May 24, 2018
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$28 million grant to Maine to focus on improved primary care

By Maxwell Mogensen, Sun Journal

LEWISTON, Maine — Maine has been selected, along with seven other states, to receive federal funds specifically earmarked for improving and enhancing the state’s primary health care system.
The state will get about $28 million over the next three years in the form of increased Medicare fees, which will be paid to practices and hospitals participating in Maine’s Primary Care Medical Home pilot program.
Nancy Morris, communications and member relations manager for the Maine Health Management Coalition, said the Medical Home program is already active in 26 practices and hospitals throughout the state, including DFD Russell Medical Centers in Turner. The program focuses on enhanced primary care, sustained communication between physicians and patients, and better resolution of issues facing patients, Morris said.
“We’re trying to redesign primary care to make it more patient-centered,” she said.
The current system combines primary care with specialized care and patients are often forced to change doctors as their insurance provider changes. But the Medical Home program integrates consistent visits with primary care providers, access to patient information, communication and follow-up between patients and their care providers. It provides troubleshooters within each Medical Home to resolve issues that inhibit patients’ improvements, such as a lack of access to low-cost prescription drug programs.
The new system represents a way to give patients the care they need, “right when they need it … and the sort of care that doctors want to be giving,” Morris said. “We hope it will bring back the joy of primary care.”
This enhancement of patient-centered primary care means an increased cost on the front end, according to a statement released Tuesday by the Maine Health Management Coalition.
The program requires increased costs for, among other things, reimbursing doctors for following up with their patients (often neglected by the current system), as well as creating new positions for troubleshooters within practices. However, according to Morris, the initiative is being considered “cost neutral” by the Medicare directors who will ultimately pay out the $28 million over the next three years.
By “addressing problems more successfully initially,” she said, the hope is that money will be saved in the long term. The money will be paid out in the form of increased fees, on behalf of Medicare beneficiaries.
The funding of the Medical Homes program represents the first act of the newly created Centers for Medicare and Medicaid Services, a division of the U.S. Department of Health and Human Services.
“They wanted to support those things that were already working well,” Morris said.
The Maine Health Management Coalition collects and publishes data on health services. Among its goals, Morris said, is the promotion of “evidence-based care.” Over the next three years, the coalition will review the Medical Homes program to determine its effectiveness.
“We think that more and more practices are going to move to this,” she said.
Maine, along with Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan and Minnesota, won “a vigorous competition” in its selection to participate in this initiative, according to the statement released by the coalition. The application was submitted by the Maine Quality Forum, part of the Dirigo Health Agency.
It was completed in conjunction with the coalition, which is a group of employers, unions, doctors, health plans and hospitals working together to improve the value of Maine health care, according to material submitted by the organization. Other organizations were also involved in the application process, including Quality Counts, an independent organization that works to improve health care in Maine.
Morris credited Maine’s current health-care culture with its successful bid to participate in the initiative.
“We had to show that we were already (making improvements),” she said, including working with employers and payers to develop the Medical Home pilot program. Among the groups already committed to the program, Morris mentioned Anthem, Aetna, Harvard Pilgrim, the Maine State Teachers Union and the University of Maine.
Distributed by McClatchy-Tribune Information Services.

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