Next Generation Accountable Care Organization (ACO)

ACO Name and Location:
Beacon Health
797 Wilson Street
Brewer, Maine 04412

Hours of Operation:
Monday - Friday 8am - 5pm

ACO Primary Contact:
Carrie Arsenault, COO and Vice President
carsenault@emhs.org
(207) 973-5692

Organizational Information:

  • ACO Participants: Eastern Maine Medical Center, Inland Hospital, Maine Coast Memorial Hospital, Mercy Hospital, and The Aroostook Medical Center

  • ACO Participants in Joint Ventures between ACO Professionals and Hospital: No participants are involved in a joint venture between ACO professionals and hospitals.
  • ACO Governing Body: Beacon Health is a multi-member limited liability company and participates in the Next Generation Program, the MaineCare Accountable Care Communities Program, and several commercial arrangements. Most decisions are made at the Board of Managers of Beacon Health.  Michael Donahue, MBA, president Beacon Health, is the manager appointed to represent the EMHS member hospitals that participate in the Next Generation Program. He has one vote. Art Blank, president and CEO of Mount Desert Island (MDI) Hospital, is the manager appointed by MDI Hospital to represent it.  He has one vote.
    As MDI Hospital does not participate in the Next Generation Program, it does not participate in Next Generation decision making. All decisions regarding Next Generation are made by Michael Donahue, MBA, president of Beacon Health, as the manager appointed to represent the EMHS member hospitals that are Next Generation Participants.
     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 Beacon Health takes care of day to day business and reports to the Beacon Health Board of Managers.
Key Clinical and Administrative Leadership:
Michael Donahue, MBA, Beacon Health President
Claus Hamann, MD, Beacon Health Chief Population Health Officer
Tori Gaetani, RN, Beacon Health Chief Nursing Officer and Vice President of Care Coordination
Carrie Arsenault, Beacon Health Chief Operating Officer and Vice President

Daniel Mitchell, Esq, Beacon Health Chief Compliance Officer
 

Associated Committees and Committee Leadership:

 Shared Savings and Losses:  Amount of Shared Savings/Losses

  • Agreement period Beginning January 1, 2016, Performance Year(s) 2016

  • Performance year 2016: To be completed at the conclusion of the performance year

  • Shared losses are designated with a minus sign (-) in front of the dollar amount and red font.

How Shared Savings are Distributed:

  • Agreement period Beginning January 1, 2016, Performance Year(s) 2016

  • To be completed at the conclusion of the performance year

  • Proportion invested in infrastructure:  Not yet determined

  • Invested in redesigned care process / resources: Not yet determined

  • Proportion of distribution to ACO participants: Not yet determined

Payment Rule Waivers:

By participating in the Next Generation ACO Model, Beacon Health providers are piloting new better, more efficient ways to support our patients getting the right care, at the right time, in the right place. For example:
  • 3-day Skilled Nursing Facility (SNF) Rule Waiver: Under current Medicare law, Medicare only covers care in a SNF if a patient has a prior three-day inpatient hospital stay. This new feature may allow you to get Medicare covered SNF services at a participating SNF without a mandatory three-day inpatient hospital stay. Participating Skilled Nursing Facilities.
  • Post-Discharge Home Visits: Beacon Health is expanding its post-discharge service to provide more comprehensive follow-up care at home after discharge from a hospital to help with the sometimes challenging transition between the hospital and home.
  • Telehealth Expansion: Beacon Health is expanding telehealth services allowing you to receive some healthcare services using real-time communication between you and your primary care provider or specialist
Quality Performance Results
  • To be completed at the conclusion of the performance year

    2016 is our first year as a Next Generation ACO Program. We look forward to sharing our Quality Performance with you in the future.
Beacon Health is proving with the right tools and mentality we can transform healthcare to one that meets the needs of our patients and community and save money while we do it. On behalf of our partners, Eastern Maine Medical Center, Inland Hospital, Maine Coast Memorial Hospital, Mercy Hospital, and The Aroostook Medical Center, Beacon Health is participating in Medicare’s Next Generation Accountable Care Organization (ACO). This Model offers us a new opportunity  in accountable care—one that enables providers and patients greater opportunities to coordinate care, and allow care teams to continue to provide personalized highest quality of care to each person every day.

View the list of 2017 Participating Next Generation Providers

Next Generation Preferred Provider Search

View the Preferred Provider Organization List

What should our healthcare experience feel like for you our patients?
  • Personalized, consistent care that is evidence-based and efficient.
  • You and your caregivers will have a team surrounding and supporting you, no matter where you receive care across the Beacon Health integrated network.Your team includes doctors, nurse practitioners, physician assistants, care coordinators, nurses, medical assistants, pharmacists, and others proactively delivering care.
  • You will receive consistent, coordinated care and communication, and your team will help arrange for specialty care whenever it is needed. For example, if you are hospitalized, this team will make contact when you get home from the hospital and answer any questions about next steps. Or, as another example, if you are living with diabetes and go to the emergency department to get blood glucose levels under control you would be contacted by a care coordinator to help manage medications and stabilize your condition.
You are in good hands, the Beacon Health network is a national leader in delivering some of the highest quality care that includes patient satisfaction. The Next Generation Program will allow us to build upon our experience in the Medicare Pioneer Program.
Collectively for the past five years, our network of primary and speciality 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 patients when they are sick. Providers across Beacon Health are driving these changes to enhance the care they offer their patients and community.

Next Generation Population Health and Performance Improvement Committee Members 

Beacon Health doctors, hospitals, and other healthcare providers and suppliers work together to engage patients and provide coordinated, high-quality care at a lower cost. Our patients, along with their providers and care teams, are true partners in care. Patients have better control over their healthcare, and providers will have better information about their patients’ medical history and better relationships with patients’ other providers.
 
By participating in the Next Generation ACO Model, Beacon Health providers are piloting new better, more efficient ways to support our patients getting the right care, at the right time, in the right place. For example:
  • 3-day Skilled Nursing Facility (SNF) Rule Waiver: Under current Medicare law, Medicare only covers care in a SNF if a patient has a prior three-day inpatient hospital stay. This new feature may allow you to get Medicare covered SNF services at a participating SNF without a mandatory three-day inpatient hospital stay. Participating Skilled Nursing Facilities.
  • Post-Discharge Home Visits: Beacon Health is expanding its post-discharge service to provide more comprehensive follow-up care at home after discharge from a hospital to help with the sometimes challenging transition between the hospital and home.
  • Telehealth Expansion: Beacon Health is expanding telehealth services allowing you to receive some healthcare services using real-time communication between you and your primary care provider or specialist.
You can learn more about these initiatives by visiting the following web page: http://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/
 
 
Questions or Concerns?
If you have any questions about Beacon Health or the Next Generation ACO Model, you can ask your provider, by calling Beacon Health at 1-207-973-9629, contact your local State Health Insurance Assistance Program (SHIP), or contact Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.