Primary Care

Primary Care Plus (PCPlus) - Formerly the PCP 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)

PCPlus Application

The PCPlus Application is now open for primary care providers that want to apply to this program. See the PCPlus application Provider Form (PDF) to view the questions before completing the electronic form.

The Community Health Worker (CHW) Environmental Scan Guide and Template (Word) provides guidance for providers in submitting the CHW Environmental scan, which is part of the PCPlus application.

PCPlus Presentations

For an overview of the PCPlus program, see the following presentations:

Performance Based Adjustment (PBA)

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

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

Questions? 

Email the PCCM Unit for questions.