Becker’s Healthcare Podcast

Episode: Andy Mueller, MD on Redesigning Primary Care and Advancing Affordable Healthcare at MaineHealth
Date: January 29, 2026
Host: Laura Deardle (Becker's Healthcare)
Guest: Dr. Andy Mueller, President and CEO, MaineHealth

Overview

This episode features Dr. Andy Mueller, President and CEO of MaineHealth, discussing innovative approaches in primary care, the shift to value-based models, strategies for delivering affordable healthcare, and leadership challenges amid ongoing industry change. Dr. Mueller offers insights into MaineHealth's recent initiatives—particularly their launch of Trellis Health, a novel capitated primary care model—and shares thoughts on adapting organizational culture and workforce mindset to meet a rapidly evolving healthcare landscape.

Key Discussion Points and Insights

MaineHealth: Scope and Focus

[01:19-01:45]

• MaineHealth serves diverse urban and rural communities throughout Maine and part of New Hampshire with 24,000 care team members.
• Dr. Mueller emphasizes the importance of engaging teams and consistently focusing on five foundational priorities (the "five pack"): care team engagement, quality and safety, patient experience, access, and financial system health.
• These are not just strategic pillars but the "table stakes in delivering care for our patients and communities."

Major Initiatives: The "Five Pack" and Capitated Primary Care

[01:59-03:38]

• MaineHealth’s leadership zeroes in on:
  • Engaging care teams
  • Ensuring high quality and safety
  • Optimizing patient experience
  • Improving access to care
  • Maintaining financial health
• New primary care model:
  • Launched Trellis Health, a startup-like subsidiary focused on capitated (not fee-for-service) primary care.
  • Converted an existing clinic to a "synthetic capitated model," yielding promising results.
• "In fact, sometimes we even hesitate to call it primary care because we don't want to conform to anything that exists today." – Dr. Andy Mueller [04:19]

Trellis Health: Experimenting with a New Model

[04:01-06:27]

• Genesis: Idea originated from wanting to rethink primary care after recognizing significant, justifiable challenges faced by clinicians.
• MaineHealth hired a "serial entrepreneur from Silicon Valley" to run the project as a true startup.
• Guiding principles:
  1. No fee-for-service payments accepted.
  2. Must achieve a positive standalone P&L within two years.
• From concept to first patient in 11 months.
• Results from the first year (Trellis Health):
  • 16% reduction in admissions per thousand
  • 35% reduction in ER visits
  • 37% reduction in specialty referrals
  • $600,000 saved for about 1,000 care team members using Trellis as a benefit
  • Net Promoter Score of 90
  • "Quality and safety outcomes that are outstanding." – Dr. Andy Mueller [05:25]
• Regular (non-Trellis) practice showed improvement, especially in patient experience and team engagement, even if not as dramatic.

Change Management and Team Response

[07:04-07:54]

• Trellis Health built its team from scratch, attracting those open to doing things differently.
• Adapting existing practices met mixed reactions—some enthusiasm, some skepticism, and a range of responses in between.
• "Change is hard in the moment, particularly when you still have the demands of seeing patients in the environment." – Dr. Andy Mueller [07:27]
• Transparent internal communication helped, but ongoing efforts are needed to bring all clinicians on board.

The 2026 Agenda: Affordability and Sustainable Access

[08:06-09:10]

• Affordability: Main focus going forward, given Maine’s less affluent population and financial strain on patients and employers.
• Strategies include:
  • Rethinking relationships with payers and pricing models.
  • Managing utilization efficiently (as with Trellis and Project Horizon).
  • Reducing clinical variation to improve outcomes and lower costs.
• "That's going to be an area that we're going to continue to have to focus more and more on." – Dr. Andy Mueller [08:24]

Metrics and Accountability

[09:46-11:20]

• Key metric: Total cost of care per capita—beginning to use this as a central internal measure.
• Deepening conversations and listening sessions with stakeholders (government, employers, brokers) to inform strategies and address pain points.
• Drug costs and external innovations (AI, precision medicine, genomics) will continue to impact cost and service.

Leadership, Culture, and Change Fatigue

[11:40-13:58]

• Supporting teams through relentless change is the toughest leadership challenge.
• The pace of transformation is high: "We don't have the luxury of time. We have to move quickly." – Dr. Andy Mueller [12:23]
• Dr. Mueller emphasizes explaining the "why" behind changes, and redirecting focus to stable, core values (the "five pack") even amid transformation.
• "Redirecting people back to the things that really don't change... focus on engagement, quality, safety, patient experience, access, and financial health. Those things never change." – Dr. Andy Mueller [13:34]

Growth and Managing Demand

[14:08-15:38]

• Growth remains a consideration, but must align with the core mission and be sustainable.
• Maine’s aging population drives "insatiable demand" outstripping capacity; other in-state health system challenges increase regional patient volume.
• Double-digit volume growth has occurred in recent years, but there's a limit to what is sustainable.
• Focus remains on "avoiding unnecessary utilization and reducing duplicative care" to address both growth and cost.

Notable Quotes & Memorable Moments

• "It would almost be easier to sort of blow up primary care and start with from scratch. And we kind of thought, well, why don't we try it?" – Dr. Andy Mueller [04:19]
• "We've demonstrated we can do both... went from nothing to seeing the first patient in that new payment model in 11 months." – Dr. Andy Mueller [05:00]
• "We've had about a thousand use it [Trellis] during the first year... we're seeing about a 16% reduction in admissions per thousand... and savings of about $600,000." – Dr. Andy Mueller [05:12]
• "Change is hard in the moment... they did an amazing job of figuring that out." – Dr. Andy Mueller [07:27]
• "One of the most important quality metrics that we probably don't talk enough about... is the total cost of care on a per capita basis." – Dr. Andy Mueller [09:50]
• "We don't have the luxury of time. We have to move quickly." – Dr. Andy Mueller [12:23]
• "Redirecting people back to the things that really don't change... focus on engagement, quality, safety, patient experience, access, and financial health. Those things never change." – Dr. Andy Mueller [13:34]

Timestamps for Important Segments

• [01:19] — Dr. Mueller introduces himself and MaineHealth
• [01:59] — MaineHealth "Five Pack" priorities
• [03:38] — Capitated primary care (Trellis Health) and initial results
• [04:01] — Building Trellis Health: Process and challenges
• [05:12] — Outcomes from Trellis Health and synthetic capitation in regular clinics
• [07:04] — Change management and clinician response
• [08:06] — 2026 focus: Affordability and sustainable care
• [09:46] — Total cost of care as a quality metric
• [11:40] — Leadership challenge: Navigating continuous change
• [13:06] — Creating a resilient, adaptable team culture
• [14:08] — Organizational growth and managing healthcare demand

Summary

Dr. Andy Mueller details MaineHealth’s approach to transforming primary care through innovation and value-based experimentation, such as the Trellis Health initiative. The organization’s leadership accommodates both system-wide priorities and the adaptability required during industry change, with transparency and focus on metrics like per capita cost of care. Dr. Mueller’s candid reflections illustrate both the opportunities and pressures facing health system executives as they strive for affordability, improved outcomes, and sustainable growth.