Value-based contracts that settled in 2021 reflect performance in 2020. Total annual earnings displayed below include shared savings plus pay-for-performance payments made to the ACO and directly to ACO participants.
Andrew T. Mueller, MD
CEO, MaineHealthCommentary from Andrew T. Mueller, MD
As I review its financial performance, I’m reminded how fortunate we are to have the MaineHealth ACO as an integral part of our system.
The value of the ACO’s two decades of experience in alternative payment models cannot be overstated, particularly now that value-based care and risk-based contracts have become prominent features of the reimbursement landscape.
The ACO experienced financial gains in 2021. More than an end in itself, this success is a confirmation that the ACO’s participants are providing patients with the right care, at the right time and at the right place. Behind every dollar the ACO has earned is a patient who avoided an ED visit or a hospital admission or kept their chronic condition under control. That’s only achievable through the highly-effective preventive and coordinated care that ACO participants are delivering every day.
Even with frequent shifts in Medicare Shared Savings Program financial and quality benchmarks, along with increasingly complex agreements with private payers, the ACO has more than doubled its annual shared savings over the last three years. Meanwhile, pay-for-performance revenue has remained steady.
The dramatic increase in shared savings is due to several factors, including lower ED utilization and admissions overall, and, perhaps most significantly, much improved clinical documentation on the part of the ACO’s participating providers and care teams. The increased precision of their diagnostic coding provides a clearer view of patient acuity and can lead to more achievable financial targets and greater success in risk-based contracts.
Congratulations to the ACO and its participants for their measurable success in helping our communities become the healthiest in America.
Andrew T. Mueller, MD
CEO, MaineHealth
Commentary from Andrew T. Mueller, MD
As I review its financial performance, I’m reminded how fortunate we are to have the MaineHealth ACO as an integral part of our system
The value of the ACO’s two decades of experience in alternative payment models cannot be overstated, particularly now that value-based care and risk-based contracts have become prominent features of the reimbursement landscape.
The ACO experienced financial gains in 2021. More than an end in itself, this success is a confirmation that the ACO’s participants are providing patients with the right care, at the right time and at the right place. Behind every dollar the ACO has earned is a patient who avoided an ED visit or a hospital admission or kept their chronic condition under control. That’s only achievable through the highly-effective preventive and coordinated care that ACO participants are delivering every day.
Even with frequent shifts in Medicare Shared Savings Program financial and quality benchmarks, along with increasingly complex agreements with private payers, the ACO has more than doubled its annual shared savings over the last three years. Meanwhile, pay-for-performance revenue has remained steady.
The dramatic increase in shared savings is due to several factors, including lower ED utilization and admissions overall, and, perhaps most significantly, much improved clinical documentation on the part of the ACO’s participating providers and care teams. The increased precision of their diagnostic coding provides a clearer view of patient acuity and can lead to more achievable financial targets and greater success in risk-based contracts.
Congratulations to the ACO and its participants for their measurable success in helping our communities become the healthiest in America.