Through Accountable Communities, MaineCare will engage in shared savings arrangements with provider organizations that, as a group, coordinate and/or deliver care to a specified patient population. Accountable Communities that demonstrate cost savings, as well as the achievement of quality of care standards, 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:
- 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.
- Practice-level transformation- Accountable Communities will align with and build on the principles of Maine's multi-payer Patient-Centered Medical Home (PCMH) Pilot and MaineCare Health Homes Initiatives.
- Coordination across the continuum of care- Accountable Communities will ensure the coordination of primary, acute, and behavioral health care, as well as long-term services and supports. 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.
- 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.
Accountable Communities State Plan Amendment
On June 2nd, 2014 we received confirmation from the Centers for Medicare & Medicaid Services (CMS) that our Accountable Communities State Plan Amendment was approved.
State Plan Amendment:
Accountable Community Applicant Webinar Series
- January 28 Attribution Webinar (.pdf)
- February 26 Shared Savings Webinar (.pdf)
- March 3 Quality Framework Webinar (.pdf)
- March 3 Quality Framework Adobe Recording of Webinar
- ACA Teleconference - 4/1/2014
- AC Data Book Walk-Through 5/14/14 (.ppt)
- Accompanying Data Workbook Excel Document 5/14/14 (.xls)
MaineCare Notifies Accountable Communities Applicants of Intent to Contract
The Department was pleased to receive applications for its Accountable Communities initiative from organizations serving MaineCare members in Central, Midcoast, Southern, and Western Maine. Attached is a listing of Accountable Communities that the Department has notified of its intent to contract. Contact information is available for Lead Entities that chose to share this information.
- Accountable Communities List (.pdf)
Revised Quality Framework for Accountable Communities
- AC Proposed Quality Metrics - Revised 07/16/14 (.xls)
- Summary of Changes to Maine AC Quality Framework - Revised 07/17/14 (.pdf)
- Proposed Quality Performance Scoring for Accountable Communities- Revised 07/18/14 (.pdf)
Proposed Quality Framework for Accountable Communities
- AC Proposed Quality Metrics (.xls)
- Proposed Quality Performance Scoring for Accountable Communities (.doc)
Interested parties may submit comments regarding the proposed framework by close of business on Friday, November 15, to Michelle Probert at firstname.lastname@example.org.
Request for Applications (RFA)- Posted 10/10/13
- Accountable Communities Request for Application (RFA) (.pdf)
- Template A - Site and Rendering Provider NPI's and Information (.xlsx) Excel 2010 is required for this template. Please Contact email@example.com if you are unable to access the drop-down menus in this document.
- Attachment A - MIHMS PCP, core, optional, excluded svcs (.xls)
- Attachment B - CI Providers Updated by Site (.xls)
- Attachment C - Health Home and Community Care Team (.xls)
- Attachment D - Case Management Providers (.xls)
- Attachment E - Application for reference only (.pdf) Updated 12/2/13: Question 14 updated to ask for the Lead Entity NPI versus TIN number.
- Attachment F- Notice of Interest or Intent for reference only (.pdf) Updated 10/17/13
Key dates are listed below:
- Optional Notice of Intent/ Interest Survey due - November 15, 2013 - https://www.surveymonkey.com/s/MaineCareACInterest
- Application due - December 9, 2013
- Implementation - May 1, 2014
Written Responses Posted re Accountable Communities RFA
Responses have been posted to questions submitted in writing and posed during individual provider question and answer sessions. All responses are subject to approval of the Department's proposed model by CMS.
Public Notice of Interest/ Intent (NOI) Response Summary Posted
Information has been posted from respondents to the optional NOI who gave their consent for the Department to share their information. Providers interested in seeking partner organizations under the Accountable Communities Initiative are encouraged to utilize this list as a tool in their outreach efforts to other providers.
September 2013 Forum Materials: (See Materials under Accountable Communities Overview for most up to date information)
- Complete VBP Forum Presentation Portland 09/26/2013 PowerPoint
- VBP Recording from the Augusta 09/16/2013 Webinar (Accountable Communities is the last of 3 presentations)
Maine Accountable Communities Overview:
- Maine Accountable Communities Concept Paper - 10/15/2013 (.pdf)
- Accountable Communities Overview Presentation- 10/15/2013 (.pdf)
More information concerning MaineCare's Accountable Communities Initiative can be found in the VBP Archives.
If you have questions, please contact Peter Kraut.