ACO Name and Location
Community Care Partnership of Maine (CCPM)
103 Maine Avenue Bangor, ME 04401
ACO Primary Contact
Sandy Nesin
(207) 992-9200 x 2282
sandy.nesin@sjhhealth.org
Organizational Information
| ACO Participants | ACO Participant in Joint Venture |
|---|---|
| Bucksport Regional Health Center | No |
| City Of Caribou / Cary Medical Center | No |
| Community Clinical Service, Inc. | No |
| Eastport Health Care, Inc. | No |
| Fish River Rural Health | No |
| Harrington Family Health Center | No |
| Health Access Network Inc. | No |
| Island Community Medical Center, Inc. | No |
| Katahdin Valley Health Center | No |
| Millinocket Regional Hospital | No |
| Mount Desert Island Hospital | No |
| Penobscot Community Health Center / Penobscot Community Health Care | No |
| Pines Health Services | No |
| Portland Community Health Center / Greater Portland Health | No |
| Regional Medical Center at Lubec | No |
| Sacopee Valley Health Center | No |
| Sebasticook Family Doctors / Hometown Health Center | No |
| St. Croix Regional Family Health Center | No |
| St. Joseph Hospital / St. Joseph Healthcare | No |
| York County Community Action Corporation / Nasson Health Care | No |
ACO Governing Body
| Member First Name | Member Last Name | Member Title / Position | Member’s Voting Power | Membership Type | ACO Participant TIN Legal Business Name/DBA, if Applicable |
|---|---|---|---|---|---|
| Carol | Carew | CEO | 4.76% | ACO Participant Representative | Bucksport Regional Health Center |
| Kris | Doody | CEO | 4.76% | ACO Participant Representative | City of Caribou / Cary Medical Center |
| Coleen | Elias | CEO | 4.76% | ACO Participant Representative | Community Clinical Services, Inc. |
| Ellen | Krajweski | CEO | 4.76% | ACO Participant Representative | Eastport Health Care, Inc. |
| Heather | Pelletier | Executive Director, Board Chair | 4.76% | ACO Participant Representative | Fish River Rural Health |
| Demee | Manchester | CEO | 4.76% | ACO Participant Representative | Harrington Family Health Center |
| Nicole | Morrison | CEO | 4.76% | ACO Participant Representative | Health Access Network, Inc. |
| Robin | Winslow | CEO | 4.76% | ACO Participant Representative | Hometown Health Center / Sebasticook Family Doctors |
| Dinah | Moyer | Executive Director | 4.76% | ACO Participant Representative | Islands Community Medical Services Inc. |
| Claudette | Humphrey | CEO | 4.76% | ACO Participant Representative | Katahdin Valley Health Center |
| Robert | Peterson | CEO | 4.76% | ACO Participant Representative | Millinocket Regional Hospital |
| Christina | Maguire | President & CEO | 4.76% | ACO Participant Representative | Mount Desert Island Hospital |
| Paul | Kennedy | CEO | 4.76% | ACO Participant Representative | York County Community Action Corp / Nasson Health Care |
| Lori | Dwyer | President & CEO | 4.76% | ACO Participant Representative | Penobscot Community Health Center / Penobscot Community Health Care |
| Kris | Doody | CEO | 4.76% | ACO Participant Representative | Pines Health Services |
| Ann | Tucker | CEO, Treasurer | 4.76% | ACO Participant Representative | Portland Community Health Center / Greater Portland Health |
| Tom | MacDonald | CEO | 4.76% | ACO Participant Representative | Regional Medical Center at Lubec |
| Linda | Watson | CEO | 4.76% | ACO Participant Representative | Sacopee Valley Health Center |
| Michael | Farrell | Executive Director | 4.76% | ACO Participant Representative | St. Croix Regional Family Health Center |
| Mary | Prybylo | President | 4.76% | ACO Participant Representative | St. Joseph Hospital / St. Joseph Healthcare |
| Sandy | Bovard | Medicare Beneficiary | 4.76% | Medicare Beneficiary |
Key ACO Clinical and Administrative Leadership
| Name | Title |
|---|---|
| Sandy Nesin | Chief Executive Officer / ACO Executive |
| Mary Butler-Fleming | Chief Operating Officer |
| Timothy Clifford | Chief Medical Officer / Medical Director |
| Kimberly Alexander | Chief Clinical Operations Officer |
| Mary Prybylo | Chief Research & Innovation Officer |
| Kimberly Alexander | Quality Assurance / Improvement Officer |
| Mary Butler-Fleming | Compliance Official |
Associated Committees and Committee Leadership
| Committee Name | Committee Leader Name and Position |
|---|---|
| Finance Committee | Ann Tucker, Board Treasurer |
| Leadership and Operations Committee | Mary Butler-Fleming, Chief Operating Officer |
| Quality and Clinical Integration Committee | Kim Alexander, RN, Chief Clinical Operations Officer, CCPM |
| Care Management Committee | Kim Alexander, RN, Chief Clinical Operations Officer, CCPM |
Types of ACO Participants, or Combinations of Participants, that Formed the ACO
- Critical Access Hospital (CAH) billing under Method II
- Federally Qualified Health Center (FQHC)
- Hospital employing ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses
- Performance Year 2022, $4,454,635.60
- Performance Year 2021, $5,098,646.94
- Performance Year 2020, $2,489,104
- Performance Year 2019, $2,655,332
- Performance Year 2018, $7,426,177
- Performance Year 2017, $4,184,087
- Performance Year 2016, $2,130,758
Shared Savings Distribution
- Seven Agreement Period
- Performance Year 2022
- Proportion invested in infrastructure: 15%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 55%
- Sixth Agreement Period
- Performance Year 2021
- Proportion invested in infrastructure: 25%
- Proportion invested in redesigned care processes/resources: 0%
- Proportion of distribution to ACO participants: 75%
- Performance Year 2021
- Fifth Agreement Period
- Performance Year 2020
- Proportion invested in infrastructure: 15%
- Proportion invested in redesigned care processes/resources: 20%
- Proportion of distribution to ACO participants: 65%
- Performance Year 2020
- Fourth Agreement Period
- Performance Year 2019
- Note: Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
- Proportion invested in infrastructure: 15%
- Proportion invested in redesigned care processes/resources: 25%
- Proportion of distribution to ACO participants: 60%
- Third Agreement Period
- Performance Year 2018
- Proportion invested in infrastructure: 15%
- Proportion invested in redesigned care processes/resources: 25%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2018
- Second Agreement Period
- Performance Year 2017
- Proportion invested in infrastructure: 20%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2017
- First Agreement Period
- Performance Year 2016
- Proportion invested in infrastructure: 20%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2016
Quality Performance Results
2022 Quality Performance Results
| ACO Quality Measure Number | Measure Name | Collection Type | Rate | ACO Mean |
|---|---|---|---|---|
| 1 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control2 | CMS Web Interface | 8.06 | 10.71 |
| 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 82.22 | 76.97 |
| 236 | Controlling High Blood Pressure | CMS Web Interface | 80.6 | 76.16 |
| 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 91.48 | 87.83 |
| 110 | Preventive Care and Screening: Influenza Immunization | CMS Web Interface | 79.53 | 77.34 |
| 226 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 100 | 79.27 |
| 113 | Colorectal Cancer Screening | CMS Web Interface | 73.54 | 75.32 |
| 112 | Breast Cancer Screening | CMS Web Interface | 83.21 | 78.07 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 83.98 | 86.37 |
| 370 | Depression Remission at Twelve Months | CMS Web Interface | 9.76 | 16.03 |
| 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2 | CMS Web Interface | 0.1491 | 0.151 |
| MCC1 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2 | CMS Web Interface | 33.35 | 30.97 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | CMS Web Interface | 86.22 | 83.96 |
| CAHPS-2 | How Well Providers Communicate | CMS Web Interface | 94.39 | 93.47 |
| CAHPS-3 | Patient’s Rating of Provider | CMS Web Interface | 92.05 | 92.06 |
| CAHPS-4 | Access to Specialists | CMS Web Interface | 73.43 | 77 |
| CAHPS-5 | Health Promotion and Education | CMS Web Interface | 64.61 | 62.68 |
| CAHPS-6 | Shared Decision Making | CMS Web Interface | 57.9 | 60.97 |
| CAHPS-7 | Health Status and Functional Status | CMS Web Interface | 70.16 | 73.06 |
| CAHPS-8 | Care Coordination | CMS Web Interface | 86.58 | 85.46 |
| CAHPS-9 | Courteous and Helpful Office Staff | CMS Web Interface | 94.07 | 91.97 |
| CAHPS-11 | Stewardship of Patient Resources | CMS Web Interface | 20.09 | 25.62 |
For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.
Payment Rule Waivers
No, our ACO does not use the SNF 3-Day Rule Waiver.
Waiver for Payment for Telehealth Services:
Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.
Fraud and Abuse Waivers
ACO Pre-Participation Waiver
The following information describes each arrangement for which our ACO seeks protection under the ACO Pre-Participation Waiver, including any material amendment or modification to a disclosed arrangement.
Parties to the arrangement: Not Applicable
Date of arrangement: Not Applicable
Items, services, goods, or facility provided: Not Applicable
Date and nature of any amendments to the arrangement, if applicable: Not Applicable
ACO Participation Waiver
The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement.
Parties to the arrangement: Not Applicable
Date of arrangement: Not Applicable
Items, services, goods, or facility provided: Not Applicable
Date and nature of any amendments to the arrangement, if applicable: Not Applicable
Conflicts of Interest Policy
https://ccpm.sharefile.com/public/share/web-s4e8e0b80924d4d40a4dd88d39a3b01e1