Redefining care saves federal money, earns MaineHealth a $9.2 million windfall

Medicare compensates the parent of Maine Medical Center for efficiencies as the health care system moves toward rewarding prevention and patients' outcomes.

MaineHealth, the health care conglomerate anchored by Maine Medical Center, received a check from the federal government for $9.2 million in October, a reward for saving Medicare nearly $20 million through cost efficiencies in primary care.

The $9.2 million is just a small part of MaineHealth’s $1.9 billion budget, but the savings represent what health experts say could be a sea change in how health care is paid for in the United States. Similar changes in reimbursement for health care are underway at insurance companies, and Medicare is expected to continue to move away from payment models that favor activity over patient satisfaction.

MaineHealth’s payday happened because it participated in the Medicare Shared Savings Program, a voluntary initiative that provides incentives to cut costs in primary care networks. The networks are called accountable care organizations, or ACOs. Central Maine ACO, and a group that represents community health centers, Maine Community ACO, also achieved savings for Medicare, although not enough to get a check from the government, according to the Medicare program’s website. Central Maine saved $2.6 million and Maine Community saved $1.9 million.

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