Shared Savings Program ACO Public Report
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1 ACO ame and Location Shared Savings Program ACO Public Report University of Health Alliance Accountable Care Organization, LLC 1227 E. Rusholme Street Davenport, ACO Primary Contact Primary Contact ame Bonnie Braatz Primary Contact Phone umber (319) Primary Contact Address Organizational Information ACO participants: ACO s avinchandra Dadhaniya, M.D. Genesis Health System Great River Medical Center Mercy Medical Center Radiology Group, PC, SC Community Health Care Inc Eye Surgeons Associates, PC Mercy Care Management, Inc. Linn County Anesthesiologists, PC Great River Physicians and Clinics Inc Genesis Health System Davis Radiology, PC Mercy Physician Associates Inc University of Community Medical Services, Inc. Physicians' Clinic of, PC Radiology Consultants of, PLC Waterford Family Medicine, P.C. ACO in Joint Venture (Enter Y or )
2 State University Of Genesis Medical Center, Aledo City Cancer Treatment Center, LLC County Of Mercer Hospital City Heart Center, P.C. University Of Community Homecare Heritage Partners Pharmacy Heritage Medical Equipment and Supplies ACO governing body: Last ame First ame Title/Position Jackson Brook Voting, Chair Cropper Doug Voting, Vice Chair Vermeer Jennifer Voting Waterman Dana Voting Andresen Andrew Voting Quinn Tim Voting 's Voting Power ship Type 1 Medicare Beneficiary ACO TI Legal Business ame/dba, if Applicable Genesis Health System /A Genesis Health System Mercy Physician Associates Inc Van Genderen athan Voting, Secretary & Treasurer Mercy Medical Center
3 Weigel Ron Voting Richardson Mark Voting 1 Sladky Todd Voting 1 ACO ACO Great River Medical Center Great River Medical Center Van Daele Doug Voting Key ACO clinical and administrative leadership: Jennifer Vermeer ACO Executive William Langley Debbie Thoman William Langley Medical Director Compliance Officer Quality Assurance/Improvement Officer Associated committees and committee leadership: Committee ame Committee Leader ame and Position Physician Leadership Council Doug Van Daele, MD, Chair Value Based Purchasing Council athan Van Genderen, Chair Data Governance Committee Tony Myers, MD, Chair Clinical Operations Committee Michael AbouAssaly, MD, Chair Types of ACO participants, or combinations of participants, that formed the ACO: Partnerships or joint venture arrangements between hospitals and ACO professionals Critical Access Hospital (CAH) billing under Method II Federally Qualified Health Center (FQHC) Rural Health Clinic (RHC) Shared Savings and Losses Amount of Shared Savings/Losses First Agreement Period
4 o Performance Year 2016, $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 Quality Performance Results 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 Conditions 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
5 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 Intervention 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
6 ote: In the Quality Performance Results file(s) above, search for University of Health Alliance Accountable Care Organization, LLC to view the quality performance results. This ACO can also be found by using the ACO ID A91712 in the public use files on data.cms.gov. Payment Rule Waivers o, our ACO does not use the SF 3-Day Rule Waiver. The University of Health Alliance ACO, LLC (UIHA ACO) Board has approved the following arrangements for waivers as authorized by CMS and the OIG pursuant to the Medicare Program; Final Waivers in Connection with the Shared Savings Program (76, Fed. Reg , ov. 2, 2011) Care Coordination Program Participation Waivers The Care Coordination Program for care coordinators consists of health care professionals living within the communities served by UIHA ACO, working closely with the local community providers, specialty providers and other interdisciplinary team members across the entire care continuum. The goal is to promote seamless transitions of care for patients and their families through enhanced communication processes between all providers on the care team. Adopted by the Board of Managers, April 22, UIHC ACO Total Budget Participation Waiver UIHA ACO has undertaken investment in the infrastructure required to operate a successful accountable care organization that cares for an identifiable population. Such infrastructure will enable the UIHA ACO to prepare for changing reimbursement models, large-scale population health data analysis, and movement toward a value-based approach from a quality and safety, reimbursement and general business model perspective. In this way the infrastructure investment will assist in appropriately addressing the Triple Aim of the Shared Savings Program. Adopted by the Board of Managers, April 22, Shared Saving Distribution Waiver All providers and participants in the UIHA ACO are eligible to qualify for shared savings. The UIHA ACO will distribute Medicare shared savings based upon participants and providers meeting benchmarks described in the UIHA ACO Performance Management Plan. Adopted by the Board of Managers, April 22, Infrastructure Development Support Waivers The Infrastructure Development Waiver for the profits/losses of a general ambulatory pediatric practice consists of the development of new patient care delivery models to reduce the cost and improve the quality of patient care consistent with the Triple Aim by the University of Hospitals and Clinics sharing any profits/losses incurred by a general ambulatory pediatric practice during the first three years of MSSP participation. Adopted by the Board of Managers, December 16, 2016.
7 Group Practice Reporting Option Support Waiver The Group Practice Reporting Option (GPRO) Support Waiver provides for assistance, as necessary, from the University of Hospitals and Clinics to any UIHA ACO participant in completion of abstracting and subsequent submission of GPRO measures to the Medicare Shared Savings Program. Consistent with the Triple Aim, this waiver helps to ensure full submission of quality measures to assist in evaluating the quality of care, identifies ways to improve care through the development of clinical practice tools, and encourages provider engagement in efforts to reduce costs. Adopted by the Board of Managers, January 20, Care Coordination Program Participation Waiver The Care Coordination Program Participation Waiver for blood pressure cuffs and bathroom scales consists of a pilot project to provide blood pressure cuffs and/or bathroom scales to select patients to encourage participation in the management of their chronic condition(s) by self-monitoring changes in their biometric readings. The purpose of the program is to promote healthy behaviors and encourage self-management skills. The goal is to closely monitor the patients blood pressure and weight so that interventions occur before the readings become concerning, which will aid in improving the patients care experience, contribute to improvement of overall population health and the reduction in the per capita cost of health care consistent with the Triple Aim. Adopted by the Board of Managers, September 22, Infrastructure Development Support Waiver The Infrastructure Development Waiver for MSSP Track 1+ participation provides for the UIHA ACO to be responsible for any shared losses that Providers with fewer than one thousand (1,000) lives attributed to them may experience in the first year of Track 1+ via the use of the CMS-required escrow account that provides reinsurance against downside risk. Within UIHA ACO the specific financial responsibility for any losses will be borne by those entities that funded the CMS-required escrow account based upon the entity that is closest geographically to the Provider experiencing the losses in order to incentivize the sharing of patients, facilitate transitions of care and bolster redesign of care processes, improve patient care, and decrease the costs associated with such care, consistent with the Triple Aim. Correspondingly, any shared savings earned by such providers shall be distributed to those entities that funded the CMSrequired escrow account. Adopted by the Board of Managers, October 27, 2017.
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