Shared Savings Program ACO Public Report

Size: px
Start display at page:

Download "Shared Savings Program ACO Public Report"

Transcription

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.

ACO Name and Location. ACO Primary Contact. Organizational Information

ACO Name and Location. ACO Primary Contact. Organizational Information ACO ame and Location Ascension Care Management Health Partners Indianapolis, LLC Previous Legal Business Entity ame: MissionPoint Indianapolis, LLC 523 Mainstream Dr ashville, Tennessee 37228-1238 ACO

More information

ACO Name and Location. ACO Primary Contact. Organizational Information

ACO Name and Location. ACO Primary Contact. Organizational Information ACO ame and Location Ascension Care Management Health Partners Indianapolis, LLC Previous Legal Business Entity ame: MissionPoint Indianapolis, LLC 523 Mainstream Dr ashville, Tennessee 37228-1238 ACO

More information

Shared Savings Program ACO Public Reporting Instructions. with Pre-Populated Template

Shared Savings Program ACO Public Reporting Instructions. with Pre-Populated Template Shared Savings Program ACO Public Reporting Instructions Introduction with Pre-Populated Template The purpose of this document is to provide ACOs participating in the Shared Savings Program with a public

More information

ACO Name and Location ACO Primary Contact

ACO Name and Location ACO Primary Contact ACO ame and Location Chrysalis Medical Services, LLC 4888 Loop Central Drive Suite 700 Houston, Texas 77081 ACO Primary Contact Primary Contact ame Adrienne Opalka Primary Contact Phone umber 914-281-0827

More information

ACO Name and Location. ACO Primary Contact. Organizational Information

ACO Name and Location. ACO Primary Contact. Organizational Information ACO ame and Location Illinois Health Partners ACO, LLC 1100 West 31st Street Suite 300 Downers Grove, Illinois 60515 ACO Primary Contact Primary Contact ame Teri Kaneski Primary Contact Phone umber 630-527-3055

More information

Shared Savings Program ACO Public Reporting Instructions. with Pre-Populated Template

Shared Savings Program ACO Public Reporting Instructions. with Pre-Populated Template Shared Savings Program ACO Public Reporting Instructions Introduction with Pre-Populated Template The purpose of this document is to provide ACOs participating in the Shared Savings Program with a public

More information

ACO Name and Location. ACO Primary Contact. Organizational Information. Page 1 of 8

ACO Name and Location. ACO Primary Contact. Organizational Information. Page 1 of 8 ACO ame and Location Essential Care Partners, LLC 5900 Southwest Parkway Building 3 Austin, Texas 78735 ACO Primary Contact Primary Contact ame Jeff Spight Primary Contact Phone umber 914-597-2073 Primary

More information

Benchmark Data Sources

Benchmark Data Sources Medicare Shared Savings Program Quality Measure Benchmarks for the 2016 and 2017 Reporting Years Introduction This document describes methods for calculating the quality performance benchmarks for Accountable

More information

ACO Name and Location. ACO Primary Contact. Organizational Information

ACO Name and Location. ACO Primary Contact. Organizational Information ACO Name and Location Physician Quality Partners, LLC 1505 Doctors Circle Building B Wilmington, North Carolina 28401 ACO Primary Contact Primary Contact Name Lydia Newman, MPP Primary Contact Phone Number

More information

Erin Page

Erin Page ACO ame and Location Accountable Care Coalition of orth Texas, LLC. 4888 Loop Central Drive, Suite 700 Houston, Texas 77081 ACO Primary Contact Primary Contact ame Primary Contact Phone umber Erin Page

More information

St. Vincent s Health Partners

St. Vincent s Health Partners St. Vincent s Health Partners St. Vincent s Health Partners is now working with your doctor to offer: Care Coordination Among All our Healthcare Providers St. Vincent s will work with all your providers

More information

United Medical ACO Participation Criteria

United Medical ACO Participation Criteria United Medical ACO Participation Criteria Items Requiring Practice Reporting 1) Submission of Reports: Practices must report A,B, and C to UMACO A. Thirty-four ACO Quality Measures -See Appendix A B. Average

More information

ACO GPRO 2016 Ready to Report Basics GPRO ACO Random Sample Reporting January 17, 2017 to March 17, 2017

ACO GPRO 2016 Ready to Report Basics GPRO ACO Random Sample Reporting January 17, 2017 to March 17, 2017 ACO GPRO 2016 Ready to Report Basics 2016 GPRO ACO Random Sample Reporting January 17, 2017 to March 17, 2017 ACO GPRO 2016 Ready to Report Basics What is an Accountable Care Organization (ACO)? Which

More information

Improving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients: Accountable Care Organizations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Improving Quality of Care for Medicare Patients: FACT SHEET Overview http://www.cms.gov/sharedsavingsprogram On October

More information

ACO Information Required to be Published on ACO Website per CMS Regulations

ACO Information Required to be Published on ACO Website per CMS Regulations ACO Name and Location SJFI, LLC dba Oklahoma Health Initiatives St. John Administration 1923 S. Utica Ave Tulsa, OK 74104 ACO Primary Contact Ann Paul, MPH ACO President OKHI@sjmc.org 918.744.2180 Organizational

More information

Accountable Care and the Laboratory Value Proposition. Les Duncan Director of Operations Highmark Health - Home and Community Services

Accountable Care and the Laboratory Value Proposition. Les Duncan Director of Operations Highmark Health - Home and Community Services Accountable Care and the Laboratory Value Proposition Les Duncan Director of Operations Highmark Health - Home and Community Services Agenda The Goals and Status of Delivery System Reform and Alternative

More information

3/29/2013. Effective ACO Compliance. Objectives THE HEALTH CARE DILEMMA: ARE ACOS THE ANSWER? HCCA Compliance Institute April 21, 2013

3/29/2013. Effective ACO Compliance. Objectives THE HEALTH CARE DILEMMA: ARE ACOS THE ANSWER? HCCA Compliance Institute April 21, 2013 Effective ACO Compliance HCCA Compliance Institute April 21, 2013 Margaret Hambleton, MBA, CHC, CHPC Sr. Vice President, Chief Compliance Officer St. Joseph Health System 1 Objectives Understand Accountable

More information

ACO Update. LVHN Scholarly Works. Lehigh Valley Health Network. Lehigh Valley Health Network. Spring 2017

ACO Update. LVHN Scholarly Works. Lehigh Valley Health Network. Lehigh Valley Health Network. Spring 2017 Lehigh Valley Health Network LVHN Scholarly Works ACO Update Newsletters Spring 2017 ACO Update Lehigh Valley Health Network Follow this and additional works at: https://scholarlyworks.lvhn.org/acoupdate

More information

Slide 1. Slide 2 Rural Princeton. Slide 3 Agenda Rural ACO RURAL ACOS CAN WORK AND LEAD THE WAY

Slide 1. Slide 2 Rural Princeton. Slide 3 Agenda Rural ACO RURAL ACOS CAN WORK AND LEAD THE WAY Slide 1 RURAL ACOS CAN WORK AND LEAD THE WAY Nebraska Rural Health Association September 20, 2017 Slide 2 Rural Princeton Slide 3 Agenda Rural ACO Illinois Rural Community Care Organization (IRCCO)/Statewide

More information

Quality Measurement and Reporting Kickoff

Quality Measurement and Reporting Kickoff Quality Measurement and Reporting Kickoff All Shared Savings Program ACOs April 11, 2017 Sandra Adams, RN; Rabia Khan, MPH Division of Shared Savings Program Medicare Shared Savings Program DISCLAIMER

More information

Session 10: Integrating Data and Analytics into Provider Workflows Improves ACO Quality and Financial Performance

Session 10: Integrating Data and Analytics into Provider Workflows Improves ACO Quality and Financial Performance Session 10: Integrating Data and Analytics into Provider Workflows Improves ACO Quality and Financial Performance Joan Valentine, MSA, RN Executive Vice President Visiting Physicians Association David

More information

Meaningful Use Measures: Quick Reference Guide Stage 2 (2014 and Beyond)

Meaningful Use Measures: Quick Reference Guide Stage 2 (2014 and Beyond) Meaningful Use Measures: Quick Reference Guide Stage 2 (2014 and Beyond) Core Measures Required: All 17 objectives Objective: Requirement: Exclusions: Accomplish in Clinical 1. Computerized - Documenting

More information

Meaningful Use: a Primer

Meaningful Use: a Primer Health Information Technology Extension Center of Los Angeles Meaningful Use: a Primer Mary Mitchell Director of Meaningful Use Defined as: What is Meaningful Use? A. Use of a certified EHR in a meaningful

More information

Quality Measurement Approaches of State Medicaid Accountable Care Organization Programs

Quality Measurement Approaches of State Medicaid Accountable Care Organization Programs TECHNICAL ASSISTANCE TOOL September 2014 Quality Measurement Approaches of State Medicaid Accountable Care Organization Programs S tates interested in using an accountable care organization (ACO) model

More information

Accelerating the Impact of Performance Measures: Role of Core Measures

Accelerating the Impact of Performance Measures: Role of Core Measures Accelerating the Impact of Performance Measures: Role of Core Measures Mark McClellan, MD, PhD Director, Engelberg Center for Health Care Reform Senior Fellow, Economic Studies Leonard D. Schaeffer Chair

More information

Practice Implications for Accountable Care Organizations

Practice Implications for Accountable Care Organizations Practice Implications for Accountable Care Organizations An Overview following the Final Rule Gregory M. Marsh, MPH, PMP December 14, 2011 Why CCME? Effective EHR/HIE Implementation will: Improve patient

More information

ACO Name and Location. ACO Primary Contact. Organizational Information

ACO Name and Location. ACO Primary Contact. Organizational Information ACO ame and Location Mid-Atlantic Collaborative Care, LLC 4888 LOOP CETRAL DR Suite 700 Houston, Texas 77081 ACO Primary Contact Primary Contact ame Adrienne Opalka Primary Contact Phone umber Primary

More information

Medicare & Medicaid EHR Incentive Program Final Rule. Implementing the American Recovery & Reinvestment Act of 2009

Medicare & Medicaid EHR Incentive Program Final Rule. Implementing the American Recovery & Reinvestment Act of 2009 Medicare & Medicaid EHR Incentive Program Final Rule Implementing the American Recovery & Reinvestment Act of 2009 Conceptual Approach to Meaningful Use Improved Data capture and sharing Advanced Clinical

More information

Proposed 2015 PFS: Quality Updates

Proposed 2015 PFS: Quality Updates SCGX1423 08/14 Proposed 2015 PFS: Quality Updates Johnson & Johnson Health Care Systems Inc. Providing services for: Janssen Biotech, Inc. Janssen Pharmaceuticals, Inc August, 2014 This document is presented

More information

Medicare & Medicaid. William Kassler, MD Chief Medical Officer Centers for Medicare & Medicaid Services Boston, MA

Medicare & Medicaid. William Kassler, MD Chief Medical Officer Centers for Medicare & Medicaid Services Boston, MA Medicare & Medicaid EHR Incentive Program William Kassler, MD Chief Medical Officer Centers for Medicare & Medicaid Services Boston, MA Overview Background / Policy Context EHR Incentive Program basics

More information

Financial Models for Clinical Pharmacy Integration

Financial Models for Clinical Pharmacy Integration Financial Models for Clinical Pharmacy Integration Todd J. Lessley, MPH, RN, BSN Accountable Care Manager Salud Family Health Centers Gina D. Moore, PharmD, MBA Assistant Dean for Clinical and Professional

More information

Quality Measurement, Population Health and Payment Reform

Quality Measurement, Population Health and Payment Reform Quality Measurement, Population Health and Payment Reform The Move from Volume to Value Dale W. Bratzler, DO, MPH, FACOI, FIDSA Professor, Colleges of Medicine and Public Health Associate Dean, College

More information

ACO Name and Location: Central US ACO, LLC 901 W. Commercial Street Kennett, MO ACO Primary Contact:

ACO Name and Location: Central US ACO, LLC 901 W. Commercial Street Kennett, MO ACO Primary Contact: ACO Name and Location: Central US ACO, LLC 901 W. Commercial Street Kennett, MO 63857 ACO Primary Contact: Greg Shockey, Executive Consultant Greg@CentralUSaco.com 417-873-9011 Organizational Information:

More information

Improving Clinical Outcomes

Improving Clinical Outcomes Improving clinical outcomes and reducing health care costs under the Affordable Care Act - are enhanced medication management strategies part of the solution? Sandra L. Baldinger, Pharm.D., M.S. Kenneth

More information

2015 Updates to the Physician Quality Reporting System (PQRS) & the Value-based Payment Modifier

2015 Updates to the Physician Quality Reporting System (PQRS) & the Value-based Payment Modifier 2015 Updates to the Physician Quality Reporting System (PQRS) & the Value-based Payment Modifier April 7, 2015 12:00 Noon EDT Phone: 1-877-267-1577 Passcode: 994 365 238 Presented by the Philadelphia Regional

More information

=======================================================================

======================================================================= ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary

More information

How Does This Fit into the Provisions of the Affordable Care Act? The goals are aligned

How Does This Fit into the Provisions of the Affordable Care Act? The goals are aligned Background April 2012 The Federal Centers for Medicare and Medicaid Services (CMS) approved 3 NJ Accountable Care Organizations (ACOs) to participate in the Medicare Shared Savings Program Accountable

More information

Sandra Robinson, RN, MSN, ACM, CEN

Sandra Robinson, RN, MSN, ACM, CEN Developing and Measuring Care Coordination Outcome Goals and Objectives ACMA National Conference April 28, 2015 Cleveland Clinic Care Management Sandra Robinson, RN, MSN, ACM, CEN (robinss12@ccf.org) Joan

More information

Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654

Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654 This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide

More information

NEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES

NEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES NEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment

More information

Patient-centered medical homes (PCMH): eligible providers.

Patient-centered medical homes (PCMH): eligible providers. ACTION: Final DATE: 09/21/2018 3:40 PM 5160-1-71 Patient-centered medical homes (PCMH): eligible providers. (A) A Patient-centered medical home (PCMH) is a team-based care delivery model led by primary

More information

TO BE RESCINDED Patient-centered medical homes (PCMH): eligible providers.

TO BE RESCINDED Patient-centered medical homes (PCMH): eligible providers. ACTION: Final DATE: 09/21/2018 3:40 PM TO BE RESCINDED 5160-1-71 Patient-centered medical homes (PCMH): eligible providers. (A) A Patient-centered medical home (PCMH) is a team-based care delivery model

More information

Goals & Challenges for Outpatient Quality Directors. Quality HealthCare Consulting, LLC CEO: Jennifer O'Donnell, MHA, PCMH-CCE

Goals & Challenges for Outpatient Quality Directors. Quality HealthCare Consulting, LLC CEO: Jennifer O'Donnell, MHA, PCMH-CCE Goals & Challenges for Outpatient Quality Directors Quality HealthCare Consulting, LLC CEO: Jennifer O'Donnell, MHA, PCMH-CCE Objectives Learn a practical way for Quality Directors to align Quality Measures

More information

Getting Ready for the Maryland Primary Care Program

Getting Ready for the Maryland Primary Care Program Getting Ready for the Maryland Primary Care Program Presentation to Maryland Academy of Nutrition and Dietetics March 19, 2018 Maryland Department of Health All-Payer Model: Performance to Date Performance

More information

Medicare & Medicaid EHR Incentive Program Final Rule. Implementing the American Recovery & Reinvestment Act of 2009

Medicare & Medicaid EHR Incentive Program Final Rule. Implementing the American Recovery & Reinvestment Act of 2009 Medicare & Medicaid EHR Incentive Program Final Rule Implementing the American Recovery & Reinvestment Act of 2009 Purpose of this Presentation To give an overview of the CMS final rule on the EHR Incentive

More information

2013 EHR INCENTIVE PROGRAM MANUAL

2013 EHR INCENTIVE PROGRAM MANUAL 0 EHR INCENTIVE PROGRAM MANUAL Billing Technology Results ahsrcm.com info@ahsrcm.com 877 50 6 Table of Contents INTRODUCTION TO EHR & MEANINGFUL USE... CMS EHR INCENTIVE PROGRAM - PARTICIPATION... COMPARISON

More information

Proposed CMMI Rural Shared Savings Demonstration Project: Frontier/Rural Community Care Organizations

Proposed CMMI Rural Shared Savings Demonstration Project: Frontier/Rural Community Care Organizations Proposed CMMI Rural Shared Savings Demonstration Project: Frontier/Rural Community Care Organizations Executive Summary Rural networks across the nation have been working with rural providers to assist

More information

Proposed Meaningful Use Incentives, Criteria and Quality Measures Affecting Critical Access Hospitals

Proposed Meaningful Use Incentives, Criteria and Quality Measures Affecting Critical Access Hospitals Proposed Meaningful Use Incentives, Criteria and Quality Measures Affecting Critical Access Hospitals Paul Kleeberg, MD, FAAFP, FHIMSS Clinical Director Regional Extension Assistance Center for HIT (REACH)

More information

Meaningful Use of EHR in Dental School Clinics: How to Benefit from the U.S. HITECH Act s Financial and Quality Improvement Incentives

Meaningful Use of EHR in Dental School Clinics: How to Benefit from the U.S. HITECH Act s Financial and Quality Improvement Incentives Milieu in Dental School and Practice Meaningful Use of EHR in Dental School Clinics: How to Benefit from the U.S. HITECH Act s Financial and Quality Improvement Incentives Elsbeth Kalenderian, D.D.S.,

More information

How ACO s Are Thinking of Home Care: the Atrius Health Experience

How ACO s Are Thinking of Home Care: the Atrius Health Experience How ACO s Are Thinking of Home Care: the Atrius Health Experience Richard Lopez, MD Chief Medical Officer Richard_Lopez@AtriusHealth.org May 29, 2014 Contents Overview of Atrius Health Overview of Pioneer

More information

What Have we Learned from the Pioneer ACO Model?

What Have we Learned from the Pioneer ACO Model? What Have we Learned from the Pioneer ACO Model? Sherly Binu, CMMI December 7, 2016 Disclaimers 2 This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose

More information

Patient-centered medical homes (PCMH): Eligible providers.

Patient-centered medical homes (PCMH): Eligible providers. ACTION: Final DATE: 09/20/2016 8:11 AM 5160-1-71 Patient-centered medical homes (PCMH): Eligible providers. (A) A Patient-centered medical home (PCMH) is a team-based care delivery model led by primary

More information

Exhibit 1. Medicare Shared Savings Program: Year 1 Performance of Participating Accountable Care Organizations (2013)

Exhibit 1. Medicare Shared Savings Program: Year 1 Performance of Participating Accountable Care Organizations (2013) Exhibit 1. Medicare Shared Savings Program: Year 1 Performance of Participating Accountable Care Organizations (2013) 24 percent (52 ACOs) earned shared savings bonus 27 percent (60 ACOs) reduced spending,

More information

Medicare Physician Group Practice Demonstration

Medicare Physician Group Practice Demonstration Medicare Physician Group Practice Demonstration Disease Management Colloquium Philadelphia, Pennsylvania June 23, 2005 John Pilotte Senior Research Analyst Medicare Demonstrations Program Group Centers

More information

State of the State: Hospital Performance in Pennsylvania October 2015

State of the State: Hospital Performance in Pennsylvania October 2015 State of the State: Hospital Performance in Pennsylvania October 2015 1 Measuring Hospital Performance Progress in Pennsylvania: Process Measures 2 PA Hospital Performance: Process Measures We examined

More information

Cleveland Clinic Implementing Value-Based Care

Cleveland Clinic Implementing Value-Based Care Cleveland Clinic Implementing Value-Based Care Overview Cleveland Clinic health system uses a systematic approach to performance improvement while simultaneously pursuing 3 goals: improving the patient

More information

Minnesota Statewide Quality Reporting and Measurement System: APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654

Minnesota Statewide Quality Reporting and Measurement System: APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654 Minnesota Statewide Quality Reporting and Measurement System: APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654 DECEMBER 2017 APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654 Minnesota

More information

Patient Experience Heart & Vascular Institute

Patient Experience Heart & Vascular Institute Patient Experience Heart & Vascular Institute Keeping patients at the center of all that Cleveland Clinic does is critical. Patients First is the guiding principle at Cleveland Clinic. Patients First is

More information

Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654

Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654 This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide

More information

Maximizing the Financial Performance of Employed Physicians

Maximizing the Financial Performance of Employed Physicians Maximizing the Financial Performance of Employed Physicians Presented by: Health Directions, LLC Sabrina Burnett, Vice President HFMA Kentucky Chapter Summer Institute, July 24, 2014 About Health Directions,

More information

Framing Rural Health Value Webinar Series

Framing Rural Health Value Webinar Series 600 East Superior Street, Suite 404 I Duluth, MN 55802 I Ph. 800.997.6685 or 218.727.9390 I www.ruralcenter.org Framing Rural Health Value Webinar Series Data Measurement, Outcomes and Impact Kami Norland

More information

Case Study High-Performing Health Care Organization December 2008

Case Study High-Performing Health Care Organization December 2008 Case Study High-Performing Health Care Organization December 2008 Luther Midelfort Mayo Health System: Laying Tracks for Success Jen n i f e r Ed w a r d s, Dr.P.H. Health Management Associates The mission

More information

Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654

Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654 Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654 Minnesota Department of Health October 2011 Division of Health Policy Health Economics

More information

Through the 2009 HITECH (Health Information

Through the 2009 HITECH (Health Information Milieu in Dental School and Practice Meaningful Use of EHR in Dental School Clinics: How to Benefit from the U.S. HITECH Act s Financial and Quality Improvement Incentives Elsbeth Kalenderian, D.D.S.,

More information

Olutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA

Olutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA Olutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA Introduce the methods of using core measures to compare quality of health care US hospitals provide Have

More information

Examining the Differences Between Commercial and Medicare ACO Models

Examining the Differences Between Commercial and Medicare ACO Models Examining the Differences Between Commercial and Medicare ACO Models Michelle Copenhaver December 10, 2015 Agenda 1 Understanding Accountable Care Organizations 2 Moving to Accountable Care: Enhancing

More information

ACO SUCCESS STORY FROM A DIFFERENT PERSPECTIVE. By: Dr. Shelton Hager, Samantha Sizemore, and Dr. Alicia Wright

ACO SUCCESS STORY FROM A DIFFERENT PERSPECTIVE. By: Dr. Shelton Hager, Samantha Sizemore, and Dr. Alicia Wright ACO SUCCESS STORY FROM A DIFFERENT PERSPECTIVE By: Dr. Shelton Hager, Samantha Sizemore, and Dr. Alicia Wright Creating A Successful ACO By: Dr. Shelton Hager Who is Qualuable Medical Professionals LLC?

More information

Measuring High Performers and Assessing Readiness to Change Looking Beyond the Lamppost

Measuring High Performers and Assessing Readiness to Change Looking Beyond the Lamppost Measuring High Performers and Assessing Readiness to Change Looking Beyond the Lamppost Mathematica Policy Research Washington, DC November 19, 2014 Moderator Timothy Lake Director of Health Research,

More information

PCMH to ACO: Carilion Clinic s Journey

PCMH to ACO: Carilion Clinic s Journey PCMH to ACO: Carilion Clinic s Journey Michael P. Jeremiah, MD, FAAFP Chair, Department of Family and Community Medicine Carilion Clinic and the Virginia Tech-Carilion School of Medicine Patient-Centered

More information

The long and winding road to Accountable Care

The long and winding road to Accountable Care The long and winding road to Accountable Care Elliott Fisher, MD, MPH Director, The Dartmouth Institute John E. Wennberg Distinguished Professor Geisel School of Medicine The long and winding road Past

More information

Achieving Meaningful Use with Centricity Electronic Medical Record

Achieving Meaningful Use with Centricity Electronic Medical Record GE Healthcare Achieving Meaningful Use with Centricity Electronic Medical Record Version 9.8 Revised July 2015 Centricity EMR DOC1620430 2015 General Electric Company All information is subject to change

More information

Stage 2 Meaningful Use: Menu Objectives and Clinical Quality Measures. James R. Christina, DPM Director Scientific Affairs APMA

Stage 2 Meaningful Use: Menu Objectives and Clinical Quality Measures. James R. Christina, DPM Director Scientific Affairs APMA Stage 2 Meaningful Use: Menu Objectives and Clinical Quality Measures James R. Christina, DPM Director Scientific Affairs APMA What Stage Am I In? 2 2 CMS Proposed Rule On May 20, 2014 CMS and Office of

More information

Medicare Shared Savings ACOs: One Organization s Lessons Learned. Gregory A. Spencer MD FACP Chief Medical Officer Crystal Run Healthcare LLP

Medicare Shared Savings ACOs: One Organization s Lessons Learned. Gregory A. Spencer MD FACP Chief Medical Officer Crystal Run Healthcare LLP Medicare Shared Savings ACOs: One Organization s Lessons Learned Gregory A. Spencer MD FACP Chief Medical Officer Crystal Run Healthcare LLP Learning Objectives Identify organizational strengths and weaknesses

More information

Medical Record Review Tool Standards with Definitions

Medical Record Review Tool Standards with Definitions WellCare Health Plans, Inc. WellCare of Georgia, Inc The WellCare Group of Companies Medical Record Review Tool Standards with Definitions Item # STANDARD DEFINITION SOURCE All Medical Records: 1 Patient

More information

Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654

Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654 This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide

More information

Accountable Care Organizations Under Medicare Shared Savings Program PROPOSED RULE

Accountable Care Organizations Under Medicare Shared Savings Program PROPOSED RULE Accountable Care Organizations Under Medicare Shared Savings Program PROPOSED RULE The information in this document summarizes a proposed rule issued by the Centers for Medicare and Medicaid id Services.

More information

Falcon Quality Payment Program Checklist- 2017

Falcon Quality Payment Program Checklist- 2017 Falcon Quality Payment Program Checklist- 2017 DISCLAIMER: This material is provided for informational purposes only and should not be relied upon as legal or compliance advice. If legal advice or other

More information

1.01 Government Programs: CMS and Pay for Performance: Current Issues. CMS Regional Administrator March 2009

1.01 Government Programs: CMS and Pay for Performance: Current Issues. CMS Regional Administrator March 2009 1.01 Government Programs: CMS and Pay for Performance: Current Issues David Saÿen CMS Regional Administrator March 2009 Overview Why value-based purchasing? What demonstrations are underway? Hospital demonstrations

More information

Note: Accredited is the highest rating an exchange product can have for 2015.

Note: Accredited is the highest rating an exchange product can have for 2015. Quality Overview Accreditation Exchange Product Accrediting Organization: NCQA HMO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating an exchange product can have for 215.

More information

MOC Part IV: Your Guide to Making it Happen.

MOC Part IV: Your Guide to Making it Happen. MOC Part IV: Your Guide to Making it Happen. Joseph P. Drozda, Jr., MD, F.A.C.C. Mercy, MO Paul D. Varosy, MD, F.A.C.C., FAHA, FHRS University of Colorado Denver School of Medicine, CO Disclosures Course

More information

CLINICAL PRACTICE EVALUATION II: CLINICAL SYSTEMS REVIEW

CLINICAL PRACTICE EVALUATION II: CLINICAL SYSTEMS REVIEW Diplomate: CLINICAL PRACTICE EVALUATION II: CLINICAL SYSTEMS REVIEW A. INFORMATION MANAGEMENT 1. Does your practice currently use an electronic medical record system? Yes No 2. If Yes, how long has the

More information

Richard E. Wild, MD,JD,MBA, FACEP

Richard E. Wild, MD,JD,MBA, FACEP CMS Incentive Program for Meaningful Use of HIT and Reporting Quality of Care Measures Healthcare Transparency & Patient Advocacy Conference Lexington, KY November 19, 2010 Richard E. Wild, MD,JD,MBA,

More information

2017 CMS Web Interface Quality Reporting. Questions & Answers January 2018

2017 CMS Web Interface Quality Reporting. Questions & Answers January 2018 2017 CMS Web Interface Quality Reporting Questions & Answers January 2018 Table of Contents Quality Reporting for Calendar Year 2017: Overview... 1 Beneficiary Sample Without Data File... 2 Sampling and

More information

Rural-Relevant Quality Measures for Critical Access Hospitals

Rural-Relevant Quality Measures for Critical Access Hospitals Rural-Relevant Quality Measures for Critical Access Hospitals Ira Moscovice PhD Michelle Casey MS University of Minnesota Rural Health Research Center Minnesota Rural Health Conference Duluth, Minnesota

More information

ACO ame and Location Accountable Care Coalition of ew Jersey, LLC 4888 Loop Central Drive Suite 700 Houston, Texas 77081 ACO Primary Contact Primary Contact ame Primary Contact Phone umber Primary Contact

More information

Health Plan with Health Insurance Exchange Measures, Version 1.3

Health Plan with Health Insurance Exchange Measures, Version 1.3 Health Plan with Health Insurance Exchange s, Version 1.3 Disclaimer: reserves the right to update its measures and measure sets to maintain measure relevancy and accuracy and to remedy any unintended

More information

A Clinically Integrated Network. R.W. Chip Watkins, MD, MPH, FAAFP Independent Affinity Group 3 March 2015

A Clinically Integrated Network. R.W. Chip Watkins, MD, MPH, FAAFP Independent Affinity Group 3 March 2015 A Clinically Integrated Network R.W. Chip Watkins, MD, MPH, FAAFP Independent Affinity Group 3 March 2015 HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to

More information

MBQIP Quality Measure Trends, Data Summary Report #20 November 2016

MBQIP Quality Measure Trends, Data Summary Report #20 November 2016 MBQIP Quality Measure Trends, 2011-2016 Data Summary Report #20 November 2016 Tami Swenson, PhD Michelle Casey, MS University of Minnesota Rural Health Research Center ABOUT This project was supported

More information

EHR Incentives for Professionals and Hospitals. Paul Forlenza, VP Policy, VITL updated October 1, 2010 v.8.1

EHR Incentives for Professionals and Hospitals. Paul Forlenza, VP Policy, VITL updated October 1, 2010 v.8.1 EHR Incentives for Professionals and Hospitals Paul Forlenza, VP Policy, VITL updated October 1, 2010 v.8.1 Disclaimer Not legal analysis or advice Analysis based on reviewing Centers for Medicare and

More information

Medicine Institute Outcomes

Medicine Institute Outcomes Medicine Institute 214 Outcomes Measuring Outcomes Promotes Quality Improvement Measuring and understanding outcomes of medical treatments promotes quality improvement. Cleveland Clinic has created a series

More information

The Incentive Roadmap

The Incentive Roadmap The Incentive Roadmap The Meaningful Use of Certified Technology: Stage 1 A Manual for Medical Practices Jim Tate jimtate@emradvocate.com www.emradvocate.com 2010 by EMRAdvocate.com All rights reserved.

More information

HouseCalls Objectives

HouseCalls Objectives Overview Agenda Overview Objectives Background Case studies Member Experience Primary Care Provider Experience Referrals and Follow-up Influence on Centers for Medicare & Medicaid Services (CMS) Star Ratings

More information

Policy CHCS. Brief. Leveraging the Medicaid Primary Care Rate Increase: The Role of Performance Measurement. Center for Health Care Strategies, Inc.

Policy CHCS. Brief. Leveraging the Medicaid Primary Care Rate Increase: The Role of Performance Measurement. Center for Health Care Strategies, Inc. CHCS Center for Health Care Strategies, Inc. Policy Brief Leveraging the Medicaid Primary Care Rate Increase: The Role of Performance Measurement By David Marc Small and Tricia McGinnis, Center for Health

More information

HealthVisions. Delmarva. improved health, healthcare quality and experience, lower healthcare costs and improved provider experience

HealthVisions. Delmarva. improved health, healthcare quality and experience, lower healthcare costs and improved provider experience HealthVisions Delmarva improved health, healthcare quality and experience, lower healthcare costs and improved provider experience 1 Randy Farmer, MS, M Ed Mr. Farmer joined the DHIN in September of 2011

More information

HEALTH CARE REFORM IN THE U.S.

HEALTH CARE REFORM IN THE U.S. HEALTH CARE REFORM IN THE U.S. A LOOK AT THE PAST, PRESENT AND FUTURE Carolyn Belk January 11, 2016 0 HEALTH CARE REFORM BIRTH OF THE AFFORDABLE CARE ACT Health care reform in the U.S. has been an ongoing

More information

Advancing Primary Care Delivery

Advancing Primary Care Delivery Advancing Primary Care Delivery Tenth National Pay for Performance Summit March 3, 2015 Simeon Schwartz, MD CEO, WESTMED Medical Group, P.C. WESTMED Medical Group Established 1996 by 16 physicians 300

More information

Enhancing Outcomes with Quality Improvement (QI) October 29, 2015

Enhancing Outcomes with Quality Improvement (QI) October 29, 2015 Enhancing Outcomes with Quality Improvement (QI) October 29, 2015 Learning Objectives! Introduce Quality Improvement (QI)! Explain Clinical Performance Person-Centered Medical Home (PCMH) Measures! Implement

More information

QUALITY IMPROVEMENT. Molina Healthcare has defined the following goals for the QI Program:

QUALITY IMPROVEMENT. Molina Healthcare has defined the following goals for the QI Program: QUALITY IMPROVEMENT Molina Healthcare maintains an active Quality Improvement (QI) Program. The QI program provides structure and key processes to carry out our ongoing commitment to improvement of care

More information

FirstHealth Moore Regional Hospital. Implementation Plan

FirstHealth Moore Regional Hospital. Implementation Plan FirstHealth Moore Regional Hospital Implementation Plan FirstHealth Moore Regional Hospital Implementation Plan For 2016 Community Health Needs Assessment Summary of Community Health Needs Assessment Results

More information

Oregon's Health System Transformation

Oregon's Health System Transformation Oregon's Health System Transformation MEASUREMENT PERIOD Baseline Year 2011 and Calendar Year 2013 JUNE 24, 2014 TABLE OF CONTENTS Executive Summary...iii 2013 CCO Performance and Quality Pool Distribution...1

More information