MaineCare Issued Annual Hospital Value-Based Purchasing (VBP) Supplemental Payments
Earlier this month, MaineCare issued supplemental payments to nine hospitals rewarding the high levels of primary care utilization for MaineCare members in their Hospital Service Areas (HSAs). The table below shows how the top eight (8) HSAs, which include nine (9) hospitals, surpassed the statewide average of 57% of MaineCare members within the HSA with a primary care visit in 2024. This sub-pool, totaling $600,000 annually, supports hospitals that partner with a MaineCare Accountable Community. MaineCare Accountable Community leads currently include Community Care Partnership of Maine (CCPM), Kennebec Region Health Alliance (KRHA), MaineHealth ACO (MHACO), and Northern Light Health (NLH).
For a full description of this VBP supplemental payment methodology please review MaineCare Benefits Manual, Chapter III, Section 45, Hospital Services (Section 45.07).
For the full crosswalk used to map HSA to zip code please review the Dartmouth Atlas Supplemental Data.
|
Accountable Community |
Hospital (HSA) |
Percentage of MaineCare Members in the HSA with a Primary Care Visit (CY 2024) |
|
CCPM |
Millinocket Regional Hospital (20022) |
70% |
|
MHACO |
MaineHealth – Franklin Memorial Hospital (20016) |
66% |
|
CCPM/ NLH |
St. Joseph Hospital / Northern Light Eastern Maine Medical Center (20002) |
62% |
|
MHACO |
St. Mary's Regional Medical Center (20019) |
62% |
|
MHACO |
MaineHealth – Mid Coast Hospital (20010) |
61% |
|
NLH |
Northern Light Maine Coast (20015) |
61% |
|
KRHA |
MaineGeneral Medical Center (20001) |
60% |
|
MHACO |
MaineHealth – Pen Bay Hospital (20027) |
59% |
For hospitals awarded these funds, the invoice type displays on any paper Remittance Advice (RA) as “OTHER.” The invoice number displays on any electronic 835 with a prefix of “VBPS.”
For questions, please contact Tiffany Norton, Provider Relations Specialist.