Maine Adopts New Primary Care Models to Improve Access
- Sep 19
- 2 min read
The healthcare infrastructure in Maine is undergoing a significant transformation, with the emergence of alternative service delivery models and key alliances focused on affordability and accessibility.
One of the most notable recent news items is the designation of Community Health Options (CHO), a Maine-based non-profit insurer, as the new administrator for MaineHealth's CarePartners program. CarePartners, launched in 2001, offers free or low-cost health care for low-income, uninsured adults who do not qualify for public programs. CarePartners members receive primary care services and access to specialists for a $10 co-pay, prescriptions for $10–$25, and no-cost hospital, lab, and X-ray services. CHO took over administration on September 3, providing enrollment cards that work similarly to health insurance cards. The use of these cards helps reduce the stigma of being uninsured and facilitates the processing of claims. MaineHealth views this collaboration as a vital community effort that aligns with its mission of "working together so our communities are the healthiest in America".
In parallel, the state is witnessing the growth of the Direct Primary Care (DPC) model, a medical practice that dates back to the 1950s. DPC clinics skip insurance entirely and bill patients directly through periodic payments, which allows them to be better positioned to withstand expected cuts to Medicaid. There are already at least 30 DPC clinics in Maine, more than half of which have opened in the last five years.
Providers like Brad and Alley Tuttle, who opened Apotheosis Health in Bangor, have capped their practices at approximately 500 patients (compared to the typical 1,500 at MaineHealth hospitals) to combat burnout and allow for longer visits, including 90 minutes for intake. In exchange for a monthly fee (e.g., $90 per individual), patients receive unlimited visits and 24/7 access to the medical team.
DPC growth occurs against a backdrop of serious concerns about the financial stability of hospitals and the projected national shortage of primary care physicians. Dr. Forbush, a DPC pioneer in Maine, notes that this model attracts patients who previously couldn't access primary care, including 80% of her patients who do not have health insurance.
Even MaineHealth is adopting similar membership models. It recently launched Trellis Health, a membership-based primary care service starting at $109 per month. This fee covers all appointments and care coordination with a multidisciplinary team, including a primary care physician, a behavioral health specialist, and a pharmacist, among others.
The expansion of Trellis Health also benefits from legislative changes; starting in January, patients with high-deductible health plans and direct primary care arrangements will be able to pay for services like Trellis Health through their Health Savings Accounts (HSAs).
While these innovations seek to alleviate frustration with the traditional system, challenges persist. Potential reductions of nearly $1 trillion in Medicaid spending could lead up to 31,000 people to lose their insurance in Maine, exacerbating the problem of Mainers resorting to emergency rooms for basic care, a significant issue already given that Maine has one of the highest rates of emergency department visits in the nation.
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