Maryland Quality Innovation Program (M-QIP), a Medicaid Managed Care Value-Based Physician Supplemental Payment Program

Case Study Details:
University of Maryland’s Faculty Physicians, Inc.
Baltimore, MD

University of Maryland’s Faculty Physicians, Inc. (FPI) wanted to change how they delivered care in West Baltimore. FPI worked with Sellers Dorsey to develop M-QIP, a Medicaid directed payment program designed to drive better outcomes for FPI’s Medicaid patients. This innovative, CMS-approved program, now in its second year, aligns with Maryland Department of Health’s (MDH) quality improvement goals and generates additional Medicaid funding to enable FPI to transform its physician practice into a fully integrated “medical neighborhood” to deliver quality healthcare for West Baltimore communities.

Program Focus

The Sellers Dorsey team has worked with FPI and MDH over the course of four years to address:

  • Limited access to primary and specialty preventive care
  • Higher costs of care due to increased utilization of both emergency department and hospital services
  • Treatment delays resulting in exacerbation of conditions
  • Suboptimal health outcomes

By supplementing Medicaid reimbursement levels, M-QIP works to drive better population health outcomes.

Emerging Impacts

The expansion of services made possible through M-QIP is having the following impacts in West Baltimore:

  • Preventing over 100 avoidable emergency department visits per year. Saving over $1.2M annually in avoidable admission costs
  • Increasing access to resources for those struggling with addiction. Improving access to specialty care for both pediatric and adult patients. Enhancing integration with community resources to deliver care where the patients reside
  • To support successful implementation of the program, FPI has used funds generated as a result of the program to: Hire more than 25 staff members and allocate time from more than 10 current staff members and Provide over 400 hours of training

Program Creation

The Sellers Dorsey team collaborated with FPI and MDH to:

  • Design a transformative, value-based program
  • Educate key leaders on the approvability and design of the program
  • Create a flow of funds to establish the necessary programs for West Baltimore

Throughout the design process, Sellers Dorsey:

  • Worked closely with all stakeholders on the quality evaluation plan
  • Provided policy rationale on how M-QIP aligns with MDH’s other quality and strategic plans

Additionally, the Sellers Dorsey team worked closely with MDH to:

  • Support the CMS Approval process
  • Facilitate implementation

“The work of Sellers Dorsey has allowed us to continue to support our Medicaid patients. Prior to their help, we were struggling to make the finances work to support our programs.”
– Bill Tucker, Chief Corporate Officer, FPI