Introduction

NOTE: Please be aware that ONLY ONLINE submissions of this application will be accepted.

This application is for MaineCare primary care practices interested in participating in MaineCare's primary care Health Home program. Providers with more than one location must complete a separate application for each location, or NPI+3 (National Provider Identifier plus 3-digit site indicator). The primary care Health Home (HH) program is open to both adult and pediatric qualified practices.
 
Providers interested in applying must complete this online application by Friday, December 11, 2020. Implementation for new practices in the HH program will occur no sooner than Thursday, January 21, 2021. 
 
Please be advised that the achievement and maintenance of National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) recognition is a requirement of MaineCare Benefits Manual (MBM), Chapter II, Section 91, Health Home Services, for participating HH providers. In order for this application to be processed, providers must, at a minimum, have already submitted their application for NCQA PCMH recognition.

MaineCare Health Home Program

The HH program is a key component of the Maine Department of Health & Human Services’ Value-Based Purchasing (VBP) strategy.  There are currently approximately 170 primary care practices participating in the HH program.

In the HH model, HH practices partner with a Community Care Team (CCT) to serve MaineCare members with specified chronic conditions. MaineCare reimburses a $12 per member, per month payment to these HH providers and an additional payment to CCTs to provide comprehensive, coordinated care to eligible MaineCare members. 

For HH members served through MBM, Chapter II, Section 92, Behavioral Health Home Services, HH practices partner with a community mental health organization enrolled as a Behavioral Health Home (BHH) organization, to serve adults with serious mental illness and/or children with serious emotional disturbance. The Health Home practice receives a $15 per member, per month payment and the BHH receives an additional payment for providing comprehensive, coordinated care to eligible MaineCare members.

Please note that, in the summer/fall of 2021, the Department will be implementing a new primary care model, which will combine many elements and funding from Health Homes, Primary Care Case Management, and the Primary Care Provider Incentive Payment. At that time, the VBP team will work directly with new and existing  Health Home practices during the transition. For more information about this primary care transition, please go to the Value-Based Purchasing primary care page for a high-level PowerPoint presentation.

For additional HH program information, visit the MaineCare VBP website at http://www.maine.gov/dhhs/oms/vbp/.

Thank you for your interest in the MaineCare HH program.

Value-Based Purchasing Unit
MaineCare Services

T