ME PCMH Pilot Expansion - Application Process Re-Opened!

Maine PCMH Pilot / MAPCP Demo - Application Process Re-Opened

Conveners of the multi-payer Maine Patient Centered Medical Home (PCMH), the Dirigo Health Agency’s Maine Quality Forum, Maine Quality Counts, and the Maine Health Management Coalition, have expanded the pilot to include up to 50 adult practices beginning January 2013.

An opportunity exists to increase the planned expansion of the multi-payer Maine PCMH Pilot to include up to 50 qualified adult primary care practices.  It should be noted that several issues must be addressed before this opportunity can be finalized - please see memo below and follow linnks to the timeline and additional details.

Maine’s participation in the CMS MAPCP demo currently brings in approximately $2.5M per year in new Medicare payments to the 22 adult Pilot practices ($1.7M) and the 8 Community Care Teams (CCTs) ($720K).  Bringing in the planned 20 new practices is expected to bring in approximately $2.5M of additional Medicare payments to practices and CCTs (i.e. nearly doubling that revenue).  Bringing in an additional 30 new practices could be expected to bring in an additional $3.4M in new Medicare payments to these new practices and CCTs.

In order to proceed, CMS requires that the other payers agree to participate, and that Pilot Conveners offer the same level of practice transformation support for all practices in the Pilot. While we fully recognize the importance of this opportunity, resources do not currently exist to provide this practice transformation support for an additional 50 practices, and we do not have sufficient time to secure additional grant resources  in the  required timeframe.  Given that, we are proposing that new practices selected for the Pilot contribute a modest per member per month (pmpm) payment to support these required practice improvement activities.

While final approval of this additional expansion of the Pilot is contingent upon these additional steps and subject to CMS approval, we feel that it is highly possible that we will be allowed to proceed.  Given that, we are re-opening the online application process for the Maine PCMH Pilot and the MaineCare Health Homes initiative for a 2 week period, from Friday, April 20 through 5PM on Friday, May 4th.  Please see below documents including full information, an updated timeline and eligibility criteria.

Link to the online application here:  http://www.surveymonkey.com/s/ME_PCMH_Pilot_Phase2_Expansion_Applic

ME PCMH Pilot_MAPCP Expansion_Conveners PCP letter_04-20-12.pdf

Maine PCMH Pilot_Phase 2 Expansion_UPDATED Timeline_04-20-12.pdf

HH & PCMH Pilot Eligibility Criteria_UPDATED_04-20-12.pdf

We appreciate your interest in and support for the Maine PCMH Pilot.

Maine PCMH Pilot Conveners,

Karlynee Harrington, DHA’s Maine Quality Forum

Lisa M. Letourneau MD, MPH, Maine Quality Counts