CEO Minute

posted in: June 2019 Edition 0

Hello Maine Community Health Centers!

Achieving the Quadruple Aim will require innovation around both how healthcare is reimbursed and how healthcare is delivered. A thorough understanding of the national and state healthcare payment reform and practice transformation landscape is the best way to inform the development of a statewide payment redesign effort. In April, MPCA shared just that with its membership, and helped to launch an ongoing—and likely intense—dialogue about how the FQHCs in Maine can lead in creating the primary care models of the future.

Leaders from CHCs across Maine are reflecting on the successes and challenges of various care delivery innovations, and beginning to consider what comes next. On April 29 and 30, MPCA staff and CHC representatives met for a day and half session on value-based transformation. We heard that the ongoing transformation of the primary care model is inevitable, and during the panel with state representatives (including the State Medicaid Director, Michelle Probert; Maine Health Data Organization Director Karynlee Harrington; and Client Operations Director for HealthInfoNet, Katie Sendze) we got the clear sense that value-based care is going to be a top priority of the new Mills administration; we also learned that key state partners are very willing and interested in working with FQHCs.

Value-based initiatives shift the care delivery focus from volume to value and redefine financial incentives toward reduced costs. From a cost perspective, the total cost of care encompasses all spending for the patient—and the patient population as a whole—grouped, benchmarked and analyzed by condition. As the provider mindset shifts to address this model, taking the appropriate steps in terms of patient engagement, technology and workflow are the key first steps to value-based success. The good news is that FQHCs have a considerable framework on which to build. From significant ACO experience to the development of novel treatment frameworks for specific diseases, Maine’s health centers have already demonstrated leadership and a commitment to patient-centered frameworks that yield results.

As our state looks to primary care to help alleviate the cost and quality issues that persist in our fragmented system, the PCA is honored to have the chance to position the health centers more visibly as the leaders they are. We look forward to framing this work together, and we hope that each health center will see a place for them to come to the table.



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