Provider Resources

Resource Topics

Participation in the ACO

Providers are eligible to participate in the ACO who are a MD, DO or Primary Care NP and a member of the medical staff of Franklin Memorial Hospital, LincolnHealth, Maine Medical Center, Memorial Hospital, Mid Coast Hospital, Pen Bay Medical Center, Southern Maine Health Care, Stephens Memorial Hospital, St. Mary’s Regional Medical Center or Waldo County General Hospital. To begin the process of joining the MaineHealth ACO, please email us to request an application packet.

Participants 

Conditions of Participation

Clinical Documentation Improvement Training (webpage)

Annual Compliance Training (PDF)

Code of Ethical Conduct (PDF)

Clinical Guidelines & Topics

COPD Resources

 

Colorectal Cancer Resources 

 

Diabetes Resources

 

End-of-Life Resources

 

Heart Failure Resources

 

Hypertension Resources

 

Adolescent & Pediatric Resources

 

Tobacco Resources

 

Medicare Annual Wellness Visits

Medicare Shared Savings Program (MSSP)

MIPS Alternative Payment Model (APM)

Practices that participate in the ACO's MSSP contract are automatically enrolled in a special MIPS payment model created for ACO participants called the MIPS APM. Because the ACO reports some categories of data on behalf of its participants, this model places a reduced reporting burden on practices, compared to those enrolled in the standard MIPS model. 

Promoting Interoperability - Each ACO participant TIN (tax ID number) is required to report for the Promoting Interoperability (PI) category, or apply for and receive a hardship exception from CMS

2015 Edition CEHRT EHR is required to report for the PI category. 

Participants must submit collected data for specific measures from each of the 4 objectives (unless an exclusion is claimed) for 90 continuous days or more during 2019:

  1. e-Prescribing
  2. Health Information Exchange
  3. Provider to Patient Exchange
  4. Public Health and Clinical Data Exchange 

A Security Risk Analysis measure is required but unscored for 2019

Specifications for each required measure are located below-

2019 MIPS Payment Adjustment

If you are receiving a payment adjustment this year, below are two resource documents from CMS to guide you through reviewing your claims remittance advice to ensure adjustments are accurately applied. Per a federal law update, adjustments should only be applied to covered professional services under the Physician Fee Schedule and not Part B drugs.

Enterprise Identity Management System (EIDM) Accounts: The Quality Payment Program Portal requires you to have a login and password. If you already possess an EIDM account you may continue to use it. However, if you do not have an account, please follow the new process called “HARP” (HCQIS Access Roles and Profile system) which is outlined in the documents below.

  1. Before You Begin
  2. Register for a HARP Account
  3. Connect to an Organization
  4. Connect as a Clinician
  5. Security Officials Manage Access

 If you have any questions, please contact Susan Whittaker at swhittaker@healthcentricadvisors.org or (207) 406-3970.

Health Plan Partners

Clinical Documentation Improvement

Best Practice Frameworks

A series of Best Practice Frameworks designed to provide a standard set of strategies and tools specific to help you improve care provided in the ambulatory environment.

Best Practice Frameworks (Webpage)

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