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 Vice President of Population Health
Tori Gaetani, RN, Beacon Health Vice President of Care Coordination
Carrie Arsenault, Beacon Health Vice President of Operations

Kathy Lirakis, RN, Beacon Health Director of Compliance and Policy
 

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: -$872,029.

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

Beacon Health is energized to move forward in 2018 with a more precision focus.

Effective December 31, 2017, Beacon Health will exit the Next Generation accountable care organization (ACO) program. Our Next Generation ACO participants will be joining our Medicare Shared Savings Program (MSSP) under our Beacon Rural Health ACO effective January 1, 2018.

Our current MSSP participants, Blue Hill Memorial Hospital, Sebasticook Valley Health, CA Dean Memorial Hospital, and Mount Desert Island Hospital, will be joined by The Aroostook Medical Center, Eastern Maine Medical Center, Maine Coast Memorial Hospital, Inland Hospital, and Mercy Hosptial.

This strategic move will enable us to continue to accelerate population health through enhanced and focused provider, care team, and patient engagement.

Primary care providers throughout Maine that participate in our ACO will continue to work alongside their peers to enhance healthcare delivery and patient and provider experience throughout the communities we serve. We are committed to true population health, providing the level of care patients need where they need it most.

Beacon Health continues to be one of the highest-quality ACOs in the country, especially in diabetic care and preventive health, and Beacon Rural Health will continue to carry that torch. We have every intention of pushing forward and shaping a healthcare delivery system that is patient-friendly and of the highest quality. We look forward to our continued partnerships with the people and communities across Maine!


View the list of 2017 Participating Next Generation Providers

Next Generation Preferred Provider Search

View the Preferred Provider Organization List
  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.