Outcomes and Evaluation

Quality and Utilization Measures

Practices participating in the MMPP span the entire range of primary care delivery in Maryland, including large and small physician-owned practices, sole physician and nurse practitioner practices, health system-owned practices, and community health centers. The amount of shared savings a practice can earn is based on the level of quality reporting and degree of overall savings achieved by a practice site.

First Year Highlights

  • In addition to shared savings, all participating practices received $2.1 million to deliver a more advanced form of primary care;
  • On average, the 22 practices that earned shared savings received bonus payments of about $36,500; and
  • A total of 50 of the 52 practices reported quality metrics extracted from the electronic health record systems. These metrics are nationally recognized measures for appropriate use of health care services and effectiveness of care.

Second Year Highlights

  • Every MMPP practice received up-front FTP; making a total of approximately $4.4M in 2012 for commercial payers;
  • Nearly half of MMPP practices generated savings (19 of 52);
  • No single variable currently tracked by the program (such as location, size, quality measure composite score, etc.) correlated to cost savings; and
  • Approximately 10 percent improvement over the last two years in the quality measure composite score.

Program Evaluation

The MHCC is interested in learning whether the MMPP can improve health care quality while reducing costs of care.  The MHCC is planning to assess the practice transformation process and benefits received by practices from shared savings. External evaluators -- IMPAQ International and its partners, Johns Hopkins, Health Care Resolution Services, and University of Maryland -- are analyzing the MMPP to assess the process and outcomes of transforming practices into medical homes.

The evaluators are using a pre/post, mixed methods evaluation design that consists of three parts:  (1) access quality, utilization, disparities and cost outcomes, using administrative data;  (2) implementation and practice transformation, using interviews, site visits, and administrative data; and  (3) satisfaction among patients and providers, using existing survey instruments.  Evaluators will also hypothesize that participating practices:  improve access to and increase the quality of care;  increase patient, provider, and staff satisfaction;  reduce health disparities;  decrease the utilization of costly services; and  lower payor costs of care.  The evaluation tools are located at the following links:

 Self-Reported Quality Measures
 Shared Savings Available Based on the Attainment of Performance Criteria