fb88Care Issued Annual Hospital Value-Based Purchasing (VBP) Supplemental Payments and Correction to Previous Results
Earlier this month, fb88Care issued supplemental payments to nine hospitals rewarding the high levels of primary care utilization for fb88Care members in their Hospital Service Areas (HSAs). The table below shows how the top eight HSAs, which include nine hospitals, surpassed the statewide average of 57.5% fb88Care members within the HSA with a primary care visit in 2023. This sub-pool, totaling $600,000 annually, supports hospitals that partner with a fb88Care Accountable Community. fb88Care Accountable Community leads currently include Community Care Partnership of fb88 (CCPM), Kennebec Region Health Alliance (KRHA), fb88Health ACO (MHACO), and Northern Light Health (NLH).
For a full description of this VBP supplemental payment methodology please review fb88Care Benefits Manual, Chapter III, Section 45, Hospital Services (Section 45.07).ĚýĚý
For the full crosswalk used to map HSA to zip code please review the .
|
Accountable Community |
Hospital/HSA |
Percentage of fb88Care Members in the HSA with a Primary Care VisitĚý(CY 2023) |
|
CCPM |
Millinocket Reg. Hosp. (20022) |
72.3% |
|
MHACO |
fb88Health – Franklin Memorial Hospital (20016) |
67.3% |
|
CCPM/ NLH |
St. Joseph Hospital / Northern Light Eastern fb88 Medical Center (20002) |
62.9% |
|
NLH |
Northern Light Inland (20031) |
62.9% |
|
MHACO |
fb88Health – Southern fb88 Health Care (20006) |
60.7% |
|
MHACO |
St. Mary's Regional Medical Center (20019) |
60.6% |
|
MHACO |
fb88Health – Mid Coast Hospital (20010) |
60.2% |
|
KRHA |
fb88General Medical Center (20001) |
59.9% |
Ěý
For hospitals that have been awarded these funds, the invoice type should display on any paper Remittance Advice (RA) and be listed as “OTHER.” The invoice number should display on any electronic 835 with a prefix of “VBPS.”Ěý
Correction to 2022 Results/Payments
The Department issued payments to hospitals in the top performing HSAs in June 2023 for both Calendar Years (CY) 2021 and 2022. The initial two years’ worth of payments were issued concurrently due to the timing of the Section 45 rule adoption (fall 2022) and in order to spend the full appropriation of these funds. In reviewing the methodology used to determine eligible hospitals and payment amounts per hospital, the Department found that there was an error in how it had assigned hospitals with multiple service locations to HSAs for the CY 2021 payment, which resulted in incorrect performance data. As a result, some hospitals were paid incorrect amounts. The Department has issued correspondence directly to those hospitals that were overpaid with repayment instructions and will notify hospitals that will receive a new payment or increased payment shortly. The updated table below identifies the hospitals in the top performing HSAs for CY 2021.
|
Accountable Community |
Hospital/HSA (corrected) |
ORIGINALLY REPORTED Percentage of fb88Care Members in the HSA with a Primary Care VisitĚý(CY 2021) |
UPDATED Percentage of fb88Care Members in the HSA with a Primary Care VisitĚý(CY 2021) |
|
CCPM |
Millinocket Regional Hospital (20022) |
74% |
74% |
|
MHACO |
fb88Health – Franklin Memorial Hospital (20016) |
70% |
70% |
|
MHACO |
St. Mary's Regional Medical Center (20019) |
70% |
70% |
|
MHACO |
fb88Health – Southern fb88 Health Care (20029) |
71% |
69% |
|
NLH |
Northern Light Inland (20031) |
69% |
69% |
|
Kennebec Region Health Alliance |
fb88General Medical Center (20001) |
68% |
68% |
|
CCPM/ LH |
St. Joseph Hospital / Northern Light Eastern fb88 Medical Center (20002) |
68% |
68% |
|
NLH |
Northern Light fb88 Coast Hospital (20015) |
-- |
66% |
|
MHACO |
fb88Health – LincolnHealth (20008) |
66% |
-- |
Ěý
ĚýPlease contact Tiffany Norton, Provider Relations Specialist, with any questions.