ACO Name and Location. ACO Primary Contact. Organizational Information
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1 ACO ame and Location Illinois Health Partners ACO, LLC 1100 West 31st Street Suite 300 Downers Grove, Illinois ACO Primary Contact Primary Contact ame Teri Kaneski Primary Contact Phone umber Primary Contact Address Organizational Information ACO participants: ACO s Antonios Papadopoulos Seema Gupta Md Pc Spine & Sports Physiatrists, S.C. Seema Gupta, MD Robert Winiecki Alvaro Pena, MD Elmhurst Memorial Hospital orthwest Community Hospital Du Page Medical Group Ltd William Z Langreder & Gary Yong Ptrs Edward Hospital orthwest Community Health Services, Inc. Addison Medical Associates Ltd ACO in Joint Venture (Enter Y or ) Y
2 Robert Winiecki Hobson Meadows Family Medicine S C Suburban Gastroenterology LTD aperville Psychiatric Ventures Elmhurst Memorial Healthcare Alvaro Pena, MD DR. CAROL R. WEIBERG Antonios Papadopoulos PREMIER ITERISTS OF APERVILLE IC Karim S Yunez Md Sc Edward Health Ventures Generations Family Medicine ACO governing body: Member Last ame First ame Title/Position Member's Voting Power Membership Type Mastro Mary Lou System CEO Kasper Michaael CEO Friant Jeff System VP, Finance Pacetti Michael CFO Khatua M.D. Sanjeeb VP Chief Medical Officer Roark Shawn VP of Payor Strategy, President Illinois Health ACO TI Legal Business ame/dba, if Applicable Edward Hosptial DuPage Medical Group, LTD Edward Hosptial DuPage Medical Group, LTD Edward Hosptial Edward Hosptial
3 Partners Houlihan M.D. Jean Vice President Merrick M.D. Paul President Hartke Michael Executive VP and Chief Operating Officer Scogna Steve President and Chief Executive Officer Poland Robert Medicare Beneficiary Lindsay Andy Medicare Beneficiary 1 Medicare Beneficiary 1 Medicare Beneficiary DuPage Medical Group, LTD DuPage Medical Group, LTD orthwest Community Healthcare orthwest Community Healthcare Key ACO clinical and administrative leadership: Shawn Roark ACO Executive Michael Kwiecinski Medical Director Karen Adamson Compliance Officer Quality Assurance/Improvement Officer Associated committees and committee leadership: Committee ame ominations Committee ACO Physician Advisory Committee Clinical Integration Committee Utilization Management Committee Committee Leader ame and Position Mary Lou Mastro,System CEO, Edward Elmhurst Health, Chair Dr. Michael Kwiecinski, Medical Director, IHP ACO, Chair Dr. Sanjeeb Khatua, VP Chief Medical Officer, Edward Hospital, Dr. Susan elson, VP Physician Operations, orthwest Community Healthcare, Dr. Michael Kwiecinski, Medical Director, IHP ACO, Co-Chairs Dr. Michael Kwiecinski, Medical Director, IHP ACO,
4 Committee ame Finance and Contracting Committee Chair Committee Leader ame and Position Michael Pacetti, CFO, DuPage Medical Group, Jeff Friant, System VP Finance, Edward Elmhurst Health, Co-Chairs Types of ACO participants, or combinations of participants, that formed the ACO: Partnerships or joint venture arrangements between hospitals and ACO professionals Shared Savings and Losses Amount of Shared Savings/Losses First Agreement Period o Performance Year 2016, $0 o Performance Year 2015, $0 o Performance Year 2014, $0 Shared Savings Distribution First Agreement Period o Performance Year 2016 Proportion invested in infrastructure: /A Proportion invested in redesigned care processes/resources: /A Proportion of distribution to ACO participants: /A o Performance Year 2015 Proportion invested in infrastructure: /A Proportion invested in redesigned care processes/resources: /A Proportion of distribution to ACO participants: /A o Performance Year 2014 Proportion invested in infrastructure: /A Proportion invested in redesigned care processes/resources: /A Proportion of distribution to ACO participants: /A Quality Performance Results
5 2016 Quality Performance Results: ACO# Measure ame Rate ACO Mean 1 CAHPS: Getting Timely Care, Appointments, and Information CAHPS: How Well Your Providers Communicate CAHPS: Patients Rating of Provider CAHPS: Access to Specialists CAHPS: Health Promotion and Education CAHPS: Shared Decision Making CAHPS: Health Status/Functional Status CAHPS: Stewardship of Patient Resources Risk Standardized, All Condition Readmission Skilled ursing Facility 30-day All-Cause Readmission measure (SFRM) All-Cause Unplanned Admissions for Patients with Diabetes All-Cause Unplanned Admissions for Patients with Heart Failure All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) Percent of PCPs who Successfully Meet Meaningful Use Requirements Documentation of Current Medications in the Medical Record Falls: Screening for Future Fall Risk Preventive Care and Screening: Influenza Immunization Pneumonia Vaccination Status for Older Adults Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Preventive Care and Screening: Tobacco Use: Screening and Cessation
6 17 Intervention 18 Preventive Care and Screening: Screening for Clinical Depression and Followup Plan Colorectal Cancer Screening Breast Cancer Screening Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented Statin therapy for the Prevention and Treatment of Cardiovascular Disease Diabetes Mellitus: Hemoglobin A1c Poor Control Diabetes: Eye Exam Hypertension (HT): Controlling High Blood Pressure Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) Please note, the 40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples. For 2016 Quality Performance Results please visit: Initiatives-Medicare-Shared-Savin/2016-Shared-Savings-Program-SSP-Accountable-Care- O/3jk5-q6dr/data For 2015 Quality Performance Results please visit: Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/x8vaz7cu/data For 2014 Quality Performance Results please visit: Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/uccehhpu/data ote: In the Quality Performance Results file(s) above, search for Illinois Health Partners ACO, LLC to view the quality performance results. This ACO can also be found by using the ACO ID A23908 in the public use files on data.cms.gov. Payment Rule Waivers o, our ACO does not use the SF 3-Day Rule Waiver.
7 The Illinois Health Partners ACO Board has approved the following arrangements for the waivers authorized by CMS and the OIG pursuant to the Medicare Program; Final Waivers in Connection with the Shared Savings Program published on ovember 2, 2011: Illinois Health Partners ACO, LLC (ACO), DuPage Medical Group, Ltd. (a participant in the ACO) ( DMG ), and certain of its physicians (ACO health care professionals in the ACO) are parties to an arrangement whereby participating DMG physicians may receive payments from DMG for their activities relating to educating identified at-risk patients regarding DMG s patient-centric care delivery model, which is designed to provide more personalized monitoring of patients who have, or are at -risk of having, one or more chronic medical condition, thus enhancing the patient experience and improving clinical outcomes. Illinois Health Partners ACO, LLC (ACO), Edward Hospital and Elmhurst Memorial Hospital (each a participant in the ACO) ( Participating Hospitals ) and eligible group practices that are comprised of ACO health care professionals in the ACO ( Participating Group Practice(s) ) are parties to an arrangement whereby Participating Hospitals will provide Participating Group Practices with implementation services related to, access to, and ongoing upgrades and maintenance of, an electronic health record system ( EHR Items and Services ) and will contribute a portion of the costs related to such EHR Items and Services. This arrangement is designed to improve quality and manage care coordination through better integration and sharing of care plans, provide the data necessary for the ACO to determine trending of care patterns, identify best practices, and develop population health and disease management protocols and initiatives. Illinois Health Partners ACO, LLC (ACO), Edward Health Ventures (a participant in the ACO) ( EHV ), and certain ACO health care professionals in the ACO are parties to an arrangement whereby participating physicians may receive payments from EHV for their activities relating to educating identified at -risk patients regarding EHV s patient-centric care delivery model for patients with diabetes, which is designed to provide more personalized monitoring of such patients, thus enhancing the patient experience and improving clinical outcomes. Illinois Health Partners ACO, LLC (ACO), Elmhurst Memorial Hospital (a participant in the ACO) has engaged physicians participating in the ACO to administer a program to advance evidence-based medicine, increase patient satisfaction, and manage the cost of care for the orthopedic service line of Elmhurst Memorial Hospital. The focus will be general ortho, total joint replacement, and spine; eligible physicians will be eligible for compensation based upon meeting quality and cost metrics. Illinois Health Illinois Health Partners ACO, LLC (ACO), Edward Hospital (a participant in the ACO) has engaged physicians participating in the ACO to administer a program to advance evidence-based medicine, increase patient satisfaction, and manage the cost of care for the orthopedic service line of Edward Hospital. The focus will be general ortho, total joint replacement, and spine; eligible physicians will be eligible for compensation based upon meeting quality and cost metrics. Illinois Health Illinois Health Partners ACO, LLC (ACO), and certain of its eligible professionals (health care professionals in the ACO) are parties to an arrangement whereby physician and advance practice professional (APP) teams, rounding in Skilled ursing Facilities (SF), may be incentivized to improve quality while providing enhanced patient oversight and optimize efficiency to reduce sub-acute health care costs. Physicians and advance practice professionals will be eligible for compensation based upon meeting clinical quality and utilization outcomes.
8 Illinois Health Partners ACO, LLC (ACO), Edward Hospital, Elmhurst Memorial Hospital, orthwest Community Hospital, and certain of its physicians and physician groups participating in the ACO network are parties to an arrangement whereby ACO participants may receive payments for target achievement on select performance metrics which promote accountability for quality, cost and overall care for the ACO population.
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