Community Care Partnership of Maine (CCPM) is an accountable care organization (ACO) of mission-based health care organizations in Maine focused on improving the health of the communities they serve. By working together, CCPM strives to transform the delivery of healthcare through meaningful sharing and accountability for the health of their patients by:
- Advancing the cause of service to the community by improving access to care, improving clinical outcomes, reducing costs, improving patient experience of care and improving employee satisfaction.
- Working collaboratively and sharing information openly to achieve constant improvement in patient care, patient satisfaction and efficient healthcare delivery.
- Sharing decision-making with respect to the ACO equally among members, and establishing a governance structure that ensures full participation of all members in the decisions affecting them.
- Challenging the status quo to change the way healthcare is delivered, and challenging each other to take on bold initiatives.
- Sharing openly best practices and internal systems and creating new shared systems with the goal of delivery system transformation.
- Stating explicitly the expectations of each group initiative, along with the specific role of members, their leaders and providers in meeting those expectations.
- Holding leaders, providers and each other accountable to explicit expectations of the ACO once those expectations are agreed upon by the group.
- Seeking administrative efficiency in the governance and operations of the ACO, and creating a sustainable model of operations that will be both stable and adaptable.
- Committing to membership criteria agreed-upon by ACO members, to include, without limitation, (1) being a not-for-profit legal entity, (2) maintaining or achieving NCQA recognition (or its equivalent) or, at a minimum, being in the process of submitting for NCQA (or equivalent recognition) within a reasonable period of time from the date of admission to the ACO, (3) utilizing a meaningful use-certified electronic medical record in a manner that allows meaningful participation in population health management, (4) providing effective practice-based care coordination, and (5) having the capacity to generate and utilize population health data.
- Participating actively in a strong team committed to supporting and learning from each other, and devoting the time necessary, among the senior leaders and staff of member organizations, to accomplish shared initiative.
Remarks from CCPM CEO, Ken Schmidt at kickoff press conference on September 22, 2015
Community Care Partnership of Maine (CCPM) is not only a new Accountable Care Organization (ACO), but it’s a different model of ACO.
ACOs were developed out of the Affordable Care Act (ACA). They are being encouraged by Medicare, MaineCare, and commercial insurance companies. Why? Health care costs in the US are twice the cost per person of other industrialized countries: they eat up 18% of the US gross domestic product, and in Maine a startling 22%. Even after paying so much for our health care system, the results in our country are about the worst of any industrial country: we have much higher rates of chronic preventable disease, and tens of millions uninsured in the country, and sadly and many quite unnecessarily, about 135,000 uninsured in Maine. These very high health care costs and inadequate results hurt businesses, take too much money out of the pockets of employees, and cost taxpayers too much.
Having said that, due to the ACA there are real signs of hope. Community health centers, and many hospitals in Maine have worked very hard with vibrant organizations such as Maine Quality Counts, Maine Health Access Foundation, Maine Health Management Coalition, and many others to seriously transform the delivery of health care. Patient Centered Medical Homes have blossomed throughout the state; they have focused on improving quality, access and patient experience, and providing care coordination integrated into primary care. Many organizations and leaders are working extremely hard to help patients and communities to be healthier, reduce unnecessary ED visits and hospital bed usage and readmissions, and to reduce the overall cost of health care.
ACOs are a significant part of this transformation movement. They are brand new over the last few years. ACOs are piloting different models to encourage groups of health care providers to work much more closely together for the good of patients. In Maine, ACO models include large hospital systems, their affiliates and a few other organizations, as well as a model of community health centers working together and with a national health care organization. All of these are good and valuable models to help demonstrate what might work best under different circumstances. At CCPM we think our ACO approach can be particularly beneficial for our patients and our communities.
What is our CCPM ACO model and underlying philosophy?
- It is based on full collaboration and joint and equal ownership of the ACO among all its members.
- We all have real skin in the game financially, and due to the extensive time commitments of our clinical and administrative leaders.
- We share a culture as community rooted organizations and as non-profit and mission-based organizations. All of us are deeply committed to ensuring that the most vulnerable among us have access to quality and effective health care.
- We all collaborate with larger hospital systems and many other groups, but we all strongly believe in remaining independent organizations.
- All CCPM members are quality health care providers with nationally certified Patient Centered Medical Homes. We all have local care coordinators who outreach to patients with higher levels of chronic disease and high rates of ED or hospital readmissions.
- We are all committed to utilize to the fullest our excellent, national-model Maine Health Information Exchange – in order to improve the care of our patients.
- Finally, we have developed – due to real skin in the game by all of us – a low overhead central support ACO operation, so that any shared savings earned can fully accrue to member organizations based on the number of their patients in the ACO program. When we do a good job as an ACO helping patients improve their outcomes and reducing overall health care costs, MaineCare, Medicare, and commercial payers in shared savings models with us will share some of the cost savings with CCPM, which will all go back to our member organizations who can then use these savings to strengthen patient care.
CCPM is a learning community of eleven community health centers and community hospitals. All of us have adopted various effective strategies to help our patients stay healthier. We will learn these strategies from each other and then commonly implement the best of them.
Our founding members are St. Joseph Healthcare in the greater Bangor area; Mayo Regional Hospital in Piscataquis County; Sebasticook Family Doctors in Somerset, Penobscot and Piscataquis counties; Millinocket Regional Hospital; Katahdin Valley Health Center in Penobscot and Aroostook counties; Pines Health Services and Cary Medical Center in Aroostook County; DFD Russell Medical Centers in the greater Leeds area in central Maine; Portland Community Health Center; Nasson Health Care in York County; and PCHC in the greater Bangor area, Waldo County, and the Jackman area.
All of us will be participating in a MaineCare Accountable Care Community – which started August 1. CCPM has also applied to participate in a Medicare shared savings ACO which most of our member organizations will participate in and if approved as expected will commence Jan 1, 2016. In addition, most of us will be participating in 3-4 ACO shared savings programs next year which CCPM is arranging with a number of commercial insurance companies. In total, in our first full year we anticipate having over 70-80,000 patients in real ACO shared savings arrangements. That number will then grow in future years.
The health care system is rapidly changing – and it really needs to change. The health care reimbursement system is evolving to one that recognizes value – that is, rewards health care providers for measurable effectiveness in improving quality, clinical outcomes and patient experience, and for reducing the overall cost of health care. All of us involved in CCPM are committed to work together to help provide some of the best possible health care in Maine or America.
Every CCPM member participates in a MaineCare Accountable Care Community. Some members also participate in other ACO arrangements:
For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048