State Plan Amendment (SPA) for Accountable Communities

February 27, 2014

The Department will be submitting a State Plan Amendment to implement the Accountable Communities program.

Through the MaineCare Accountable Communities Initiative, the Department will engage in shared savings arrangements with provider organizations that commit to coordinating the care of all patients who rely on those organizations as their point of access to healthcare services. Accountable Communities that demonstrate cost savings and meet quality performance benchmarks will share in savings generated under the model. This initiative will be offered statewide as a Medicaid State Plan option.

Accountable Communities will achieve the triple aim of better care for individuals, better population health, and lower cost through four overarching strategies:

  1. Shared savings based on quality performance- Accountable Communities will benefit from a Value-Based Purchasing strategy that supports more integrated and coordinated systems of care.
  2. Practice-level transformation- Accountable Communities will align with and build on the principles of MaineCare’s Health Homes Initiatives.
  3. Coordination across the continuum of care- Accountable Communities will ensure the coordination of primary, acute, and behavioral health care. This includes leveraging the Maine Department of Health and Human Services’ existing investment in care coordination for members with chronic conditions, behavioral health needs, and long term services and supports needs.
  4. Community-led innovation- Local health care needs, resources, and solutions will drive Maine’s Accountable Communities. While each Accountable Community will meet baseline criteria, report on core quality measures, and be responsible for the cost of a set of core services, they will also be encouraged and afforded flexibility to structure services and solutions that fit locally-identified priorities and context.

Any questions or comments may be directed to Peter.Kraut@maine.gov or Michelle.Probert@maine.gov