fee for each Medicare beneficiary. The fee can range on average from $17 to $28 per patient, with more money for patients with complex needs.

Interested practices must apply via an online portal at https://app1.innovation.cms.gov/mdprov/mdprovLogin on the Maryland Department of Health website https://health.maryland.gov/mdpcp/Pages/practices.aspx by August 31, 2018 to be considered for the first year of the program, which launches January 1, 2019.