C.M.R. 10, 144, ch. 101, ch. VI, 144-101-VI-03, subsec. 144-101-VI-0301
Primary Care Plus (PCPlus) is a model that gives Primary Care Providers (PCPs) greater flexibility and incentives to effectively meet MaineCare members' health care needs by transitioning away from a volume-based (fee-for-service) payment system with little connection to value, toward an approach that provides Population-Based Payments (PBPs) tied to cost- and quality-related outcomes. Participation in PCPlus is voluntary for PCPs. For PCPs that elect to participate, the Maine Department of Health and Human Services (Department) shall share quality and utilization data, offer a value-based payment model, and provide technical assistance to help practices transform care delivery and achieve performance outcomes.
Member participation in this model is voluntary, is based on members' selection of a PCP, and has no bearing on MaineCare members' freedom of choice to access services from any qualified MaineCare provider. Section 1905(t)(1) of the Social Security Act ( 42 U.S.C. § 1396d(t)(1) ) provides the federal statutory authority for PCPlus.
C.M.R. 10, 144, ch. 101, ch. VI, 144-101-VI-03, subsec. 144-101-VI-0301