A Healthy Collaboration
MaineHealth, Anthem Blue Cross and Blue Shield In Maine Announce New Agreement to Improve Quality and Decrease the Cost of Care
Portland, ME (April 24, 2013) Anthem Blue Cross and Blue Shield in Maine (Anthem) and MaineHealth announced today that the two organizations have launched the state’s first comprehensive commercial Accountable Care Organization (ACO), which is designed to lower the cost of healthcare while improving overall quality.
“This is an exciting time for our two organizations and for the state,” said Frank McGinty, executive vice president of MaineHealth. “This agreement with Anthem will enable our ACO to expand its focus on increasing value to patients through improved quality and slowing the rate of health care cost increases, which over time will result in more affordable healthcare for Mainers. ACO’s are fairly new to Maine, and they have great potential for better care at a lower cost.”
An ACO consists of a provider organization (can be a hospital, groups of physicians, or both) that accepts the responsibility for both the cost and the quality of care delivered to a specific population of patients. The goal of an ACO is to positively impact patients health and better control expenses through improved communications with patients and coordination of healthcare services among hospitals, doctors, and insurance carriers.
MaineHealth’s Accountable Care Organization works in partnership with MaineHealth, the MMCPHO and Community Physicians of Maine, which consists of seven member hospitals and more than 1,000 physicians throughout southern Maine. “This benefits our patients because more providers in southern Maine are collaborating to coordinate care for patients,” said Mr. McGinty.
“Maine is fortunate to be at the forefront of a number of innovations in health care,” said Daniel Corcoran, president and general manager at Anthem. “MaineHealth is in a unique position because of the broad range and reach of its services, as well as its other affiliations. Anthem is the largest carrier in the state and is focused on implementing programs aimed at improving the cost and quality of health care. Together, we strongly feel that we can improve health care delivery and affordability for the citizens of Maine.”
“In addition, both organizations will collect and analyze data on quality, costs, and utilization which enables them to identify and implement efficiencies and improvements to the health care delivery system, which benefits patients and Maine’s business community.
“We view this as another positive step toward changing the way health care is delivered,” said Dr. Scott Mills, president of the MMCPHO and Community Physicians of Maine. “The concept is to bring together the hospitals, the physician group practice, and the insurance carrier all with the same goal - to provide high quality, cost-effective care to those we serve.”
Both organizations noted that this effort is yet another element of a strong collaboration between the two entities. MaineHealth actively participates in Anthem’s Quality Hospital Improvement Program which provides financial incentives for outstanding quality performance, as well as other pay-for-performance arrangements related to primary care and certain cardiac procedures, among others.
“As Maine’s largest commercial health insurer, we believe we have a unique opportunity to use our size, scope, and experience to bring about substantive improvements in health care delivery that will benefit people in Maine,” noted Jeffrey Holmstrom, D.O., medical director at Anthem. He added that Anthem is continually seeking to collaborate with key stakeholders like MaineHealth across the state to work toward better health outcomes. In additional to serving as Anthem’s medical director, Dr. Holmstrom maintains a family medicine practice in Saco, Maine.
Both organizations noted that the program will be phased in throughout the year.
MaineHealth is a not-for-profit family of leading high-quality providers and other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated delivery networks, MaineHealth member organizations include: Maine Medical Center, Goodall Hospital, LincolnHealth, Maine Mental Health Partners, Pen Bay Healthcare, Southern Maine Medical Center, Waldo County Healthcare, Western Maine Health, HomeHealth Visiting Nurses, Maine Physician Hospital Organization, NorDx and Synernet. Affiliates of MaineHealth include MaineGeneral Medical Center, Mid Coast Hospital, St. Mary’s Regional Medical Center, and New England Rehabilitation Hospital of Portland.
About Anthem Blue Cross and Blue Shield in Maine
Anthem Blue Cross and Blue Shield in Maine is the trade name of Anthem Health Plans of Maine, Inc., an independent licensee of the Blue Cross and Blue Shield Association. ®ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Maine is available at www.anthem.com. Also, follow us on Twitter at www.twitter.com/healthjoinin, on Facebook at www.facebook.com/HealthJoinIn, or visit our YouTube channel at www.youtube.com/healthjoinin
Anthem Blue Cross and Blue Shield in Maine