Maine’s State Innovation Model work is designed to move the entire healthcare system forward by addressing the following key areas for development:
Payment Reform - Reforming the way we pay for healthcare in Maine is essential to improving the quality of care and lowering cost. Under the current fee-for-service system, providers are financially rewarded for each test and procedure they perform, regardless of the outcomes. In many cases this leads to unnecessary care and outcomes that are often not as good as other industrialized nations.
Maine’s State Innovation Model work will seek to move the state’s healthcare payment system away from fee-for-service and replace it with payment mechanisms that incentivize appropriate, safe, high-value care. Payment systems based on patient outcomes hold significant potential for improving both the cost and quality of healthcare in our state.
Delivery System Reform - For all the incredible advances in treatment that the US has seen in recent decades, the delivery systems in which we provide care have remained largely unchanged. In the majority of places, primary care providers, specialists and hospitals operate independently of one another, and there is very little coordination between them on patient care. This lack of coordination leads to repeated tests, poorer patient outcomes and experience, and increased costs to the system. To address this issue, the Maine State Innovation Model will be focusing resources on developing an interconnected healthcare delivery system based around Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs).
Data Analytics and Reporting - Data Analytics and Reporting is crucial to improving Maine’s healthcare system, and it serves as the backbone for all the quality improvement and payment reform efforts currently underway in Maine. Good data helps providers identify strategies that are successful or struggling, and it helps them to allocate resources to the right places in order to improve patient care and lower costs. Good data also helps consumers find and choose high quality health care providers, and creates competition in the marketplace that drives improvement for everyone.
Under the SIM award, three types of reports will be enhanced and made available to stakeholders engaged in quality improvement and cost containment efforts: primary care reports, system reports and public reports.
Health Information Technology (HIT) - Health Information Technology is an important building block of a high functioning healthcare system, and developing a comprehensive, integrated HIT network will be an integral piece of the SIM work. Widespread use of HIT within the health care industry will improve the quality of healthcare, prevent medical errors, reduce healthcare costs, increase administrative efficiencies, decrease paperwork, and expand access to affordable health care.
Consumer Engagement - A large portion of the State Innovation Model work is devoted to reforming the way in which we deliver and pay for health care, but just as important is the work aimed at engaging consumers. As the end-users of our healthcare system, it is crucial that patients are aware and supportive of the changes taking place. To facilitate this, the SIM work includes a number of initiatives aimed at communicating the changes that are happening and providing pathways for consumers to have their voice heard.