Premium Care Partners ACO 2

Premium Care Partners ACO 2

An Accountable Care Organization (ACO) committed to improving patient outcomes through elevated value-based care.

An Accountable Care Organization (ACO) committed to improving patient outcomes through elevated value-based care.

ACO Name and Location
ACO Name and Location

Premium Care Partners ACO 2
20 Burton Hills Blvd
Nashville, TN 37215

ACO Primary Contact
ACO Primary Contact

Kristine Miller
Phone: (916) 542-4568
Email: kmiller@wellvana.com

Organizational Information

Organizational Information

ACO Participants

ACO Participant in Joint Venture

CROUSE MEDICAL PRACTICE PLLC

Y

CROUSE HEALTH HOSPITAL INC

Y

BAY CLINIC

Y

OLMSTED MEDICAL CENTER

Y

MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS, PA

Y

WASHINGTON REGIONAL MEDICAL CENTER

Y

AITKIN COMMUNITY HOSPITAL INC.

Y

TRI-STATE MEMORIAL HOSPITAL

Y

COMMUNITY CARE WEST SIDE LLC

Y

MOUNTAIN VIEW HOSPITAL LLC

Y

CC POCATELLO LLC

Y

MVH BMC LLC

Y

MVH PIC LLC

Y

MV POCATELLO ENT, LLC

Y

MVH SURGICAL SPECIALISTS LLC

Y

PRESCRIPTION CENTER LLC

Y

SKYLINE SURGERY CENTER, LLC

Y

SCOTLAND COUNTY MEMORIAL HOSPITAL

Y

PRESCRIPTION CENTER HOMECARE, LLC

Y

MVH PMHS LLC

Y

HUNT MEMORIAL HOSPITAL DISTRICT

Y

GREENVILLE PULMONARY ASSOCIATES,PA

Y

GREENVILLE WOMENS WELLNESS CENTER

Y

HUNT REGIONAL MEDICAL PARTNERS

Y

ZAPATA WOMEN'S HEALTH CENTER, P.C.

Y

JACK M THOMAS MD PLLC

Y

WASHINGTON REGIONAL MEDICAL SYSTEM

Y

HUNT REGIONAL MEDICAL PARTNERS SPECIALISTS

Y

HANNIBAL CLINIC OPERATIONS LLC

Y

BLESSING HOSPITAL

Y

BLESSING CORPORATE SERVICES INC

Y

BLESSINGCARE CORPORATION

Y

Lake City Family Physicians PC

Y

OHIO COUNTY HOSPITAL CORPORATION

Y

CUMBERLAND INTERNAL MEDICINE

Y

IDAHO FALLS COMMUNITY HOSPITAL LLC

Y

INSPIRA MEDICAL CENTERS, INC

Y

JACK C WU MD PA

Y

JACK M. SHIELDS,M.D., PA

Y

MEDICAL ALLIANCE OF SOUTHERN NEW JERSEY PC

Y

SNAKE RIVER HOSPITALISTS LLC

Y

PINE STREET FAMILY PRACTICE

Y

SOUTH MAIN MEDICAL ASSOCIATES, LLC

Y

SOUTH JERSEY RADIATION ONCOLOGY PC

Y

ROBERT PATITUCCI

N

CUMBERLAND NEPHROLOGY ASSOCIATES

Y

LYONS AND CHVALA NEPHROLOGY ASSOC.

Y

THE DR MARTIN JAY KESSLER MEDICAL SERVICES LLC

Y

FAMILY PRACTICE ASSOCIATES OF CUMBERLAND CO PC

Y

SOUTH CUMBERLAND MEDICAL ASSOCIATES PC

Y

INSPIRA HEALTH NETWORK MEDICAL GROUP PC

Y

ELMER FAMILY PRACTICE,PC

Y

CUMBERLAND FAMILY MEDICINE LLC

Y

FERNANDES BANERJEE SHENOY KIDNEY CENTER,LLC

Y

IMAD AL-NAKSHABENDI M D P A

Y

FLORIDA HEALTH SCIENCES CENTER INC

Y

FLORIDA UROLOGY PARTNERS LLP

Y

INPATIENT SPECIALISTS GROUP

Y

MARGARITA R CANCIO MD PA

Y

TAMPA GENERAL MEDICAL GROUP INC

Y

UNIVERSITY MEDICAL SERVICE ASSOCIATION INC

Y

HANCOCK REGIONAL HOSPITAL

Y

HANCOCK HEALTH GATEWAY SERVICES INC

Y

HANCOCK PHYSICIAN NETWORK, LLC

Y

WINONA HEALTH SERVICES

Y

WINONA SENIOR SERVICES, INC

Y

VANNVEI LLC

Y

WAKE SPECIALTY PHYSICIANS LLC

Y

WAKEMED

Y

WAKEMED SPECIALISTS GROUP LLC

Y

SID PETERSON MEMORIAL HOSPITAL

Y

PETERSON MEDICAL ASSOCIATES

Y

FAIRVIEW CLINIC, P.C.

Y

COMMUNITY MEMORIAL HEALTH SYSTEM

Y

ABIGAIL FROCHTZWAJG

N

SANDHYA PATEL

Y

STANLEY FROCHTZWAJG

N

ASSOCIATES IN PULMONARY AND CRITICAL CARE MEDICINE

Y

BOWLING GREEN INTERNAL MEDICINE AND

Y

CAROL B PEDDICORD MD PLLC

Y

BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION

Y

COMMONWEALTH HEALTH CORPORATION INC

Y

FAMILY MEDICAL CENTER OF HART CO

Y

K G SAHETYA PSC

Y

PHYSICIAN MANAGEMENT SERVICES PSC

Y

SAM KESRI

Y

THE MEDICAL CENTER AT FRANKLIN INC

Y

VERDANT HEALTHCARE LLC

Y

ST LUKES HOSPITAL OF DULUTH

Y

LABORATORY MEDICINE SPECIALISTS OF DULUTH

Y

LAKE VIEW MEMORIAL HOSPITAL, INC.

Y

NORTHLAND GASTROENTEROLOGY PA

Y

ORTHOPEDIC ASSOCIATES OF DULUTH PA

Y

ST. MARY'S HIMG, LLC

Y

ST. MARY'S MEDICAL MANAGEMENT, LLC

Y

UNIVERSITY PHYSICIANS & SURGEONS INC

Y

ST. MARY'S MEDICAL CENTER, INC

Y

COMMUNITY MEMORIAL HOSPITAL ASSOCIATION

Y

UNITED HOSPITAL DISTRICT INC

Y

COMMUNITY HOSPITAL ASSOCIATION

Y

SIDNEY HEALTH CENTER

Y

MARCUS DALY MEMORIAL HOSPITAL CORPORATION

Y

ARTESIA GENERAL HOSPITAL

Y

REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES, INC.

Y

SKY LAKES MEDICAL CENTER INC

Y

WEST PHYSICIAN SERVICES LLC

Y

PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY

Y

PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC

Y

MARGARET MARY COMMUNITY HOSPITAL INC

Y

PLEASANT VALLEY HOSPITAL, INC.

Y

ALCONA CITIZENS FOR HEALTH INC

Y

THREE RIVERS HEALTH SYSTEM INC

Y

DMC PHYSICIAN GROUP LLC

Y

POINT PLEASANT PHYSICIAN BILLING SERVICES

Y

FAMILY PRACTICE ASSOCIATES PLLC

Y

MEADVILLE MEDICAL CENTER

Y

TITUSVILLE AREA HEALTH SERVICES, INC.

Y

TITUSVILLE AREA HOSPITAL

Y

MEADVILLE PHYSICIAN SERVICES

Y

BRADON KIMURA MD INC

Y

HOSPITAL AUTHORITY OF BEN HILL

Y

PLAINS HOSPITAL CORPORATION

Y

CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL INC

Y

CONNECTICUT HEALTH CARE GROUP LLC

Y

CARDIOLOGY ASSOCIATES OF GREATER WATERBURY, LLC

Y

IONUT ANTON M.D. PC

Y

PROSPECT CT MEDICAL FOUNDATION INC

Y

SOUTHERN HILLS FAMILY MEDICINE PROF LLC

Y

PRIMARY CARE SERVICES

Y

CURRY HEALTH DISTRICT

Y

CLAXTON-HEPBURN MEDICAL CENTER

Y

LOWVILLE MEDICAL ASSOCIATES LLP

Y

FAMILY MEDICINE OF CARTHAGE, PC

Y

SAMARITAN MEDICAL PRACTICE PC

Y

CARTHAGE AREA HOSPITAL INC

Y

OGDENSBURG FAMILY PRACTICE LLC

Y

CLAXTON MEDICAL PC

Y

KAREN A. WILLIAMS, MD, PC

Y

SAMARITAN MEDICAL CENTER

Y

NORTH COUNTRY FAMILY HEALTH CENTER, INC.

Y

WATERTOWN INTERNISTS PC

Y

RIVER HOSPITAL INC

Y

CLIFTON-FINE HEALTHCARE CORPORATION

Y

RAYMOND KURKER

N

REID HOSPITAL & HEALTH CARE SERVICES INC

Y

REID PHYSICIAN ASSOCIATES, INC.

Y

OWENSBORO HEALTH TWIN LAKES REGIONAL MEDICAL CENTER INC

Y

NEED-A-NURSE MEDICAL STAFFING, LLC

Y

PRIMARY CARE SPECIALISTS PA

Y

ONEIDA COUNTY HOSPITAL

Y

POWER COUNTY HOSPITAL DISTRICT

Y

FIRTH MEDICAL CENTER PLLC

Y

IDAHO MODERN MEDICINE - PLLC

Y

FRANKLIN COUNTY MEDICAL CENTER

Y

JOHN FORNAROTTO PLLC

Y

LIFE CHANGE ASSOCIATES PC

Y

IDAHO REGIONAL HAND & UPPER EXTREMITY CENTER PLLC

Y

WILLOW SAGE SERVICES LLC

Y

SEI ANESTHESIA PLLC

Y

DAVID PARRY

N

BRIZZEE FAMILY MEDICINE INC

Y

ANESTHESIA CONSULTANTS MEDICAL GROUP PC

Y

GUT PC

Y

DOTHAN MEDICAL ASSOCIATES, P.C.

Y

PAUL H CHAN MD PC

Y

NIEL C RASMUSSEN MD PC

Y

HEARTS SOUTH PC

Y

RAO HEART & VASCULAR LLC

Y

SOUTHEAST CARDIOLOGY CLINIC INC.

Y

HOUSTON COUNTY HEALTHCARE AUTHORITY

Y

WILLIAM HEWITT

Y

WOMEN'S MEDICAL CENTER, PC

Y

SHENANDOAH MEDICAL CENTER

Y

ROBERT JONES

N

GOOD SAMARITAN HOSPITAL

Y

GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES INC

Y

WEBSTER COUNTY MEMORIAL HOSPITAL

Y

BROADDUS HOSPITAL ASSOCIATION INC

Y

DAVIS MEMORIAL HOSPITAL

Y

KNOX COMMUNITY HOSPITAL

Y

FISHER-TITUS MEDICAL CENTER

Y

FISHER-TITUS MEDICAL CARE LLC

Y

MEMORIAL COMMUNITY HEALTH INC

Y

POUDRE VALLEY HEALTH CARE INC

Y

COAL COUNTRY COMMUNITY HEALTH CENTER

Y

HAZEN MEMORIAL HOSPITAL ASSOCIATION

Y

ERICKSON CHIROPRACTIC PC

Y

PFLIGER CHIROPRACTIC CLINIC PC

Y

FRANCES MAHON DEACONESS HOSPITAL

Y

BARRETT HOSPITAL DEVELOPMENT CORPORATION

Y

JILL GRAMER DO PA

Y

FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC.

Y

FINGER LAKES MIGRANT HEALTH CARE PROJECT, INC.

Y

NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.

Y

ROCHESTER PRIMARY CARE NETWORK INC

Y

SYRACUSE COMMUNITY HEALTH CENTER INC

Y

WHITNEY M YOUNG JR HEALTH CENTER INC

Y

UPSTATE FAMILY HEALTH CENTER, INCORPORATED

Y

ANTHONY L. JORDAN HEALTH CORPORATION

Y

EAST HILL FAMILY MEDICAL, INC.

Y

MOUNT VERNON NEIGHBORHOOD HEALTH CENTER INC

Y

AHS PRYOR HOSPITAL, LLC

Y

AHS CLAREMORE REGIONAL HOSPITAL LLC

Y

AHS OKLAHOMA PHYSICIAN GROUP LLC

Y

AHS HENRYETTA HOSPITAL LLC

Y

ACO Governing Body:

ACO Governing Body:

Member First Name

Member Last Name

Member Title/Position

Member’s Voting Power

Membership Type

ACO Participant Legal Business Name

Derek

Miller

Board Member

1.449%

ACO Participant Representative

Houston County Health Care Authority

James

Robeson Jr. MD

Board Member

1.449%

ACO Participant Representative

Fairview Clinic, P.C.

Lenny

Whiteman

Board Member

1.449%

ACO Participant Representative

Washington Regional Medical System

Jason

Wilson

Board Member

1.449%

ACO Participant Representative

Medical Associates of Northwest Arkansas, PA

Anthony

Russell, MD

Board Member

1.449%

ACO Participant Representative

Community Memorial Health System

Amy

Scanlan

Board Member

1.449%

ACO Participant Representative

Rocky Mountain Coordinated Care Network, LLC

EJay

Lockwood

Board Member

1.449%

ACO Participant Representative

Prospect Health Services CT, Inc.

Dale

Aggen

Board Member

1.449%

ACO Participant Representative

Florida Health Sciences Center, Inc.

Paige

Wynn

Board Member

1.449%

ACO Participant Representative

Hospital Authority of Ben Hill

Bradon

Kimura, MD

Board Member

1.449%

ACO Participant Representative

Bradon Kimura M.D. Inc.

Eric

Holste

Board Member

1.449%

ACO Participant Representative

Shenandoah Medical Center

Brittany

Russell

Board Member

1.449%

ACO Participant Representative

Mountain View Hospital LLC

Brock

Merrill

Board Member

1.449%

ACO Participant Representative

Patient Quality Alliance

Chris

Solaro

Board Member

1.449%

ACO Participant Representative

Blessing Hospital

Julie

Keene

Board Member

1.449%

ACO Participant Representative

Margaret Mary Community Hospital, Inc.

Tara

McVay

Board Member

1.449%

ACO Participant Representative

Memorial Hospital

Brian

Muckerheide

Board Member

1.449%

ACO Participant Representative

Hancock Regional Hospital

David

Dunkle, MD

Board Member

1.449%

ACO Participant Representative

Johnson Memorial Hospital

Billie

Kester

Board Member

1.449%

ACO Participant Representative

Reid Hospital & Health Care Services, Inc

Adam

Thacker

Board Member

1.449%

ACO Participant Representative

Good Samaritan Hospital Physician Services Inc

Michael

Handley

Board Member

1.449%

ACO Participant Representative

Ohio County Hospital

John Mark

Fones

Board Member

1.449%

ACO Participant Representative

Bowling Green Warren County Community Hospital

Paul

Berg

Board Member

1.449%

ACO Participant Representative

War Memorial Hospital

Robin

Hoeg

Board Member

1.449%

ACO Participant Representative

Winona Health Services

Ken

Westman

Board Member

1.449%

ACO Participant Representative

Aitkin Community Hospital Inc.

Rob

Cunningham

Board Member

1.449%

ACO Participant Representative

Olmsted Medical Center

Eric

Lohn

Board Member

1.449%

ACO Participant Representative

St. Luke's Hospital of Duluth

Rick

Breuer

Board Member

1.449%

ACO Participant Representative

Community Memorial Hospital Association

Rick

Ash

Board Member

1.449%

ACO Participant Representative

United Hospital District

Julie

Jones

Board Member

1.449%

ACO Participant Representative

Community Hospital Association, Inc.

Meagan

Weber

Board Member

1.449%

ACO Participant Representative

Scotland County Memorial Hospital

Nathan

Kunz

Board Member

1.449%

ACO Participant Representative

Marcus Daly Memorial Hospital Corporation

Greg

Hanson

Board Member

1.449%

ACO Participant Representative

Plains Hospital Corporation

Kathleen

Nenninger

Board Member

1.449%

ACO Participant Representative

Frances Mahon Deaconess Hospital

Jamie

Brownell

Board Member

1.449%

ACO Participant Representative

Marias Healthcare Services Inc

Theresa

Amerson

Board Member

1.449%

ACO Participant Representative

WakeMed

Nitin

Desai, MD

Board Member

1.449%

ACO Participant Representative

Sandhills Physicians, Inc.

Sanjiv

Dalvi

Board Member

1.449%

ACO Participant Representative

CUMBERLAND MEDICAL ASSOCIATES PC

Heather

Ammons

Board Member

1.449%

ACO Participant Representative

Lifelink Medical Group LLC

Chastity

Dolbec

Board Member

1.449%

ACO Participant Representative

Hazen Memorial Hospital Association

Justin

Wolf

Board Member

1.449%

ACO Participant Representative

Memorial Community Health

April

Venable

Board Member

1.449%

ACO Participant Representative

Inspira Medical Centers, Inc.

Joe

Salgado

Board Member

1.449%

ACO Participant Representative

Artesia General Hospital

Bill

Patten

Board Member

1.449%

ACO Participant Representative

Rehoboth McKinley Christian Healthcare Services

Brandi

Isham

Board Member

1.449%

ACO Participant Representative

Hunt Memorial Hospital District

Joleen

Carper

Board Member

1.449%

ACO Participant Representative

Tri-State Memorial Hospital

Matthew

Forge

Board Member

1.449%

ACO Participant Representative

Public Hospital District #1-A Of Whitman County

Catherine

Chua, D.O.

Board Member

1.449%

ACO Participant Representative

Davis Health System

Chadwick

Smith, MD

Board Member

1.449%

ACO Participant Representative

MHC Accountable Care Organization, LLC

Seth

Kronenberg

Board Member

1.449%

ACO Participant Representative

Crouse Health Hospital Inc

Joanna

Loomis

Board Member

1.449%

ACO Participant Representative

HealthCare Partners of the North Country, LLC

Briannon

O’Connor

Board Member

1.449%

ACO Participant Representative

Finger Lakes IPA, Inc.

Jim

Olver

Board Member

1.449%

ACO Participant Representative

HORIZON MEDICAL GROUP PC

Michael

Ambrosiani

Board Member

1.449%

ACO Participant Representative

Knox Community Hospital

Matthew

Mattner

Board Member

1.449%

ACO Participant Representative

Fisher-Titus Medical Care LLC

Linet

Samson

Board Member

1.449%

ACO Participant Representative

Bay Clinic

Richard

Rico

Board Member

1.449%

ACO Participant Representative

Sky Lakes Medical Center Inc

Virginia

Williams

Board Member

1.449%

ACO Participant Representative

Curry Health District

Philip

Pandolph

Board Member

1.449%

ACO Participant Representative

Meadville Medical Center

Paul

Tarap

Board Member

1.449%

ACO Participant Representative

Southern Hills Family Medicine

Eloy

Sena

Board Member

1.449%

ACO Participant Representative

Ardent Health

Cory

Edmonson

Board Member

1.449%

ACO Participant Representative

Sid Peterson Memorial Hospital

Courtney

Gildon

Board Member

1.449%

ACO Participant Representative

Jill Gramer DO PA

Jen

Doty

Board Member

1.449%

ACO Participant Representative

Sidney Health Center

Taylor

Rose

Board Member

1.449%

ACO Participant Representative

Barrett Hospital Development Corporation

Russ

Ranallo

Board Member

1.449%

ACO Participant Representative

Owensboro Health Medical Group INC

Nancy

Spencer

Board Member

1.449%

ACO Participant Representative

Alcona Citizens for Health, Inc.

Barbara

Garrett

Board Member

1.449%

ACO Participant Representative

Three Rivers Health System, Inc

Darrold

Bertsch

Board Member

1.449%

Medicare Beneficiary

N/A

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

ACO Executive: Khue Nguyen

ACO Executive: Khue Nguyen

Medical Director: Dr. Jeffrey Galles

Medical Director: Dr. Jeffrey Galles

Compliance Officer: Emma Oakley

Compliance Officer: Emma Oakley

Quality Assurance/Improvement Officer: Rayna Caplan

Quality Assurance/Improvement Officer: Rayna Caplan

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

  • Partnerships or joint venture arrangements between hospitals and ACO professionals

  • Hospital employing ACO professionals

  • Critical Access Hospital (CAH) billing under Method II

Shared Savings and Losses:

Shared Savings and Losses:

Shared Savings and Losses:

Shared Savings and Losses:

Amount of Shared Savings/Losses:

Amount of Shared Savings/Losses:

  • First Agreement Period

    • Performance Year 2019, $1,092,848.54

    • Performance Year 2020, $15,432,521.48

    • Performance Year 2021, $14,379,795.53

    • Performance Year 2022, $30,812,483.60

    • Performance Year 2023, $57,432,453

Shared Savings Distribution:

Shared Savings Distribution:

  • First Agreement Period

    • Performance Year 2019

      • Proportion invested in infrastructure: 10%

      • Proportion invested in redesigned care processes/resources: 0%

      • Proportion of distribution to ACO participants: 90%

    • Performance Year 2020

      • Proportion invested in infrastructure: 10%

      • Proportion invested in redesigned care processes/resources: 0%

      • Proportion of distribution to ACO participants: 90%

    • Performance Year 2021

      • Proportion invested in infrastructure: 10%

      • Proportion invested in redesigned care processes/resources: 0%

      • Proportion of distribution to ACO participants: 90%

    • Performance Year 2022

      • Proportion invested in infrastructure: 31.93%

      • Proportion invested in redesigned care processes/resources: 0%

      • Proportion of distribution to ACO participants: 68.07%

    • Performance Year 2023

      • Proportion invested in infrastructure: 44%

      • Proportion invested in redesigned care processes/resources: N/A

      • Proportion of distribution to ACO participants: 66%

2022 Quality Performance Results: *Quality performance results are based on CMS Web Interface

Measure #

Measure Name

Collection Type

Rate

ACO Mean

001

Diabetes: Hemoglobin A1c (HbA1c) Poor Control2

CMS Web Interface

6.25

10.71

134

Preventative Care and Screening: Screening for Depression and Follow-up Plan

CMS Web Interface

91.07

76.97

236

Controlling High Blood Pressure

CMS Web Interface

82.00

76.16

318

Falls: Screening for Future Fall Risk

CMS Web Interface

94.10

87.83

110

Preventative Care and Screening: Influenza Immunization

CMS Web Interface

83.49

77.34

226

Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention

CMS Web Interface

84.00

79.27

113

Colorectal Cancer Screening

CMS Web Interface

83.72

75.32

112

Breast Cancer Screening

CMS Web Interface

85.41

78.07

438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

CMS Web Interface

85.42

86.37

370

Depression Remission at Twelve Months

CMS Web Interface

14.67

16.03

321

CAHPS for MIPS3

CMS Web Interface

N/A

N/A

479

Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2

CMS Web Interface

0.1547

0.1510

484

Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1]

CMS Web Interface

33.94

30.97

2023 Quality Performance Results: *Quality performance results are based on CMS Web Interface

Measure #

Measure Name

Collection Type

Rate

ACO Mean

001

Diabetes: Hemoglobin A1c (HbA1c) Poor Control2

CMS Web Interface

7.17

9.84

134

Preventative Care and Screening: Screening for Depression and Follow-up Plan

CMS Web Interface

80.47

80.97

236

Controlling High Blood Pressure

CMS Web Interface

70.57

77.8

318

Falls: Screening for Future Fall Risk

CMS Web Interface

91.16

89.42

110

Preventative Care and Screening: Influenza Immunization

CMS Web Interface

66.4

70.76

226

Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention

CMS Web Interface

65.52

79.29

113

Colorectal Cancer Screening

CMS Web Interface

72.41

77.14

112

Breast Cancer Screening

CMS Web Interface

81.3

80.36

438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

CMS Web Interface

83.19

87.05

370

Depression Remission at Twelve Months

CMS Web Interface

20.83

16.58

321

CAHPS for MIPS3

CMS Web Interface

8.06

6.25

479

Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2

CMS Web Interface

0.1538

0.1553

484

Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1]

CMS Web Interface

33.22

35.39

Hospital Admission Rates for Patients with

Multiple Chronic Conditions [1]

Payment Rule Waivers

Payment Rule Waivers

Payment Rule Waivers

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-Day Rule Waiver:

  • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.

ACO Participation Waiver: ACO Participation Waiver:

ACO Participation Waiver: ACO Participation Waiver:

ACO Participation Waiver: ACO Participation Waiver:

ACO Participation Waiver: ACO Participation Waiver:

  • AWV Scheduling Initiative: 

    • Parties to the arrangement: Caravan Health ACO 22 and ACO Participants

    • Date of arrangement: January 1, 2024

    • Items, services, goods, or facility provided: See description below

    • Date and nature of any amendments to the arrangement, if applicable: N/A 

  • The board made a bona fide determination effective January 1, 2024, that the AWV Scheduling Initiative is reasonably related to the purpose of the MSSP to manage and coordinate care for Medicare fee-for-service beneficiaries throughout the ACO.  The AWV Scheduling initiative is intended to increase the likelihood that patients whom CMS has identified as assigned or assignable to the ACO under the MSSP and whom CMS has recognized would benefit from an AWV will receive an AWV. The AWV Scheduling initiative includes a provision of scheduling services to ACO participants at no cost to assist in increasing availability and performance of medically necessary and appropriate AWVs on patients whom CMS has identified as assigned to the ACO under the MSSP. Caravan in collaboration with, and subject to the approval of, ACO shall develop and implement appropriate operating processes and procedures to implement the AWV Scheduling Initiative and ensure that the provision of services on a no cost basis is limited to the AWV Scheduling Initiative, unless otherwise approved by the Board of Managers. ACO participants shall ensure that each completed AWV shall include all required elements and associated quality data for patients whom CMS has identified as assigned to the ACO under the MSSP.

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