Eastern Maine Healthcare Systems

The Right Care, at the Right Time, in the Right Place for Better Results!

EMHS is reinventing how care is provided throughout our system. This new way of providing healthcare means taking on the responsibility to better coordinate a patient’s care throughout all types of healthcare services. This means working with our patients and the healthcare team to build cooperation and to help people live as healthy a life as possible. Some key goals include:

Helping patients to live healthier at home and out of the hospital
Adopting care coordination for those patients with chronic disease
Improving the overall health of the population through a focus on wellness and health improvement
Reducing spiraling healthcare costs

Today, EMHS is reorganizing its providers to be an accountable care system. Initially focused on Medicare Patients, this new model of care will provide eligible patients access to chronic disease and wellness services, as well as improve the coordination of care for the patient. In this new system, the structure of care delivery shifts from how much healthcare providers do for their patients to how well the patient does – placing a higher value on the quality of care that is delivered as opposed to the quantity of care.

EMHS Difference in Care

Strategic Considerations For Becoming an ACO

View our Video Series on Accountable Care

EMHS Difference in Care
Strategic Considerations For Becoming an ACO
Leadership
Gerry's Story
Kay's Story
Neil's Story
Performance Improvement

Why are EMHS and its members leading the way?

EMHS’ mission is to ensure that we are collectively able to offer the people of central, northern, and eastern Maine the right care, at the right time, and in the right place. To meet that goal we need to focus now on changing the way we provide care to be better poised for healthcare changes that will be here in the not-to-distant future.

As one of the very first nationally designated accountable care organizations EMHS will have a strong voice in shaping the future system of care delivery and helping to determine necessary changes in how care is paid for. EMHS already has many of the necessary tools in place, such as leading edge clinical information technology, a proven care coordination model, and health plan incentives.

Leadership

How does care coordination benefit patients?

Patients living with a chronic illness will have a nurse who will help coordinate and monitor care between appointments, and many will see an improvement in the quality of their daily life. In addition, patients will be encouraged and shown how to be more active participants in their health and healthcare. During the pilot phase of EMHS’ efforts to better coordinate care there were dramatic reductions in the number of hospitalizations. Patients also reported feeling more “in control” and are generally feeling healthier!

Gerry's Story
Kay's Story
Neil's Story

What does it mean to providers?

Providers will have better, easier access to colleagues, best practices, and a nurse care coordinator to help keep their patients as healthy as possible. And, more importantly, providers will be able to better practice medicine - doing what they do best and spending quality time with patients. Providers will be reimbursed using a different formula than now exists, a formula that includes incentives based on how well their patients are doing.

Performance Improvement

What is the benefit to employers?

EMHS’ efforts with Bangor Beacon demonstrated that accountable care organizations reduce hospitalizations and healthcare costs.

Who does this affect?

This EMHS effort will initially focus on Medicare patients that see primary care providers at practices that are affiliated with Eastern Maine Medical Center in Bangor:

Inland Hospital in Waterville:

The Aroostook Medical Center in Presque Isle Maine:

It will grow to include CA Dean, Sebasticook Valley Health, and Blue Hill Memorial Hospital patients in January of 2013. EMHS will also be collaborating with Penobscot Community Health Care and other community partners. We’re also reaching out to other employers in our service area to offer this model of care to their employees.

Beacon Health our Accountable Care Organization Fact Sheet

How does an Accountable Care Organization (ACO) work?

The ACO model is designed for healthcare organizations and providers that are experienced in
coordinating care for patients across the various care settings. It is designed to work in coordination
with private payers by aligning provider incentives, which will improve quality and health outcomes, as
well as cost savings.

ACOs will accept accountability to improve the quality of healthcare while reducing the cost of care
delivered for a defined population of patients.
ACOs will pave the way for continuity and seamless care, and perhaps most importantly, will help
people be able to stay at home and be healthy instead of being in a hospital bed or sick if it can be avoided.
Hospitals and other providers of healthcare will be rewarded for delivering that kind of care.
It’s important to note that Medicare patients have not lost any choices with ACOs. In fact, some patients
may receive more care in the most appropriate setting.
The ACO simply takes on the responsibility of coordinating better care, building more cooperation,
investing in care coordination, adopting electronic medical records (EMR), and working in such a way that
people can stay out of hospitals and stay healthy.
ACO does not mean skimping on care. In fact, there are 33 measures of quality tracked that are very
carefully watched. Additionally, all of the normal measures of antitrust are closely monitored.
An ACO does not affect people’s Medicare benefits. An ACO does not put the
insurance companies in charge of patient care. ACOs put the doctor in charge and it is the doctor’s, or other
primary care healthcare provider’s responsibility to make sure the patient receives the treatment needed to
stay well and out of the hospital.
The change is reflected in how healthcare providers get paid for providing care. In the ACO model,
doctors benefit financially by keeping people healthy. To help primary care providers manage care better,
Medicare has offered to provide their patient’s medical insurance claims history.
People do have the option of preventing Medicare from sharing that data, this is known as “opting out.”
Patients should discuss that decision with their provider, and the provider should make sure their patients
fully understand what that means before they opt out.

How does an Accountable Care Organization (ACO) work?

The ACO model is designed for healthcare organizations and providers that are experienced in coordinating care for patients across the various care settings. It is designed to work in coordination with private payers by aligning provider incentives, which will improve quality and health outcomes, as well as cost savings.

ACOs will accept accountability to improve the quality of healthcare while reducing the cost of care delivered for a defined population of patients.
Under the ACO model, hospitals and other providers will be rewarded for delivering the kind of care that will help people to stay at home and be healthy instead of being in a hospital bed.
It’s important to note that Medicare patients are not losing the ability to make decisions about their own care.
The ACO simply takes on the responsibility of coordinating better care, adopting electronic medical records (EMR), and working in such a way that people can stay out of hospitals and stay healthy.
Accountable care does not mean skimping on care. In fact, there are 33 measures of quality included in the reporting requirements.
An ACO does not affect people’s Medicare benefits. An ACO does not put the insurance companies in charge of patient care. ACOs put the doctor in charge and it is the doctor’s, or other primary care healthcare provider’s responsibility to make sure the patient receives the treatment needed to stay well and out of the hospital.
Accountable care organizations do change the way providers are paid for providing care. In the ACO model, doctors benefit financially by keeping people healthy. To help primary care providers manage care better, Medicare has offered to provide their patient’s medical insurance claims history.
People do have the option of preventing Medicare from sharing that data, this is known as “opting out.”Patients should discuss that decision with their provider, and the provider should make sure their patientsfully understand what that means before they opt out.