Healthcare Integration

Innovative Practice Opportunity

The State of Maryland recently announced that it has entered into a Total Cost of Care All-Payer Model contract with the Federal Government that is designed to coordinate care for patients across both hospital and non-hospital settings, improve health outcomes, and constrain the growth of health care costs in Maryland. A key element of the model is the development of a voluntary Maryland Primary Care Program (MDPCP), designed to support the delivery of advanced primary care throughout the state to improve health outcomes, while controlling total health care spending growth. Importantly, MDPCP places a special emphasis on integrating behavioral health into the primary care setting.

MDPCP is being jointly developed by the Maryland Department of Health’s Program Management Office (PMO) and CMS’ Center for Medicare and Medicaid Innovation (CMMI).  The program presents an unprecedented opportunity to participate in care transformation for physicians, clinical nurse specialists, nurse practitioners, and physician assistants with a variety of specialty designations, including co-located Psychiatry.

Modeled after CMMI’s national Comprehensive Primary Care Plus Model​ (CPC+), participating practices would receive additional prospective payments from Medicare to make transformative changes to the way they deliver care. Practices would also receive technical assistance and data supports to accelerate transformation. In addition, the MDPCP has proposed the formation of Care Transformation Organizations (CTOs) that would provide care management resources, infrastructure, and technical assistance to practices.

The State anticipates the start-up of the MDPCP in January 2019, pending federal approval.  Consequently, we would like to request your assistance with disseminating information about MDPCP to potentially eligible Psychiatric practices in Maryland.  Current educational resources that can help practices prepare for the program, as well as a schedule of upcoming in-person and online presentations, are available on our website at https://health.maryland.gov/MDPCP.

For an overview of the key elements of the program, please click here. A two-page summary is available here.  Applications are expected to be released this month and the application period for practices is open until the Fall.  If you have any questions, please contact Alice Sowinski-Rice at mdh.pcmodel@maryland.gov.

Chad Perman, Project Manager, Primary Care Program

Maryland Department of Health Public Health Services

Update:  As of the August 31 deadline, nearly 600 practice sites, representing over 2,200 clinicians, had submitted applications to participate in the Maryland Primary Care Program (MDPCP) for 2019.

Implement Integrated Care

The APA website offers help for learning how to implement integrated care, including the Collaborative Care Model.  The information includes reimbursement for the model and funding opportunities available.  APA’s Support and Alignment Network and the Advancing Integrated Mental Health Solutions (AIMS) Center, in collaboration with the Institute for Family Health, created a Financial Modeling Workbook that helps practices more accurately:

  • Estimate visit volume and the number of patients served;
  • Define and analyze how much time staff engage in key integrated care tasks; and
  • Estimate fee-for-service and G-code potential revenues

To assist with questions, the APA offers monthly office hours on Wednesdays from noon to 1 PM on the following dates:  June 6, July 11, August 1 and others through fall 2018.  If you have questions, please contact SAN@psych.org.

Getting Paid for Psychiatric Collaborative Care Services

APA On Demand Archived Webinar: This free webinar provides coding and documentation requirements that enable primary care practices providing psychiatric collaborative care services to bill appropriately.