Accountable Care Organization
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Medicare Shared Savings Program
The Medicare Shared Savings Program (MSSP) is an opportunity for Northern Light Health to continue our ongoing efforts to enhance quality of care and patient and care team engagement, while making healthcare affordable. On behalf of our partners, Northern Light Eastern Maine Medical Center, Northern Light Inland Hospital, Northern Light Maine Coast Hospital, Northern Light Mercy Hospital, and Northern Light AR Gould Hospital we have been participating in the Medicare Shared Savings Program (MSSP) as an Accountable Care Organization (ACO) since performance year 2016.
Selected to participate as a Medicare ACO by the US Centers for Medicare and Medicaid Services (CMS), the ACO will build on the work already in progress through Northern Light Health’s value-based and integrated care efforts.
The Shared Savings Program is one more way we are continuing to accelerate the pace of clinical transformation to support our patients living their healthiest lives.
As part of the Medicare Shared Savings Program, Northern Light Health will demonstrate value by meeting standards for high quality care that include patient safety and experience, care coordination, and preventive health.
What should that healthcare experience feel like for our patients?
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Patients and their caregivers will have a team surrounding and supporting them, no matter where they receive care across the ACO. Their team includes doctors, nurse practitioners, physician assistants, care coordinators, nurses, medical assistants, pharmacists, and others to proactively deliver care.
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Patients will receive consistent, coordinated care and communication, and the team will help arrange for specialty care whenever it is needed. For example, for a patient who is hospitalized, this team will make contact when they get home to answer any questions about next steps. Or, as another example, a patient living with diabetes who may visit the emergency department to get blood glucose levels under control would be contacted by a nurse care coordinator to help manage medications and stabilize the condition.
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Patients can count on personalized consistent care that is evidence based and efficient.
- Collectively our network of primary and specialty care providers have shifted to a more team-based approach to care delivery that focuses on being more proactive and supporting patients living their healthiest, not just caring for them when they are sick. Providers and care teams across Northern Light Health are driving these changes to enhance the care they offer their patients and communities.
3 Day SNF (Skilled Nursing Facility) Waiver
The waiver allows our MSSP participating providers more flexibility to enhance the quality of care they offer their patients while also decreasing unnecessary cost. The waiver does not restrict a Medicare Beneficiary's choice of provider or facility that is approved by Medicare.
However, Skilled Nursing Facilities must meet Medicare requirements in order to participate in the waiver.
- Maintenance of CMS 3-Star rating
- Admission availability 24/7/365
- Submission of Beacon Health Quality Metrics as requested
- Cooperation and coordination with a Northern Light Health Care Manager as needed
- Participation in quarterly SNF Network meetings
- Administrator/Quality Director
- Connection to ACO electronic medical record or HealthInfoNet (or plan to connect within one year)
Participating Facilities for MSSP SNF Waiver
ACO Skilled Nursing Facilities
| COUNTY |
AGENCY |
ADDRESS |
PHONE # |
| Aroostook |
Northern Light Continuing Care, Aroostook Health Center |
15 Highland Ave
Mars Hill, ME 04758 |
207-768-4915 |
| Kennebec |
Lakewood Continuing Care Center |
220 Kennedy Memorial Drive
Waterville, ME 04901 |
207-873-0721 |
| Penobscot |
Maine Vets Home |
44 Hogan Road
Bangor, ME 04401 |
207-942-2333 |
| Cumberland |
Springbrook |
300 Spring Street
Westbrook, ME 04092 |
207-856-1230 |
| Cumberland |
Cedars Nursing Care Center |
630 Ocean Ave.
Portland, ME 04103 |
207-221-7000 |
ACO Swing Bed Facilities
| COUNTY |
AGENCY |
ADDRESS |
PHONE # |
| Aroostook |
Northern Light Rehabilitation,
Aroostook Health Center (Swing Bed) |
140 Academy Street
Presque Isle, ME 04769 |
207-768-4735 |
| Somerset |
Northern Light, Sebasticook Valley Hospital (Swing Bed) |
447 N Main St.
Pittsfield, ME 04967 |
207 487-5141 |
| Hancock |
Northern Light, Maine Coast Regional Health (MCMH) (Swing Bed) |
50 Union Street
Ellsworth, ME 04605 |
207-664-5572 |
| Piscataquis |
Northern Light, C.A. Dean Hospital
(Swing Bed) |
364 Pritham Ave
Greenville Junction, ME 04442 |
207-695-5200 |
Board of Managers
Governance Structure for Beacon Rural Health, LLC (BRH)
The governance structure of BRH serves to ensure compliance with applicable federal and state laws as well as our agreements with the Centers for Medicare and Medicaid Services (CMS) regarding participation in the Medicare Shared Savings Program (MSSP).
Beacon Rural Health
BRH is a single member limited liability company and only participates in MSSP. Most decisions are made at the Board of Managers of BRH. Carrie Arsenault, MBA, Senior Vice President and Chief Value Officer of Northern Light Health, is the manager appointed to represent the Northern Light Health member hospitals that participate in MSSP. She has one vote. All decisions regarding Beacon Rural Health are made by Carrie Arsenault, MBA, Senior Vice President and Chief Value Officer of Northern Light Health, as the manager appointed to represent the Northern Light Health member hospitals.
Doug Cowan serves as the beneficiary representative, as well as the patient and consumer representative. While he is not a voting member of the Board of Managers, he does actively participate in all Board of Managers meetings, providing valuable feedback and input that is taken into account in making decisions.
The executive leadership team (ELT) of the ACO serves as the ELT for BRH for all MSSP matters. The ELT takes care of day-to-day business and reports to the BRH Board of Managers.