Maine Community ACO
Program Location:
Augusta, ME
Payer Type:
Medicare
Partner Organizations:
Maine Primary Care Association
Collaborative Health Systems (CHS)
9 FQHCs's
Parent Program:
Payers:
Medicare
Reported Outcomes
Description:
The Centers for Medicare & Medicaid Services (CMS) has established a Medicare Shared Savings Program (Shared Savings Program) to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs. Eligible providers, hospitals, and suppliers may participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO). The Shared Savings Program is designed to improve beneficiary outcomes and increase value of care by:
- Promoting accountability for the care of Medicare FFS beneficiaries
- Requiring coordinated care for all services provided under Medicare FFS
- Encouraging investment in infrastructure and redesigned care processes
The Shared Savings Program will reward ACOs that lower their growth in health care costs while meeting performance standards on quality of care and putting patients first.
Payment Model:
For an ACO’s first performance year, the repayment mechanism must be equal to at least 1 percent of its total per capita Medicare Parts A and B fee-for-service expenditures for its assigned beneficiaries, as determined based on expenditures used to establish the ACO’s benchmark (§425.204(f)). CMS estimates the amount of the ACO’s initial repayment mechanism based on available historical data, and will give this estimate to the ACO around the time CMS accepts its application.
To continue to participate in the program, each Track 2 ACO must annually demonstrate the adequacy of its repayment mechanism before the start of each performance year in which they take risk (§425.204(f)(3)). The repayment mechanism for each performance year must be equal to at least 1 percent of the ACO’s total per capita Medicare Parts A and B fee-for-service expenditures for its assigned beneficiaries, as determined based on expenditures for the ACO’s most recent performance year. Before the start of the next performance year, CMS will give Track 2 ACOs an estimate of the amount of the repayment obligation for which they must establish a repayment mechanism for the upcoming performance year.
Improved Patient/Clinician Satisfaction:
CCPM performed well in patient/caregiver experience, which is assessed through random surveys of Medicare members for the 2016 performance year.
Cost Savings:
- $1,902,705 in total accrued savings, but program did not save enough to qualify for federal shared savings payment
-
For the 2016 performance year, CCPM achieved $4.3 million in total savings for Medicare, with $2.1 million in shared savings returning to CCPM and its member organizations – all of which are federally qualified health centers or critical access and community hospitals who are collectively committed to improving the quality and effectiveness of health care delivery and reducing unnecessary healthcare costs.
Increased Preventive Services:
In the areas of preventive care and the treatment of at-risk populations with chronic disease, CCPM performed better than the mean performance rate of all participating MSSP ACOs for 14 out of 17 metrics.
Last updated March 2019
