Aetna Accountable Care - Maine

Program Location: 
Portland, ME
Payer Type: 

Aetna announced five accountable care agreements in Maine. The agreements align payment for medical services at major health systems in Maine with improved quality, efficiency and patient experiences.The agreements support Aetna's commitment to develop accountable care models for the State of Maine's employees and their dependents, which Aetna administers. In addition to serving the State of Maine's members, the new agreements will strengthen the health care delivery system for all Aetna members in Maine who receive care from any of these health care facilities and their affiliated providers.

Increased Preventive Services: 

Under each of the five new accountable care agreements, the providers will become part of a coordinated health care network and receive information about medical care and medications a patient may be receiving. By having access to information about the patient’s range of health care interactions, providers can better coordinate their patient’s care. Easier coordination and information sharing can help reduce duplicate testing and appointments, and make the health care experience simpler for the patient. This care will be supported by changes in the way these hospitals and providers are reimbursed for care with certain payments based on the achievement of mutually agreed upon measures of quality, efficiency and patient outcomes. The measures include, but are not limited to: The percentage of Aetna members who get recommended preventive care and screenings; Better management of patients with chronic conditions such as diabetes and heart failure; Reductions in hospital readmission rates; and Reductions in avoidable emergency room visits by improving primary care access hours. These measures are designed to: Improve the patient’s health care experience through greater care coordination and patient engagement; Improve the health of populations; and Reduce the costs of health care by eliminating duplicate services and unnecessary testing.

Last updated October 2013
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