ACO Public Reporting. ACO Name and Location. Primary Contact Thomas Kloos MD Executive Director

Transcription

1 ACO Public Reporting ACO Name and Location AHS ACO LLC (Atlantic Accountable Care Organization) 465 South Street, Suite 205 Morristown, NJ (973) Primary Contact Thomas Kloos MD Executive Director ORGANIZATIONAL INFORMATION AHS ACO Participants The following providers are participating in the AHS ACO (see attached.pdf).

2 AHS ACO Governing Body: Governing Board ** Voting Members Ira Monka, DO, ACO Participant, Practice Associates Medical Group, PC** Trish O Keefe ACO Participant, Practice Associates Medical Group, PC ** (Acting President - Morristown Medical Center) Alan Lieber ACO Participant, Practice Associates Medical Group, PC** (President - Overlook Medical Center) Joseph DiPaolo ACO Participant, AHS Hospital Corp. ** (President - Newton Medical Center) Maureen Schneider ACO Participant, AHS Hospital Corp. ** (Chief Nursing Officer - Chilton Medical Center) Kathy Rosen-Kerr, MD ACO Participant, Kathy Rosen Kerr MD ** Susan Kaye, MD ACO Participant, Practice Associates Medical Group, PC** Samir Shah, MD ACO Participant, Specialist- Premier Health Associates LLC** Timothy Brabston, MD ACO Participant, Medical Associates of North Jersey ** Mary Herald Medicare Beneficiary Representative** Steve Sheris, MD ACO Participant, Practice Associates Medical Group, PC** John Feltz, MD ACO Provider/Supplier Physician Member, Specialist, Lifeline Medical Associates, PA ** AHS ACO Key Clinical and Administrative Leadership ACO Executive: Thomas Kloos, MD Executive Director Management Services Group Thomas Kloos, MD Executive Director James Barr, MD Medical Director Poonam Alaigh, MD Care Management Director Deborah Rodgers, RN, MSN, JD ACO Manager Patricia Wallace, RN, MSN Improvement Manager Compliance Officer Eva Goldenberg, Esq.

3 AHS ACO Committees and Committee Leadership Finance Committee Kevin Lenahan Improvement Committee John Feltz, MD Nominating and Credentialing Committee Thomas Kloos, MD Health Information Technology Subcommittee (HIT) Thomas Kloos, MD Provider Integration & Beneficiary Engagement Subcommittee Arnold Pally, MD Co- Steve Alderson Co- Care Coordination Subcommittee Carol Jones, RN Regional Advisory Boards Passaic Region: Timothy Brabston, MD Morris Region: Ira Monka, DO Sussex Region: Kenneth Roffe, DO Union Region: Samantha Pozner, MD Identification of the Types of ACO Participants or Combinations of Participants that Formed the ACO AHS ACO, LLC is a NJ limited liability company governed by its operating agreement and by the NJ Limited Liability Company Act. AHS ACO, LLC s members consist of AHS Hospital Corp. and certain physician/clinician members. AHS ACO is comprised a partnership or joint venture arrangement between hospitals and ACO professional and a Federally Qualified Health Center (FQHC).

4 SHARED SAVINGS AND LOSSES Amount of Shared Savings/Losses Year 1: $0 Year 2014: $0 How Shared Savings Are Distributed Proportion invested in infrastructure: 15% Investment in redesigned care processes/ resources: 15% Proportion of distribution to ACO participants: 70% o Hospitals 10% of residual after Operational Expenses/Reinvestment o Physicians 90% of residual after Operational Expenses/reinvestment Primary Care Physicians 80% of this pool Specialty Physicians 20% of this pool *Required Public Disclosure for ACO Participation Waivers The Centers for Medicare & Medicaid Services ( CMS ) has made available certain waivers of federal fraud and abuse laws in connection with the operation of an accountable care organization that has entered into a participation agreement under the Medicare Shared Savings Program ( MSSP ). In accordance with the public disclosure requirements of the ACO Participation Waiver, the following describes an arrangement between AHS ACO, LLC (the ACO ) and certain ACO participants. The ACO Governing Board duly authorized the Care Management Improvement Incentive Program ( CMPIIP ) and made a bona fide determination that the program is reasonably related to the purposes of the MSSP. The CMPIIP is an incentive program whereby certain ACO participants may earn per member per month fees for achieving certain performance metrics. The performance criteria and metrics are directly related to the purposes of MSSP because they: (1) promote accountability for the quality, cost, and overall care for Medicare beneficiaries; (2) help manage and coordinate care for Medicare beneficiaries; and (3) encourage investment in infrastructure and redesigned processes for high quality and efficient service delivery for Medicare beneficiaries. The program commenced on January 1, 2013 and is expected to be in effect until December 31,2015.

5 Measure Number ACO #1 ACO #2 Measure Getting Timely Care, Appointments, and Information How Well Your Doctors Communicate Quality Results Table 2012 reporting Period 2013 reporting period 2014 reporting period Mean ACO Mean ACO For All ACOs Rate For All ACOs Rate ACO Rate Mean For All ACOs ACO #3 Patients Rating of Doctor ACO #4 Access to Specialists ACO #5 Health Promotion and Education ACO #6 Shared Decision Making ACO #7 Health Status/Functional Status ACO #8 Risk Standardized, All Condition Readmissions ACO #9 ASC Admissions: COPD or Asthma in Older Adults ACO #10 ASC Admission: Heart Failure ACO #11 Percent of PCPs who Qualified for EHR Incentive Payment ACO #12 Medication Reconciliation ACO #13 Falls: Screening for Fall Risk ACO #14 Influenza Immunization ACO #15 Pneumococcal Vaccination ACO #16 Adult Weight Screening and Follow-up ACO #17 Tobacco Use Assessment and Cessation Intervention ACO #18 Depression Screening

6 Measure Number Measure 2012 reporting Period 2013 reporting period 2014 reporting period Mean ACO Mean ACO For All ACOs Rate For All ACOs Rate ACO Rate Mean For All ACOs ACO #19 Colorectal Cancer Screening ACO #20 Mammography Screening ACO #21 ACO #22 ACO #23 Proportion of Adults who had blood pressure screened in past 2 years Hemoglobin A1c Control (HbA1c) (<8 percent) Low Density Lipoprotein (LDL) (<100 mg/dl) N/A N/A N/A N/A N/A N/A N/A ACO #24 Blood Pressure (BP) <140/ N/A N/A N/A ACO #25 Tobacco Non Use N/A N/A N/A ACO #26 Aspirin Use N/A N/A N/A ACO #27 ACO #28 ACO #29 ACO #30 ACO #31 ACO #32 ACO #33 diabetes whose HbA1c in poor control (>9 percent) hypertension whose BP <140/90 IVD with complete lipid profile and LDL control <100mg/dl IVD who use Aspirin or other antithrombotic Beta-Blocker Therapy for LVSD Drug Therapy for Lowering LDL Cholesterol ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD N/A N/A N/A N/A N/A N/A 77 N/A N/A N/A