Comprehensive care management variation between rural and nonrural Maryland Primary Care Program (MDPCP) practices

Area of Science:

• Health Services Research
• Primary Care Medicine
• Rural Health

Background:

• Primary care management effectively serves high-needs patients.
• Rural Medicare beneficiaries face challenges accessing primary care despite higher chronic disease rates.
• The Maryland Primary Care Program (MDPCP) aims to enhance primary care and chronic disease management.

Purpose of the Study:

• To assess variations in MDPCP care management implementation between rural and nonrural primary care practices.
• To determine if rural practices provide different levels of care management comprehensiveness compared to nonrural practices.
• To analyze changes in care management comprehensiveness over time in rural versus nonrural settings.

Main Methods:

• Utilized Centers for Medicare and Medicaid Services (CMS) Claims and Claim Line Feed data from 2020-2023.
• Incorporated MDPCP data and care transformation requirement reports.
• Examined rural and nonrural differences in the comprehensiveness of primary care practice-based care management.

Main Results:

• Rural MDPCP primary care practices were associated with providing more comprehensive care management services than nonrural practices.
• Rural practices demonstrated a greater increase in the comprehensiveness of care management services over the study period.
• MDPCP implementation showed positive associations with rural primary care infrastructure and access to care management.

Conclusions:

• State-led Medicare demonstration programs like MDPCP can bolster rural primary care infrastructure.
• MDPCP facilitates increased access to essential care management services for rural populations.
• Findings highlight the potential for similar programs to address disparities in rural healthcare access.