2021 Annual Report

Utilization Results

To assess trends in health care utilization, the ACO measured rates of emergency department utilization, hospital admissions and 30-day readmissions among the beneficiaries of its value-based contracts. Displayed here are the last three complete years of data available for these domains.

Avoidable Emergency Department Visits

Bars represent quarterly rate per 1,000 beneficiaries.

Avoidable ED visits are defined by the NYU Emergency Department ED Classification Algorithm (v.2.0). This algorithm estimates likelihood that an ED visit is 1) non emergent, 2) emergent, but primary care treatable or 3) emergent ED needed, but preventable/avoidable.

Admissions

Bars represent quarterly rate per 1,000 beneficiaries.

30-day Readmissions

Bars represent quarterly rate per 1,000 beneficiaries.

Joel Botler, MD
CMO, Maine Medical Center
Board Member, MaineHealth ACO
Commentary from Joel Botler, MD

Always an important undertaking, reducing low-value utilization took on even greater urgency during the public health emergency.

In Maine, hospitals approached and exceeded their capacity limits, putting unprecedented strain on our heroic care teams. Working together with the MaineHealth system, the ACO’s long-term focus to reduce avoidable utilization helped steer patients away from the ED towards other venues of care when appropriate. Through care management and improved chronic disease management, we have also helped reduce admissions for patients with multiple chronic conditions, thus reducing the burden on inpatient facilities and care teams.

Pandemic-related closures, procedure postponements and patient hesitancy to visit health care facilities certainly had a major impact on utilization rates in 2020. However, the general trend of decreased low-value utilization established in previous years, particularly in avoidable ED visits and admissions, points to the likelihood of sustainable and steady declines in the future. As the influence of the pandemic decreases over time, we’ll be watching to see that trend continue.

Joel Botler, MD
CMO, Maine Medical Center
Board Member, MaineHealth ACO

Commentary from Joel Botler, MD

Always an important undertaking, reducing low-value utilization took on even greater urgency during the public health emergency.

In Maine, hospitals approached and exceeded their capacity limits, putting unprecedented strain on our heroic care teams. Working together with the MaineHealth system, the ACO’s long-term focus to reduce avoidable utilization helped steer patients away from the ED towards other venues of care when appropriate. Through care management and improved chronic disease management, we have also helped reduce admissions for patients with multiple chronic conditions, thus reducing the burden on inpatient facilities and care teams.

Pandemic-related closures, procedure postponements and patient hesitancy to visit health care facilities certainly had a major impact on utilization rates in 2020. However, the general trend of decreased low-value utilization established in previous years, particularly in avoidable ED visits and admissions, points to the likelihood of sustainable and steady declines in the future. As the influence of the pandemic decreases over time, we’ll be watching to see that trend continue.