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Beacon Health Accountable Care Organization

Summary 
  • Need: To implement coordinated healthcare to improve patient health, increase patient engagement, and reduce the overall cost of medical services in Maine.
  • Intervention: The Beacon Health network was launched to focus on patient-centered care to improve overall wellness and reduce ever-increasing healthcare costs.
  • Results: Through care coordination, Beacon Health has enhanced provider efficiency, improved healthcare quality, and lowered costs for patients.

Description

Beacon Health logo

Northern Light Health, which serves the entire state of Maine, is transforming how healthcare is delivered throughout its system and is expanding the boundaries of a medical home. In 2012, Northern Light Health, through its population health member, Beacon Health, began an Accountable Care Organization (ACO) network. Beacon Health partners participate in the Medicare Shared Savings Program (MSSP).

Beacon Health is a product of the continued work and lessons learned from the Bangor Beacon Community. In 2010, the Office of the National Coordinator for Health Information Technology designated Bangor Beacon to serve as a model in developing its health information technology infrastructure and exchange capabilities. The Bangor Beacon Community used its grant award to gather and integrate data sources from multiple healthcare organizations. Through this, Bangor Beacon helped hardwire the best habits in delivering coordinated care. For many organizations, practices, and providers, this was the first time they had seen that level of actionable data.

Although family providers initially had a sense of losing control due to ACO quality measures and guidelines, they realized that the thorough data required by CMS helps them provide more seamless patient care in the long run. Providers participating in the Beacon Health network now have concrete information to support improved processes that promote consistency and tailored care for their patients, which should improve quality of life and help achieve cost savings for Medicare, employers, and patients.

As an ACO, Beacon Health is able to support primary care medical home teams. Being a part of larger organizations gives smaller practices the opportunity to invest in people and programs such as licensed social workers who would have been out of budget range otherwise. Practices also have potential access to new grant funding. The real-time data, human capital, and other general resources are tools many rural sites could not gain access to on their own.

The video below discusses in depth the structure and impact of the Beacon Health network:

Services offered

  • Clinical coordinators who help patients understand healthcare and provide guidance to the most appropriate clinical and social services for them
  • Specialized nurse care coordination for patients with a chronic disease
  • Community care teams, including nurses and licensed social workers, who help patients with social services in their homes
  • Data surveillance and analytics. This infrastructure is imperative in tracking quality measures and metrics not only required by Medicare but also health insurance providers
  • Patient feedback systems, patient representatives attending the Beacon Health monthly Population Health Conference, and advisory group gatherings for parents and providers

Results

In the program's first five years, Beacon Health grew from a network of 9,000 Medicare patients to nearly 28,000, as well as commercial plans including nearly 18,000 employees and dependents on the Northern Light Employee Health Plan. The program cares for roughly 105,000 individuals across Maine, most of whom reside in rural areas. The Beacon Health high-value network now has 114 primary care practices and 559 providers.

In 2013, the Beacon Health nurse care coordination program was accredited by the National Committee for Quality Assurance. In 2014, Beacon Health was ranked 2nd among ACOs based on 33 ACO quality measures required for observation by Medicare.

The cost-saving measures initially targeted by the Beacon ACO were potentially avoidable emergency department visits and hospital admissions and readmissions.

Shared savings/losses included:

  • Year One: A shared savings of $2 million – 40% of shared savings were used to support care coordination functions and responsibilities and 60% were used for data analytics and infrastructure.
  • Year Two: Loss of $2.9 million
  • Year Three: Loss of $2.6 million
  • Year Four: Loss of $872,029

From 2012 to 2014, per 1,000 patients:

  • Hospital admissions were down 34.3%
  • Medical/surgical admissions were down 46%
  • Readmissions were down 71.2%

Through its Beacon Health program, Northern Light Health has observed:

  • Reduction in emergency department visits
  • Reduction in admissions for asthma, heart failure, and chronic obstructive pulmonary disease (COPD)
  • An increase in patient satisfaction and engagement in their care
  • Coordinated care and outreach that has cut out unnecessary and preventable procedures

Barriers

  • Having nurse care coordinators requires the forethought in budgeting to fund these new ACO teammates.
  • Data surveillance and analytics require a hefty investment.
  • "Team sport" mentality can take some adjustment. It's important for providers to realize that their responsibility extends beyond their office.
  • There are multiple quality measures that providers must keep in mind, and that can be a bit of an overload. This includes answering to the hospital administration and measurements from the ACO.

Replication

Provider involvement and leadership are necessary to make an ACO work among multiple practices. In addition, nurse care coordinators and data analytic experts are potentially the most important factor in managing the array of healthcare services residing within an ACO. Embedded care coordinators seem to be more effective than outsourced coordinators, as they are able to visit both patients and providers in person.

Contact Information

Lanie Abbott, APR, Director of Communications and Experience
Beacon Health
207.973.9629
lwabbott@northernlight.org

Topics
Accountable Care Organizations
Care coordination
Health information technology

States served
Maine

Date added
November 5, 2015

Date updated or reviewed
October 31, 2019


Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.