Maine

Maine has had an impressive history and continued commitment to improve the health of its citizens through strengthening its system of primary care across the State. In the fall of 2007, the Maine Legislature convened the Commission to Study Primary Care Practice to examine the issues facing primary care and ways to stabilize and support it. In the 2008-2009 State Health Plan, the Governor’s Office for Health Policy and Finance identified the need to promote primary care as the foundation for our state’s health system.

Formed in 2003 and incorporated in 2006, Maine Quality Counts (QC) has provided leadership, advocacy and support for improving primary care in partnership with the State through several multi-stakeholder initiatives including PCMH learning collaboratives, a Multi-payer Advanced Primary Care Practice program, Coordinated Care Teams, Quality Counts for Kids, and Integrated Behavioral-Physical Health, to name a few. Maine Quality Counts, as one of the State’s designated partners in the State Innovation Model (SIM) Initiative, is working to ensure all State health improvement measures build upon the success of these and other established PCMH programs. Quality Counts is leading the learning collaborative to implement the new Maine Behavioral Health Home Initiative. 

CHIPRA: 
Yes
MAPCP: 
Yes
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
No
Private Payer Program: 
Yes
State Facts: 
Population:
1,312,200
Uninsured Population:
10%
Total Medicaid Spending FY 2013: 
$2.9 Billion 
Overweight/Obese Adults:
64.8%
Poor Mental Health among Adults: 
34.2%
Medicaid Expansion: 
No

Maine Rolls Back Health Coverage Even As Many States Expand It

on Sun, 2014-09-14 00:00   lisabeth

 By the time Laura Tasheiko discovered the lump in her left breast, it was larger than a grape. Tasheiko, 61, an artist who makes a living selling oil paintings of Maine’s snowy woods, lighthouses and rocky coastline, was terrified: She had no health insurance and little cash to spare.

Story Date: 
September 14, 2014
News Author: 
Roni Caryn Rabin
Source Link: 
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MaineHealth ACO

Through the Shared Savings Program, the MaineHealth Accountable Care Organization will work with CMS to provide Medicare fee-for-service beneficiaries with high quality service and care, while reducing the growth in Medicare expenditures through enhanced care coordination.

An effective Shared Savings Program includes:

Central Maine ACO

ACO’s, while still evolving, are expected to connect groups of providers who are willing and able to take responsibility for improving the health status,efficiency and experience of care the “Three Part Aim” for defined populations.   

An effective Shared Savings Program will include:

Maine Community ACO

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:

Primary-care practices across Maine take a new approach to help patients and reduce costs

on Mon, 2014-05-05 00:00   staci

As an internist, Dr. Carl DeMars specializes in solving puzzling diagnostic problems. For the last three years, as the medical director of Mid Coast Health Services' Accountable Care Organization, he's been practicing that skill in the arena of health care policy as an advocate for a new approach to primary care known as the "patient-centered medical home."

Story Date: 
May 5, 2014
News Author: 
James McCarthy
Source Link: 
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Maine Patient-Centered Medical Home Pilot

The Maine Patient-Centered Medical Home Pilot was launched in January of 2010 and is led by the Dirigo Health Agency’s Maine Quality Forum (MQF), Maine Quality Counts, and the Maine Health Management Coalition with additional funding from an RWJ Foundation Aligning Forces for Quality grant. The Pilot includes 26 primary care practices from around the state that are working to implement the PCMH model as a first step in ultimately achieving the goal of statewide implementation of a patient centered medical home model.

Enhanced Personal Health Care Program - Maine

The Enhanced Personal Health Care Program empowers primary care physicians (PCPs) to engage in comprehensive primary care functions that move toward a coordinated, evidence-based care model that has the greatest impact on achieving the triple aim of improved quality, patient experience and affordability.  

This Program:  

Cigna Collaborative Accountable Care ACO - Martin’s Point Health Care and Mercy Health System

Cigna launched a collaborative accountable care initiative with Martin's Pointh Health Care (a primary care medical practice in Bangor, Portland and other Maine communities, plus Portsmouth, N.H.) and Mercy Health System (a comprehensive health care delivery organization with locations throughout greater Portland) to improve patient accessto health care, enhance care coordination and achieve the “triple aim” of improved health, affordability and patient experience. The program became effective in 2012. 

Cigna Collaborative Accountable Care ACO - Kennebec Region Health Alliance

Cigna and Kennebec Region Health Alliance, a large physician hospital organization (PHO) affiliated with MaineGeneral Medical Center, have launched a collaborative accountable care initiative to improve patient accessto health care, enhance care coordination and achieve the “triple aim” of improved health, affordability and patient experience. The program became effective in 2012. 

Cigna Collaborative Accountable Care ACO - Central and Western Maine Regional PHO

Cigna and Central and Western Maine Regional PHO, a physician hospital organization in Lewiston, Farmington and other central Maine towns that’s affiliated with Central Maine Health and Franklin Community Health Network, have launched a collaborative accountable care  initiative to improve patient accessto health care, enhance care coordination and achieve the “triple aim” of improved health, affordability and patient experience. The program became effective January 1, 2013.

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