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ACO Public Reporting

What is an Accountable Care Organization (ACO)?

ACO’s, while still evolving, are designed 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:

  • Patient-centered primary care medical homes that coordinate with other providers.
  • Aligned networks of specialists, ancillary providers and hospitals focused on outcomes.
  • Explicit care integration, transition of setting coordination and quality tracking and reporting.
  • Payor provider partnership relationships and financial reimbursement models identified under healthcare reform that facilitate and reward high value, not just high volume, healthcare.
  • Population health information infrastructure to enable community-wide care coordination.

Why create an ACO?

Accountable Care Organizations (ACOs) are widely viewed as a way to transform healthcare delivery to address these concerns simultaneously.

Want More Information About ACO’s?

For general questions or additional information about Accountable Care Organizations, please visit http://www.medicare.gov/acos.html or call
1-800 MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

What is CMACO’s approach to ACO’s ?

CMACO believes that our growing integrated healthcare system of three hospitals and 400 clinicians, along with local and regional partners, position us well to use the Shared Savings Program to help finance and drive further improvements in our long standing commitment to transform our care model to improve how we serve the 400,000 people living in Central & Western Maine by:

Taking a close look at the various current and emerging Shared Savings Programs including … Medicare “Shared Savings ACO” and Medicare Innovation Center options including the “Bundled Payment Options” which promote quality improvement and cost increase moderation incentives with a sharing of realized financial savings.
Convene groups of clinicians, administrate team members and patients to help guide our approach to achieving the “Three Part Aim” for defined populations.

What is the composition of ACO’s?

It is a contractual arrangement between hospitals and ACO professionals (physicians, home health providers, behavorial health providers, etc.).

Central Maine ACO Public Reporting

ACO Name and Location

Central Maine ACO (Accountable Care Organization)
CMS designation CMACO A1080
29 Lowell Square
Lewiston, Maine 04240

ACO Primary Contact

Jim Kane, President Central Maine ACO
kanej@cmhc.org
207-795-2953

Organizational Information

ACO Participants

Stephen R Barter MD
Bridgton Hospital
Central Maine Medical Center
Rumford Hospital
Central Maine Clinical Associates Corporation
Rumford Community Family Health Center Elsemore Dixfield Family Medicine
Rumford Community Family Health Center River Valley Internal Medicine
Rumford Community Family Health Center Swift River Family Medicine
Parkview Medical Associates, PA
Freeport Medical Center
DFD Russell Medical Center Inc
Androscoggin Home Health Services, Inc.
Rumford Community Home Corp.
Paul Wooden, MD
Jean Antonucci, MD
Stephen Bien, MD
Virginia Lanoce, NP
Knapp Family Practice, LLC
Jeffrey Fuson, MD

ACO Participants in Joint Ventures between ACO Professional and Hospitals

No participants are involved in a joint venture between ACO professionals and hospitals.

ACO Governing Body

  • Douglas Boyd, Voting Member and Chairperson, ACO Participant, Central Maine Medical Center
  • Vacant, Voting Member and Vice-Chairperson, ACO Participant, Rumford Community Home Corp.
  • Jeff Brickman, Voting Member, ACO Participant, Rumford Hospital
  • David Thompson, Voting Member, ACO Participant, Bridgton Hospital
  • Richard Goldstein MD, Voting Member, ACO Participant, Central Maine Medical Center
  • Laurie Kane-Lewis, Voting Member, ACO Participant, DFD Russell Medical Centers
  • Vacant, Voting Member, ACO Participant, Androscoggin Home Health Services
  • Behzad Fakhery MD, Voting Member, Medicare Beneficiary Representative
  • Jim Kane, Non-Voting Member, ACO President

Key ACO Clinical and Administrative Leadership

  • ACO Executive: Mr. Jim Kane
  • Medical Director: Dr. John Dickens
  • Compliance Official: Ms. Jennifer Crichton
  • Quality Assurance/Improvement Officer: Ms. Patty Roy

Associated Committees and Committee Leadership

  • ACO Operations, Quality Assurance and Improvement Committee: Dr. Dervilla McCann, Co-Chair, Jim Kane Co-Chair
  • Compliance Committee: Ms. Jennifer Crichton, Chair

Types of ACO Participants or Combination of Participants that Formed the ACO

  • ACO professionals in a group practice arrangement,
  • Networks of individual practices of ACO professionals,
  • Partnerships or joint venture arrangements between hospitals and ACO professionals,
  • Hospital employing ACO professionals,
  • Critical Access Hospital (CAH) billing under Method II,
  • Federally Qualified Health Center (FQHC),
  • Rural Health Clinic (RHC)

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Agreement period beginning 2012, Performance Year 1: $0
  • Agreement period beginning 2012, Performance Year 2014: $0
  • Agreement period beginning 2012, Performance Year 2015: $0

Shared Savings Distribution

  • Agreement period beginning 2012, Performance Year 1: $0
  • Agreement period beginning 2012, Performance Year 2014: $0
  • Agreement period beginning 2012, Performance Year 2015: $0

Payment Rule Waivers

No, our ACO does not utilize the SNF 3-Day Rule Waiver

Quality Performance Results

2015 Quality Performance Results Table

 

Measure number

 

Measure Name

2015 reporting period
ACO
performance
rate
Mean
rate
(SSP- ACOs)
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 81.96 80.61
ACO-2 CAHPS: How Well Your Providers Communicate 93.85 92.65
ACO-3 CAHPS: Patients’ Rating of Provider 92.57 91.94
ACO-4 CAHPS: Access to Specialists 85.32 83.61
ACO-5 CAHPS: Health Promotion and Education 64.48 59.06
ACO-6 CAHPS: Shared Decision Making 76.29 75.17
ACO-7 CAHPS: Health Status/Functional Status 73.78 72.30
ACO-34 CAHPS: Stewardship of Patient Resources* 29.11 26.87
ACO-8 Risk Standardized, All Condition Readmission 14.48 14.86
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)* Readmission 18.70 18.07
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes* 53.08 54.60
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure* 79.59 76.96
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 64.52 62.92
ACO-9 Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary

Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)

0.94 1.11
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention

Quality Indicator (PQI) #8)

0.95 1.04
ACO-11 Percent of Primary Care Physicians who Successfully Meet Meaningful Use Requirements 99.44% 80.14%
ACO-39 Documentation of Current Medications in the Medical Record* 96.14% 84.07%
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up 93.12% 71.15%
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 98.79% 90.16%
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 74.46% 45.25%
ACO-19 Colorectal Cancer Screening 78.23% 60.06%
ACO-20 Breast Cancer Screening 87.10% 65.67%
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented 91.53% 70.04%
ACO-40 Depression Remission at Twelve Months* N/A N/A
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 14.52% 20.38%
ACO-41 Diabetes: Eye Exam* 80.65% 41.05%
ACO-28 Hypertension: Controlling High Blood Pressure 78.63% 69.62%
ACO-30 Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic 91.13% 83.82%
ACO-31 Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction    (LVSD) 92.45% 87.22%
ACO-33 Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) 89.06% 77.73%
CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

*= Measure required beginning Reporting Year 2015.

N/A= Reporting on the depression remission measure is not required for 2015, as indicated by N/A

 

 

2012-2014 Quality Performance Results Table

 

Measure number Performance measure 2012 reporting period 2013 reporting period 2014 reporting period
ACO performance rate Mean performance rate for all ACOs ACO performance rate Mean performance rate for all ACOs ACO performance rate Mean performance rate for all ACOs
ACO-1 Getting Timely Care, Appointments, and
Information
Optional Optional Optional Optional 87.09 80.13
ACO-2 How Well Your Doctors Communicate Optional Optional Optional Optional 94.25 92.39
ACO-3 Patients’ Rating of Doctor Optional Optional Optional Optional 93.59 91.58
ACO-4 Access to Specialists Optional Optional Optional Optional 84.22 83.97
ACO-5 Health Promotion and Education Optional Optional Optional Optional 62.20 58.29
ACO-6 Shared Decision Making Optional Optional Optional Optional 75.32 74.60
ACO-7 Health Status/Functional Status Optional Optional Optional Optional 74.67 71.10
ACO-8 Risk Standardized, All Condition
Readmissions
15.36 15.42 14.20 14.90 15.13 15.15
ACO-9 ASC Admissions: COPD or Asthma in
Older Adults
0.93 1.13 1.21 1.17 0.95 1.08
ACO-10 ASC Admission: Heart Failure 1.09 1.09 1.14 1.20 1.11 1.19
ACO-11 Percent of PCPs who Qualified for EHR Incentive Payment 11.82% 25.70% 51.95% 66.21% 77.54% 76.71%
ACO-12 Medication Reconciliation Optional Optional Optional Optional 98.65% 82.61%
ACO-13 Falls: Screening for Fall Risk Optional Optional Optional Optional 80.96% 45.60%
ACO-14 Influenza Immunization Optional Optional Optional Optional 90.28% 57.51%
ACO-15 Pneumococcal Vaccination Optional Optional Optional Optional 86.36% 55.03%
ACO-16 Adult Weight Screening and Follow-up Optional Optional Optional Optional 87.29% 66.75%
ACO-17 Tobacco Use Assessment and Cessation
Intervention
Optional Optional Optional Optional 97.32% 86.79%
ACO-18 Depression Screening Optional Optional Optional Optional 81.40% 39.27%
ACO-19 Colorectal Cancer Screening Optional Optional Optional Optional 77.97% 56.14%
ACO-20 Mammography Screening Optional Optional Optional Optional 80.00% 61.41%
ACO-21 Proportion of Adults who had blood pressure screened in past 2 years Optional Optional Optional Optional 81.72% 60.24%
ACO-22 Hemoglobin A1c Control (HbA1c) (<8 percent) Optional N/A Optional N/A 73.87% N/A
ACO-23 Low Density Lipoprotein (LDL) (<100 mg/dL) Optional N/A Optional N/A N/A N/A
ACO-24 Blood Pressure (BP) <140/90 Optional N/A Optional N/A 76.25% N/A
ACO-25 Tobacco Non Use Optional N/A Optional N/A 81.24% N/A
ACO-26 Aspirin Use Optional N/A Optional N/A 91.72% N/A
ACO-27 Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent) Optional Optional Optional Optional 13.19% 20.35%
ACO-28 Percent of beneficiaries with hypertension whose BP <140/90 Optional Optional Optional Optional 72.09% 68.02%
ACO-29 Percent of beneficiaries with IVD with complete lipid profile and LDL control
<100mg/dl
Optional Optional Optional Optional N/A N/A
ACO-30 Percent of beneficiaries with IVD who use
Aspirin or other antithrombotic
Optional Optional Optional Optional 96.84% 80.79%
ACO-31 Beta-Blocker Therapy for LVSD Optional Optional Optional Optional 100.00% 82.71%
ACO-32 Drug Therapy for Lowering LDL Cholesterol Optional N/A Optional N/A N/A N/A
ACO-33 ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD Optional N/A Optional N/A 93.71% N/A

Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease,, EHR = electronic health record, IVD = ischemic vascular disease, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.