Executive Summary
Maine hospitals have always been at the forefront of healthcare reform. Years before the government publicly
reported the quality of care or level of patient satisfaction, Maine hospitals were measuring those things and
publicly reporting their results.
Maine hospitals advocated for payment reform, pointing out that everyone would be better off if hospitals were
paid for keeping people well. Hospitals were key in driving the creation of Maine’s statewide medical record
system—an idea that came about long before the Affordable Care Act’s meaningful use of electronic medical
records requirement was ever enacted.
At last, thanks in part to the Affordable Care Act, government, payers and employers have joined Maine
hospitals to do meaningful healthcare reform.
Few outside the hospital community are aware of the vast systemic changes that are happening there. The
pace of change has been astounding—so fast that some aspects of reform, such as paying for quality care,
haven’t kept up with the changes that hospitals have made, like reducing readmissions. These growing pains
can be expensive with hospital beds remaining empty, yet no reimbursement for the programs that keep the
patients out of those beds.
This document features several examples of the reform and transformation that is happening in all Maine
hospitals and in the state’s healthcare system as a whole. Hospitals are meeting the challenges, but more
comprehensive solutions still are needed for some of the pressing problems in the system.
In this report, you will learn how hospitals work to keep their patients out of the emergency room and, indeed,
out of the hospital, when appropriate for the patient. You will read how many of those efforts go unpaid by the
government and insurers. But, you will also read how some providers are working with insurers to pay them
for keeping people well. Additionally, a hospital-supported statewide electronic medical record system helps
hospitals keep track of their patients, alerting doctors and nurses when they seem headed for a medical crisis.
You will also learn how one hospital found that creating a more welcoming and comfortable environment
improved the health of its patients, staff and finances. And, how another hospital, at its community's request,
is making conversations and decisions about end-of-life care part of its healthcare discussions.
These stories are just a handful of examples of the transformative work that is happening in all of Maine's
hospitals. And there is more work to be done. Payment systems need to be changed, service lines adjusted,
billing simplified and locations of care modernized. But Maine hospitals will continue to welcome and meet
these challenges.
