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Our Model of Care

JMAP strives to bring the best of Johns Hopkins Medicine to every point in the care continuum and to provide the right care for the right patient at the right place and at the right value. We do this by focusing our efforts in the key areas proven to be essential for successful population health management. 

If you are a JMAP provider, visit our JHBox site for more information about resources specifically available at your site. 

Our Model of Care Pillars

Click on the plus sign to see the description of each pillar.

1) Begin with the patient, family, and caregivers at the center
Our model begins by assessing the needs of each individual patient and their families, and matching them with key additional resources and services necessary to achieve their optimal state of health. These value-added services are explained in greater depth. JMAP also offers support services for caregivers.
2) Add renowned doctors and hospitals
We are lucky to have renowned physicians at Johns Hopkins and from its earliest beginnings. JMAP has also had primary care practices as partners, including Columbia Medical Practice and Potomac Physician Associates. When patients need specialty care or hospital care, JMAP's access specialists ensure that the patient can be seen promptly at the appropriate point of care within the Johns Hopkins Medicine network.
3) Support physicians with a care team designed to meet their patients' needs
In order to provide the value-added services, JMAP uses a team-based approach to care that integrates the efforts of several care team members in support of primary care physicians and their usual clinical and administrative support staff. These additional care team members may be available in person or telephonically, depending on the number of JMAP patients at the practice in question and individual patient needs. Examples include care coordinators, community health workers, behavioral health specialists, and population health pharmacists.
4) Get everyone to work smarter using technology to determine what's working and how to improve care
JMAP has assembled what we believe is the most advanced population health IT platform in the industry. All JMAP physicians have access to an electronic health record, which allows all members of the care team to collaborate in an efficient manner to ensure high quality, high value, tightly coordinated care for our patients. Our ACO partners use different information systems, but in each instance, we co-invest in the process and technology needed to ensure that our care teams are able to collaborate effectively on behalf of Medicare patients throughout the JMAP network. Finally, we leverage a variety of tools made available by Chesapeake Regional Information System for our Patients (CRISP), Maryland's Health Information Exchange, in order to ensure that population-based interventions are informed by real-time data from health systems throughout the state.
5) Incorporate input from our patients to continuously improve

JMAP has created a Beneficiary Advisory Council (BAC), a volunteer group of JMAP patients that reflects the diversity of our Medicare patient population. The BAC assists in meeting our goals to improve the quality and value of care by reviewing policies, advising on educational materials, and contributing patients’ views at JMAP meetings. JMAP works to identify ways to elevate the voice of patients, their families, and caregivers in the care process. 

The BAC welcomes input, suggestions, and feedback from the whole JMAP patient, family, and caregiver community to better achieve its purpose. To provide your input or for more information on how to get involved with the BAC, please email jmap@jhmi.edu. We ask that you please direct any patient care concerns or questions directly to your provider.