Primary Care 2.0 Initiative
The goal of this value-based payment model is to simplify and integrate MaineCare's three primary care programs:
- Primary Care Case Management (PCCM)
- Primary Care Health Homes (HH)
- Primary Care Provider Incentive Program (PCPIP)
For detail about this initiative, see the following presentations:
- June 2021 Stakeholder Presentation (PDF)
- March 2021 Stakeholder Presentation (PDF)
- November 2020 Listening Session Presentation (PDF)
If you would like to provide feedback on the Primary Care 2.0 proposal, please take our survey If you missed the Provider Listening Session, please review the presentation above.
Primary Care Case Management (PCCM)
This program covers eligible MaineCare members, primarily those with full MaineCare benefits and MaineCare as their primary payer. Qualified primary care providers are always welcome to become PCCM providers.
Primary Objectives of PCCM
- Recognize through incentive payments high quality primary care providers
- Improve MaineCare members’ access to providers
- Have MaineCare members establish a “medical home”
- Increase continuity of care
- Strengthen the patient and provider relationship
- Reduce unnecessary utilization and expenditures
Overview of PCCM
Primary Care Provider Incentive Payment (PCPIP)
The PCPIP pays additional compensation to PCCM providers who deliver high quality healthcare and who rank above the 20th percentile for certain measures compared to other physicians within their specialty.
Goals of PCPIP
- Increase access of MaineCare members to providers
- Reduce unnecessary or inappropriate Emergency Department utilization
- Increase utilization of preventive/quality services
Incentives are paid to providers who practice primary care and whose primary specialty is Family Practice, General Practice, Pediatrics, Obstetrics/Gynecology, geriatric care, or Internal Medicine.
Primary Care Payment Increase
- 2019 August Attestation PCP Increase (PDF)
- Please contact Tia Bolduc, Provider Relations Specialist, with questions at (207) 624-6938.
Email the PCCM Unit for questions.