Frequently Asked Questions for Patients and Referring Physicians
about the Cardiology Physician Practices Employment
MaineHealth is a family of leading, high-quality health care providers dedicated to ensuring their communities are among the healthiest in America. As the system has grown in its ten year history, MaineHealth has added a number of member, affiliate and allied health organizations to its provider base. Each of these efforts has strengthened the system’s ability to continue to support the overall health care needs of the communities it is privileged to serve.
As MaineHealth looks to the future of health care delivery in an increasingly challenging environment, an opportunity to partner with a group of cardiologists presented itself.
This partnership is defined as an employment relationship between 34 cardiologists and MaineHealth. Through this partnership, two private practice groups (Maine Cardiology Associates and Cardiovascular Consultants of Maine) have combined their and become employees of a subsidiary organization of MaineHealth.
Q. What is the name of the new cardiology practice?
A. Maine Cardiology Associates and Cardiovascular Consultants of Maine have combined their practices as part of Maine Medical Partners, a subsidiary of MaineHealth. The practice will be called Maine Medical Partners – MaineHealth Cardiology.
Q. What is Cardiovascular Consultants of Maine?
A. Cardiovascular Consultants of Maine is a group practice of physicians who specialize in the care and treatment of the heart. Board-certified Cardiologists specialize in echocardiology, nuclear, vascular, angiography, stent and CT technology with locations in the Maine communities of Scarborough, Augusta, Waterville, and clinics in Farmington, and Norway.
Q. What is Maine Cardiology Associates?
A. Maine Cardiology Associates is a group practice of physicians who specialize in diseases of the heart and circulatory system. Established as a professional association in 1976, Board-certified cardiologists specialize in all cardiac diagnostic and therapeutic techniques with office locations in the Maine communities of Lewiston, Rockport, and South Portland and clinics in Skowhegan, Waterville, Farmington, Sanford, Damariscotta, Boothbay Harbor, Rumford and North Conway, New Hampshire.
Q. What is the relationship of this new practice with Maine Medical Center?
A. Cardiovascular Consultants of Maine and Maine Cardiology Associates each have been very successful in providing the best cardiac care in our region. They have worked closely with Maine Medical Center and other regional hospitals and practices to build a coordinated network of care which has been recognized nationally. As a result, Maine Medical Center has been ranked in the top 100 programs in the United States. As part of the MaineHealth network, the combined practice will further strengthen cardiac care in Maine.
Q. Why are the physicians in these practices joining MaineHealth?
A. Looking toward the future, these practices and the health system must adapt to new realities. In order to maintain and improve upon an existing high level of care, these practices must shift to a regional and integrated system of cardiovascular care.
Q. How will this action improve quality?
A. A more integrated cardiovascular system will be better able to support local care at local hospitals which is effectively coordinated with more complex and acute tertiary care.
Q. How will this improve efficiency of care delivery?
A. Together, an integrated cardiovascular system will be better able to respond to the demand to find more cost efficient ways of caring for cardiac patients through seamless systems of care based on quality outcomes and the adoption of best practices within the financial realities of our state. Integration is expected to reduce duplicative efforts in infrastructure.
Q. What are the other benefits of this action?
A. The benefits of this employment arrangement are numerous.
- It will secure the delivery of high quality heart care to the people of southern, central and western Maine – remaining a nationally recognized cardiac care program.
- It will provide access to these services for all, regardless of their ability to pay.
- This arrangement will help further foster regional delivery of heart care services throughout the region.
- It will provide the resources necessary to improve the quality of services available.
- This action will help facilitate the retention of the existing staff and physicians and help recruit new physicians to our communities during a period of predicted physician shortage.
- And lastly, this action will provide a platform for the development of improved systems of care with a focus on health promotion and disease prevention.
Q. How might this impact Maine Medical Center’s teaching and research mission?
A. This action will allow a more coordinated, robust teaching and research function. These are essential components of the Medical Center’s mission and to the future medical workforce for the entire state – from the primary care providers to the cardiac specialists who will work in the smaller communities in Maine.
Q. Why is this happening now?
A. Practicing medicine and providing specialized treatment is more challenging today than ever before. The pressures that practice groups have been facing have been slowly and steadily increasing in intensity. Increasing costs and outpacing flat or reduced reimbursements are causing doctors throughout the country (and here in Maine) to look to others with which to partner. Hospitals, particularly in the less populated areas of our country, are seeking to stabilize and secure physician presence in their community in the face of predicted physician shortages. Integration arrangements offer some stability and the resources necessary to meet the challenges that physician practices face today and continue to provide the level of care that our communities need and deserve.
Q. What would happen if this didn’t take place?
A. Declining reimbursements relative to the costs of care, an adverse payor mix, a predicted and growing shortage of cardiologists, and opportunities for higher income elsewhere pose a threat to the continuation of the private practice of cardiology in Maine. These trends, if not addressed, will prompt private practitioners to re-allocate their time away from activities such as free care, community clinics, outreach outside of Portland, and medical teaching, to activities that are reimbursed. It will put pressure on practitioners to increase utilization. It may result in the slow erosion of the two groups, without the ability to recruit against out-of-state employment opportunities that will pay higher compensation, leading to a gradual decline in cardiology presence in Maine.
Q. Was there a regulatory approval process?
A. Yes. MaineHealth sought approval of this arrangement through the State of Maine’s Department of Health and Human Services in an administrative process in which the Office of the Attorney General was closely involved.
Q. How will this affect patient care?
A. In the immediate short term, patients will see no appreciable difference in their care. They will still see the same physicians they have before and will be treated in much the same way. The benefits to patients will be seen over time: in the manner in which care is delivered and the quality of the care provided. By working together, we can improve the processes of care and reduce the duplication of these two practice groups.
Q. Will the locations of the physician practices change?
A. The physicians based in the Portland area will continue to be based in the Portland area. We will still be providing cardiac services in those communities we currently serve (Farmington, Sanford, Augusta/Waterville, Rockland, Norway). In fact, we’re hopeful that we’ll be able to expand the geographic reach of these practices.•
Q. What changes can I expect in my billing?
A. You may see changes in your medical bill.
As a department of Maine Medical Center, we have to change the way that we bill Medicare. We have to bill Medicare separately for:
- Your doctor’s services
- Other services, like the cost of using the exam room, nursing staff, equipment, and supplies (Medicare calls this the ‘facility component’).
Because of this, you may get two Explanations of Benefit documents (EOBs) from Medicare.
The amount you have to pay out of pocket (your co-insurance) might be higher than what you previously paid. This is because Medicare treats physicians and hospitals differently. Since we are now part of Maine Medical Center, we are treated like a hospital. The estimated co-insurance for an office visit ranges from $14 to $28, but your actual co-insurance might be different.
You might not see any difference in the amount you have to pay. But if you do and you have trouble paying your bill, you can get help. Please call CarePartners at 1-877-626-1684 to learn more.
Have additional questions?
You can call Medicare at 1-800-633-4227 (1-800-MEDICARE) for more information.
We are also here to answer your questions. You can call our team at (207) 887-5100 anytime from 8:00 am – 5:00 pm, Monday – Friday.
Q. As a physician, how do I refer a patient to Maine Medical Partners – MaineHealth Cardiology?
A. At this time, there is no change in referral processes. Just call: (207) 885-9905 or (207) 774-2642.
Q. Where can I learn more about the physicians at Maine Medical Partners – MaineHealth Cardiology?
A. You can view detailed profiles of the physicians at Maine Medical Partners – MaineHealth Cardiology, as well as all those throughout the MaineHealth system, at http://findadoc.mmc.org/.