State Innovation Models Initiative: Model Testing Project Profiles

State of Maine

Geographic Reach: Maine
Funding Amount: $33,068,334

Summary

Over the next 42 months, the State of Maine will receive up to $33,068,334 to implement and test its State Health Care Innovation Plan. Continued funding will be subject to state performance, compliance with the terms and conditions of award, and demonstrated progress towards the goals and objectives of the State Innovation Model initiative.

Maine will test its plan for improving the quality of health care and improving the health of all citizens by aligning benefits from MaineCare (the state’s Medicaid program) with benefits from Medicare and commercial payers to achieve and sustain lower costs for the Medicaid, Medicare and CHIP populations while maintaining access to care, improving care quality, and improving patient satisfaction.

The Maine innovation model will support the formation of multi-payer Accountable Care Organizations (ACOs) that commit to providing greater value in return for performance-based payment for high quality care. These ACOs will agree to meet established quality standards for clinical care and publically report on their performance. Through the provisions of the plan, Maine will support and strengthen enhanced primary care; support and strengthen alignments between primary care and public health, behavioral health, and long-term care; support the development of new workforce models for the transformed system; and align measures, data and analytics across providers. In addition, the State of Maine will implement payment reform across public/private payers; spread the patient-centered medical home model of enhanced, integrated primary care; and achieve transparent understanding of the costs and quality outcomes of patients across all payers statewide.

This award will support the following enhancements in health care infrastructure: the data analytic structure needed for multi-payer claims analysis, public reporting, and secure information sharing; quality improvement support, training, and collaborative learning to achieve accountable care; support for purchaser-led payment reform, including the potential for investment in performance based shared savings; patient training and tools for shared health care decision-making; support for value-based benefit design; and development of new workforce models to more appropriately support the transformed system.

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