Dear Editor:

In a recent letter, Mr. James Donovan of Lincoln County Healthcare wrote:

“The first (story) was the creation of LincolnHealth, a single critical access hospital with campuses in Damariscotta and Boothbay Harbor. This will increase our Medicare and MaineCare reimbursement by between $5 and $7 million a year and allow us to lower our prices.”

This “single critical access hospital” with two campuses could only have been achieved after the closure of St. Andrews as a hospital/emergency room, and the transfer of its charter/license to Miles. So, based solely on Donovan’s statement above, it is highly likely that MaineHealth decided to close St. Andrews in order to qualify for CMS reimbursements of between $5 and $7 million, a huge windfall that became achievable when MaineHealth agreed to participate as a Medicare Shared Savings Program Accountable Care Organization (ACO).

A recent press release stated: “MaineHealth today announced it has been selected to participate in the Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organization (ACO), a multifaceted new program sponsored by the Centers for Medicare and Medicaid Services (CMS). Through the Shared Savings Program, the MaineHealth Accountable Care Organization will work with CMS to provide Medicare fee-for-service beneficiaries with high quality service and care, while reducing the growth in Medicare expenditures through enhanced care coordination.”

So, it logically follows that the closure of St. Andrews became inevitable after the passage of the Affordable Care Act, which established ACO’s under a Medicare Shared Savings Program (sec 3022). The Centers for Medicare and Medicaid Services (CMS) defines ACOs as “groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.” It further states that “when an ACO succeeds ... it will share in the savings it achieves for the Medicare program.”

So, when an ACO such as LincolnHealth delivers care to “predetermined standards” and spends less healthcare dollars to do so, it can see a bonus. It remains to be seen whether the ACO model can deliver quality, timely and low cost healthcare, or will result in devastating healthcare rationing. 

The bottom line: MaineHealth closed St. Andrews because of the passage of Obamacare.

Phil Molvar
Southport