Document Type

Working Paper

Publication Date



Cutler Institute, Population Health and Health Policy, USM Aging Initiative, Health and Wellness


The purpose of this Maine Patient Centered Medical Home (PCMH) Pilot is to improve quality of care, efficiency, and patient/family satisfaction provided by primary care practices. Its premise is that the resources provided to practices through the Pilot (including enhanced payments, training, consultation, and learning collaborative) will help them transform themselves and reach a higher level of functionality as medical homes, which in turn will lead to improvements in quality of care, efficiency, and patient/family satisfaction. The three-year Pilot was convened by MaineCare, the Maine Quality Forum, and Quality Counts. The participating payers are MaineCare (Maine Medicaid), Aetna, Anthem, and Harvard Pilgrim Health Care.

Three aspects of the Pilot are being evaluated by the Muskie School of Public Service: 1) patient’s experiences; 2) the implementation process and interim results during Year 1; and 3) changes in the quality and efficiency of primary care. This report focuses on findings from the implementation evaluation.

A national evaluation of a PCMH demonstration concluded that several factors, including practices’ workplace culture and resilience (or “adaptive reserve,” including communication, leadership, learning culture, teamwork and work environment) were major determinants in the degree to which practices could transform themselves into medical homes. The implementation evaluation describes the processes the Pilot practices engaged in during the first year and profiles adaptive reserve and several other factors that may contribute to their success in achieving the Pilot’s objectives.

The objectives of the implementation evaluation are to

  • Profile the characteristics of the Pilot practices
  • Describe the practices’ objectives and strategies for implementing the Pilot
  • Describe the implementation process during Year 1
  • Provide practical guidance to the practices, the Pilot conveners, and MaineCare
  • Develop profiles of the Pilot practices for use in the quality and efficiency evaluation
  • Make recommendations for use by evaluators of other PCMH pilots


The views expressed here are those of the authors and not necessarily those of the funders, the Pilot conveners, or the Pilot practices.

Funding Organization

This evaluation was funded by the Davis Family Foundation, MaineCare (Maine Medicaid), and the University of Southern Maine.



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