Brewer-based Eastern Maine Health System and an EMHS-led group of hospitals and physician practices agreed to partner with Maine health insurance giant Anthem Blue Cross and Blue Shield to form an accountable care organization, according to Bangor Daily News.
EMHS' Beacon Health, which includes 15 hospitals and a network of 405 primary care providers in 114 practices across the state, will participate in the ACO to deliver better care to 40,000 Anthem policyholders. EMHS and its partners pledged to accomplish this without any cost increase to Anthem policyholders, putting millions of dollars on the line, according to the report. If the providers fail to meet quality requirements and reduce costs, they are responsible for the downside risk. However, if the hospitals and physicians are successful in achieving savings, they can share in them.
This bold pledge comes after EMHS failed to meet its 2013 spending target as a Medicare Pioneer ACO, costing the system almost $3 million in penalties, according to the report.
"We're committed to this, but it's not without a lot of anxiety," Michelle Hood, president and CEO of EMHS, said in an interview with the Bangor Daily News.
This deal will establish the largest ACO in Maine, according to Anthem and EMHS.
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