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 go to the following website 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)
300 Main Street
Lewiston, Maine 04240
ACO Primary Contact
| Contact Information | Name |
|---|---|
| Primary Contact Name | Jeff Buck, Executive Director, Managed Care, CMH |
| Primary Contact Phone Number | 207-795-2953 |
| Primary Contact Email Address | buckje2@cmhc.org |
Organizational Information
ACO participants:
| ACO Participants | ACO Participant in Joint Venture |
|---|---|
| Stephen R Barter MD | N |
| Bridgton Hospital | N |
| Central Maine Medical Center | N |
| DFD Russell Medical Center | N |
| Rumford Hospital | N |
| Androscoggin Home Health Services, Inc. | N |
| Central Maine Clinical Associates Corporation | N |
| Rumford Community Family Health Center Inc. | N |
| Parkview Medical Associates, PA | N |
| Jean Antonucci MD | N |
| Freeport Medical Center | N |
| Lewiston Operations Llc | N |
| Knapp Family Practice, Llc | N |
| Wilson Stream Family Practice, LLC, PA | N |
Key ACO clinical and administrative leadership:
| Name | Title |
|---|---|
| Jeff Buck | Executive Director, Managed Care, CMH |
| John Alexander, MD | Medical Director |
| Nicholas Snyder | Chief Compliance Officer |
| Dan Gell, RN | Quality Assurance/Improvement Officer |
Associated committees and committee leadership:
| Committee Name | Committee Leader Name and Position |
|---|---|
| ACO Operations, Quality Assurance and Improvement | Dan Gell, RN, Co-Chair Jeff Buck, Co-Chair |
| Compliance | Nicholas Snyder, Chair |
CMACO MSSP Governing Body:
| Last Name | First Name | Position in Governing Body | Member’s Voting Power | Membership Type | Business Name |
|---|---|---|---|---|---|
| Alexander | John | Director, Chairperson | 1 | ACO Participant | Bridgton Hospital |
| Albert | Ken | Director | 1 | ACO Participant | Androscoggin Home Healthcare & Hospice |
| Brickman | Jeff | Director | 1 | ACO Participant | Rumford Hospital |
| Cave | Cynthia | Director | 1 | ACO Participant | Marshwood Center |
| Knapp DO | Michelle | Director | 1 | ACO Participant | Knapp Family Practice |
| McCann MD | Dervilla | Director | 1 | ACO Participant | Central Maine Medical Center |
| Wright | Peter | Director | 1 | ACO Participant | Rumford Community Health Center |
| Burke | Mike | Director | 1 | ACO Participant | Tri-County Mental Health Services |
| Kane-Lewis | Laurie | Director | 1 | Community Stakeholder | DFD Russell Medical Centers |
| Doyle | Jon | Director | 1 | Medicare Beneficiary | NA |
| Salko MD | David | Director | 1 | ACO Participant | Central Maine Medical Center |
ACO Participants
Types of ACO participants or combinations 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
- Second Agreement Period
- Performance Year 2018, $0
- Performance Year 2017, $0
- Performance Year 2016, $0
- First Agreement Period
- Performance Year 2015, $0
- Performance Year 2014, $0
- Performance Year 2013, $0
- Second Agreement Period
- Performance Year 2018
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2017
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2018
-
- Performance Year 2016
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2016
- First Agreement Period
-
- Performance Year 2015
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2015
-
- Performance Year 2014
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2014
-
- Performance Year 2013
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2013
Quality Performance Results
2018 Quality Performance Results:
| ACO# | Measure Name | Rate | ACO Mean |
|---|---|---|---|
| ACO-1 | CAHPS: Getting Timely Care, Appointments, and Information | 83.54 | 86.14 |
| ACO-2 | CAHPS: How Well Your Providers Communicate | 94.64 | 93.93 |
| ACO-3 | CAHPS: Patients’ Rating of Provider | 92.51 | 92.45 |
| ACO-4 | CAHPS: Access to Specialists | 80.17 | 81.50 |
| ACO-5 | CAHPS: Health Promotion and Education | 63.74 | 59.26 |
| ACO-6 | CAHPS: Shared Decision Making | 59.87 | 61.94 |
| ACO-7 | CAHPS: Health Status/Functional Status | 75.27 | 73.35 |
| ACO-34 | CAHPS: Stewardship of Patient Resources | 23.67 | 26.26 |
| ACO-8 | Risk-Standardized, All Condition Readmission | 14.65 | 14.98 |
| ACO-35 | Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) | 17.74 | 18.59 |
| ACO-36 | All-Cause Unplanned Admissions for Patients with Diabetes | 37.17 | 37.01 |
| ACO-37 | All-Cause Unplanned Admissions for Patients with Heart Failure | 68.21 | 76.75 |
| ACO-38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 54.92 | 59.00 |
| ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) | 1.35 | 1.98 |
| ACO-11 | Use of Certified EHR Technology | 100.00% | 98.20% |
| ACO-12 | Medication Reconciliation | 100.00% | 85.91% |
| ACO-13 | Falls: Screening for Future Fall Risk | 85.89% | 79.73% |
| ACO-44 | Imaging Studies for Low Back Pain | 73.77% | 64.36% |
| ACO-14 | Preventive Care and Screening: Influenza Immunization | 91.20% | 72.71% |
| ACO-15 | Pneumonia Vaccination Status for Older Adults | 86.29% | 75.97% |
| ACO-16 | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up | 87.98% | 76.83% |
| ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100.00% | 72.81% |
| ACO-18 | Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan | 87.14% | 66.74% |
| ACO-19 | Colorectal Cancer Screening | 74.60% | 68.27% |
| ACO-20 | Breast Cancer Screening | 79.92% | 71.96% |
| ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 92.95% | 81.47% |
| ACO-40 | Depression Remission at Twelve Months | 7.34% | 8.76% |
| Diabetes Composite | Diabetes Composite | 72.58% | 81.47% |
| ACO-27 | Diabetes Mellitus: Hemoglobin A1c Poor Control | 12.90% | 15.51% |
| ACO-41 | Diabetes: Eye Exam | 77.82% | 52.42% |
| ACO-28 | Hypertension (HTN): Controlling High Blood Pressure | 77.02% | 73.10% |
| ACO-30 | Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic | 91.53% | 88.92% |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.
- For 2017 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2017-Shared-Savings-Program-SSP-Accountable-Care-O/gk7c-vejx/data
- For 2016 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2016-Shared-Savings-Program-SSP-Accountable-Care-O/3jk5-q6dr/data
- For 2015 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/x8va-z7cu
- For 2014 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/ucce-hhpu
- For 2013 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/yuq5-65xt
Note: In the Quality Performance Results file(s) above, search for “Central Maine ACO” to view the quality performance results. This ACO can also be found by using the ACO ID A92107 in the public use files on data.cms.gov.
Payment Rule Waivers
- No, our ACO does not use the SNF 3-Day Rule Waiver.
