​​MaineCare Issuing Second Hospital Value-Based Purchasing (VBP) Supplemental Payments​​

Jun 28, 2023

MaineCare recently implemented its new VBP supplemental sub-pool payments, totaling $600,000, which the Department will distribute each year to eligible hospitals based on performance on one or more quality measures. This sub-pool helps align incentives across the health care system to drive desired outcomes. The 2022 and 2023 distribution of these funds will focus on primary care access among MaineCare members within designated Hospital Service Areas (HSAs).   

Eligible hospitals must:  

• Be an Acute Care Non-Critical Access Hospital, Acute Care Critical Access Hospital, or a Hospital Reclassified to a Wage Area Outside of Maine, and  

• Participate in the MaineCare Accountable Communities (AC) Initiative, which includes Beacon Health, LLC (Beacon),  Community Care Partnership of Maine, LLC (CCPM), Kennebec Region Health Alliance (KRHA), and MaineHealth Accountable Care Organization (MHACO).  

The Department issued for State Fiscal Year 2022 in the first week of June, 2023. We are now issuing a second payment this week for State Fiscal Year 2023. For a description of the payment methodology please review MaineCare Benefits Manual, Chapter III, Section 45, Hospital Services (Section 45.07). After these initial two payments have been issued, awarded hospitals should anticipate an annual May delivery date of these notices and the associated payments.  

For hospitals that are awarded these funds, the invoice type should display on any paper Remittance Advice (RA) listed as “OTHER.” For hospitals with the electronic 835, the invoice number should display with a prefix of “VBPS.”  

We congratulate these hospitals listed in the table below, their AC entities, and their community partners who are working to connect MaineCare members to primary care services.    

  

AC	Hospital	Percentage of MaineCare Members in the HSA with a Primary Care Visit   (CY 2022)
Community Care Partnership of Maine	Millinocket Regional Hospital	76%
MaineHealth ACO	MaineHealth – Franklin Memorial Hospital	70%
Community Care Partnership of Maine / Beacon Health	St. Joseph Hospital / Northern Light Eastern Maine Medical Center	66%
MaineHealth ACO	St. Mary's Regional Medical Center	66%
Beacon Health	Northern Light Inland	66%
Kennebec Region Health Alliance	MaineGeneral Medical. Center’s Alfond Center for Health	64%
MaineHealth ACO	MaineHealth - Southern Maine Health Care	64%
Beacon Health	Northern Light Maine Coast	63%

Please contact Tiffany Norton, Provider Relations Specialist, with any questions.