Medicare Shared Savings Program (MSSP)

ACO Name and Location:
Beacon Rural Health (BRH)
797 Wilson Street
Brewer, Maine 04412

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

 

Organizational Information:

  • ACO Participants: Blue Hill Memorial Hospital, EMHS doing business as Charles A. Dean Memorial Hospital, Down East Community Hospital, Mount Desert Island (MDI) Hospital, Sebasticook Valley Health (SVH)

  • 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: BRH is a single member limited liability company of which BH is the sole member and only participates in MSSP. Most decisions are made at the Board of Managers of BRH.  Michael Donahue, MBA, president of Beacon Health, is the manager appointed to represent the EMHS member hospitals that participate in MSSP. He has one vote.
    Art Blank, president and CEO of MDI Hospital, is the manager appointed by MDI Hospital to represent it.  He has one vote. Decisions are made by unanimous consent. In the event of a deadlock, the decision would go to the Class D members of BH. 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 BH 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.

     
Key ACO Clinical and Administrative Leadership:
Michael Donahue, MBA, Beacon Health President
Claus Hamann, MD, Beacon Health Chief Population Health Officer and Medical Director

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

 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

  • No, our ACO does not utilize the SNF 3-Day Rule Waier

Quality Performance Results
  • To be completed at the conclusion of the performance year

    2016 is our first year as a Medicare Shared Savings Program. We look forward to sharing our Quality Performance with you in the future.
ACO Investment Model (AIM) Funding: 
Beacon Rural Health was awarded funding by the ACO Investment Model (AIM). The AIM initiative is designed for organizations participating as accountable care organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program). AIM is a model of pre-paid shared savings that encourages new ACOs to form in rural and under served areas and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk.

Effective February 17, 2016 Beacon Rural Health is using a portion of the prepaid shared savings to support care coordinator positions at Down East Community Hospital and Mount Desert Island Hospital, both of whom participate in the Shared Savings Program. In the event Beacon Health does not receive shared savings, it will not seek repayment of the funds from either hospital. The Board of Managers has determined that the retention of AIM funds by each hospital in the event shared savings are not achieved is reasonably related to the purposes of the Shared Savings Program as the spend plan will permit the hospitals – two critical access hospitals with limited funds - to fund care coordinator positions that will serve to manage and coordinate care for Shared Savings Program beneficiaries in accordance with Beacon Rural Health redesigned processes that promote patient engagement, evaluate the health needs of the Shared Savings Program beneficiaries, implement standards for beneficiary access and communication, and standardize care coordination processes across the Beacon Rural Health network.  All of the foregoing will serve to lower cost and improve the quality of care delivered to Shared Savings Program beneficiaries and foster a clinically integrated network.  The foregoing arrangement is one for which waiver protection is sought via a Participation Waiver under the Final Waivers in Connection with the Shared Savings Program. 
The Medicare Shared Savings Program (MSSP) is a new opportunity for our critical access partners to continue their ongoing efforts to enhance quality of care and patient engagement, while lowering the overall cost of healthcare. On behalf of our partners, Blue Hill Memorial Hospital, CA Dean Memorial Hospital, Down East Community Hospital, MDI Hospital, and Sebasticook Valley Health (SVH), we joined the Medicare Shared Savings Program (MSSP) as an Accountable Care Organization (ACO).

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 Beacon 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, Beacon Rural Health will demonstrate value by meeting 33 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?
  • Patients and their caregivers will have a team surrounding and supporting them, no matter where they receive care across the Beacon Rural Health integrated network.Their team includes doctors, nurse practitioners, physician assistants, care coordinators, nurses, medical assistants, pharmacists, and others to proactively deliver care.
  • 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.
  • Patients can count on personalized consistent care that is evidence based and efficient.
Collectively for the past four years, our network of primary 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 across Beacon Health are driving these changes to enhance the care the offer their patients and community.