Delivery System Reform

The Maine Department of Health and Human Services (DHHS) and the Office of MaineCare Services (OMS) are committed to improving health care access and health outcomes for MaineCare members, demonstrating cost-effective use of resources, and creating an environment where providers can innovate and collaborate in delivering high-quality care. To ensure we continue moving toward this goal, DHHS and OMS set a goal to have at least 40 percent of MaineCare payments paid through Alternative Payment Models (APMs) by the end of 2022 [Specifically, APMs that meet the criteria for Category 2C “Pay for Performance” or higher of the HCPLAN framework].

An APM is a health care payment method that uses financial incentives to raise the quality of care, improve health outcomes, and lower costs for patients, purchasers, payers, and providers.  In concert with other strategies, APMs are key tools to advance policies that improve the quality and value of health care.

Maine is utilizing the Health Care Payment Learning & Action Network (HCPLAN) framework for assessing progress toward this goal. HCPLAN is a national organization comprised of public and private health care leaders which maintains the most commonly used framework for aligning APM design and classification. To learn more about APMs, please visit the Health Care Payment Learning & Action Network at

Example initiatives

MaineCare’s delivery system reform initiatives include, but are not limited to:

  • Accountable Communities
  • Behavioral Health Homes
  • Certified Community Behavioral Health Clinics
  • Community Care Teams
  • MaineMOM
  • Opioid Health Homes
  • Primary Care Plus

For questions, please contact 

Methodology Documents

Proposed Performance Measures for Value-Based Purchasing Supplemental Pool (PDF)