Medicare Shared Savings Program

Mission Health Partners, Inc.
509 Biltmore Avenue Asheville, North Carolina 28801

ACO Primary Contact
Primary Contact Name Amanda Gerlach
Primary Contact Phone Number 828-213-5384
Primary Contact Email Address amanda.gerlach@HCAHealthcare.com
Organizational Information
ACO Participants ACO Participant in Joint Venture (Enter Y or N)
ABC Pediatrics of Asheville PA N
Allan Nash N
Allan Nash N
ALLCARE CLINICAL ASSOCIATES PA N
Angel Medical Center, Inc. N
Appalachian Foot & Ankle Associates PA N
Appalachian Mountain Community Health Centers N
Appalachian Regional Medical Associates, Inc. N
Asheville Arthritis and Osteoporosis Center, P.A. N
Asheville Children's Medical Center PA N
Asheville Endocrinology Consultants, PA N
Asheville Eye Associates PLLC N
Asheville Gynecology & Wellness Pllc N
Asheville Pediatric Associates N
Asheville Podiatry Associates PA N
Asheville Radiology Associates, PA N
Bakersville Community Medical Clinic, Incorporated N
Blue Ridge Regional Hospital Inc. N
Blue Sky Pediatrics Asheville PA N
Brosnan Eye Associates N
Cannon Family Health, PLLC N
CAREPARTNERS HHA LLLP N
CAREPARTNERS REHABILITATION HOSPITAL, LLLP N
Carolina Hand and Sports Medicine, P.A. N
Carolina Internal Medicine Associates, PA N
Carolina Mountain Emergency Medicine PA N
Carolina Mountain Gastroenterology Endoscopy Center, LLC N
Carolina Ophthalmology, PA N
Charles A. Cannon, Jr., Memorial Hospital, Inc. N
Charles J. DePaolo, M.D, P.A. N
Clay Comprehensive Health Services, Inc. N
Community CarePartners, Inc. N
Community Family Practice, PA N
Digestive Health Partners Pa N
Don Jablonski DO PA N
Dry Ridge Family Medicine PLLC N
East Asheville Family Health Care P.A. N
ENDOSCOPY CENTER OF NORTH CAROLINA N
Forest Dermatology, PA N
Franklin Family Practice, PA N
French Broad Pediatric Associates N
Halvorson Plastic Surgery, PA N
Haywood Pediatric and Adolescent Medicine Group, P.A. N
Hazelwood Family Medicine, PLLC N
Henderson County Hospital Corporation N
Hendersonville Pediatrics, P.A. N
Highlands-Cashiers Hospital, Inc. N
Highlands-Cashiers Physician Services Inc N
James J. Caserio, M.D., PA N
John Baker N
Krishna Internal Medicine, P.C. N
MemoryCare N
MH ANGEL MEDICAL CENTER, LLLP N
MH BLUE RIDGE MEDICAL CENTER, LLLP N
MH Highlands-Cashiers Medical Center, LLLP N
MH MISSION HOSPITAL MCDOWELL, LLLP N
MH MISSION HOSPITAL, LLLP N
MH MISSION IMAGING LLLP N
MH TRANSYLVANIA REGIONAL HOSPITAL, LLLP N
Mission Community Anesthesiology Specialists LLC N
Mission Hospitals Inc N
Mission Medical Associates Inc. N
Moore Foot & Ankle Specialists, PA N
Mountain Area Health Education Center, Inc. N
MOUNTAIN AREA PATHOLOGY PA N
Mountain Area Pediatric Associates, P.A. N
Mountain Diabetes And Endocrine Center PLLC N
Mountain Kidney & Hypertension Associates, P.A. N
Murphy Medical Center, Inc. N
North Buncombe Family Medicine, P.A. N
October Road, Inc. N
Our Family Doctor, PLLC N
Park Hill Medicine, PA N
Pathologists Medical Laboratory, P.A. N
Radiation Therapy Associates Of Western North Carolina, Pa N
STMD LLC N
The Family Health Centers, PA N
The McDowell Hospital Inc. N
The Pisgah Institute for Psychotherapy & Education PA N
Transylvania Community Hospital, Inc. N
Transylvania Physician Services Inc N
W.N.C. Ear Nose Throat Head and Neck Surgeons, PA N
Watauga Medical Center, Inc. N
WNC Birth Center N
WNC INTERNAL MEDICINE, PLLC N
What's An Accountable Care Organization (ACO)?
  • ACOs are groups of doctors and other healthcare providers who voluntarily work together with Medicare to give you high quality service and care at the right time in the right setting.
  • Your doctor has agreed to participate in a Medicare Shared Savings Program ACO and to work closely with other doctors and healthcare providers in the ACO to coordinate care for Medicare beneficiaries, like yourself, who have traditional Medicare.
  • The ACO may share in any savings that result from providing you with high quality and more coordinated care.
ACOs Don't Change Your Medicare Benefits
  • An ACO is not a Medicare Advantage plan or an HMO plan.
  • If you have traditional Medicare, you still have the right to see any doctor or hospital who accepts Medicare at any time.
  • We may continue to recommend that you see particular doctors for your specific health needs, but it's always your choice about what doctors you see or hospitals you visit.
How Will An ACO Help My Doctor Coordinate My Care?
  • You benefit because your doctors will be part of a better coordinated team.
  • You may not have to fill out as many medical forms that ask for the same information.
  • Each of your doctors will not only know about the health issues they've treated, they will have a more complete picture of your health through talking with your other doctors.

If you have questions or concerns, you can talk with your physician at any time. You can also visit www.medicare.gov/acos.html or call 1-800-MEDICARE. TTY users should call 1-877-486-2048.

ACO Governing Body
Member Member's Voting Power Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable
Last Name First Name Title / Position
Buys Elizabeth Director Class I 1 ACO Participant Representative Mountain Area Health Education Center, Inc.
Cannon Lateef Director Class I 1 ACO Participant Representative Henderson County Hospital Corporation
Cramer Rebecca Director Class I 1 ACO Participant Representative Community Family Practice, PA
Goldie Jason Director Class I 1 ACO Participant Representative The Family Health Centers, PA
Heck Jeffery Director Class I and Board Chair 1 ACO Participant Representative Mountain Area Health Education Center, Inc.
Kubitschek Kenneth Director Class I 1 ACO Participant Representative Carolina Internal Medicine Associates, PA
Mahaffey Danielle Director Class I 1 ACO Participant Representative Appalachian Regional Medical Associates, Inc.
Moore Robert Director Class I 1 ACO Participant Representative North Buncombe Family Medicine, P.A.
Tomkins Calvin Director Class I 1 ACO Participant Representative Asheville Pediatric Associates
Weizman Michael Director Class I and Vice Chair 1 ACO Participant Representative Our Family Doctor, PLLC
Wells Ora Director Class I 1 ACO Participant Representative Hendersonville Pediatrics, P.A.
Franklin David Director Class II 1 ACO Participant Representative Mission Medical Associates Inc.
Garrett John Director Class II 1 Medicare Beneficiary Representative N/A
Gwynne Mark Director Class II 1 ACO Participant Representative Henderson County Hospital Corporation
Hathaway William Director Class II 1 ACO Participant Representative Mission Hospitals Inc
Mims Susan Director Class II 1 ACO Participant Representative Mountain Area Health Education Center, Inc.
Patrick Chad Director Class II 1 Community Stakeholder Representative N/A
Van Arkel Terence Director Class II 1 Community Stakeholder Representative N/A
Wysong Mark Director Class II 1 Community Stakeholder Representative N/A
Gerlach Amanda Ex Officio 0 Executive Director N/A
Russell Amy Ex Officio 0 Medical Director N/A
Key ACO Administrative Leadership
Amanda Gerlach ACO Executive        
Amy Russell, M.D. Medical Director        
Gwen McKinney Compliance Officer        
Chad Boring Treasurer        
Amy Russell, M.D. Quality Assurance/Improvement Officer        
           
Associated Committees and Committee Leadership
Committee Name Committee Leader Name and Position
Finance and Compliance Committee Dr. Robert Moore/Chair
Quality Committee Dr. Wendy Coin/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
  • Second Agreement Period
    • Performance Year 2018, $0
  • First Agreement Period
    • Performance Year 2017, $0
    • Performance Year 2016, $5,375,365
    • Performance Year 2015, $0
Shared Savings Distribution
  • Second Agreement Period
    • Performance Year 2018
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
  • First Agreement Period
    • Performance Year 2017
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2016
      • Proportion invested in infrastructure: 10%
      • Proportion invested in redesigned care processes/resources: 45%
      • Proportion of distribution to ACO participants: 45%
    • Performance Year 2015
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
2018 Quality Performance Results
ACO# Measure Name Rate ACO Mean    
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 86.33 86.14    
ACO-2 CAHPS: How Well Your Providers Communicate 95.44 93.93    
ACO-3 CAHPS: Patients’ Rating of Provider 92.51 92.45    
ACO-4 CAHPS: Access to Specialists 80.41 81.50    
ACO-5 CAHPS: Health Promotion and Education 62.45 59.26    
ACO-6 CAHPS: Shared Decision Making 60.58 61.94    
ACO-7 CAHPS: Health Status/Functional Status 74.33 73.35    
ACO-34 CAHPS: Stewardship of Patient Resources 25.93 26.26    
ACO-8 Risk Standardized, All Condition Readmission 13.83 14.98    
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 16.98 18.59    
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 33.83 37.01    
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 67.59 76.75    
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 51.27 59.00    
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.33 1.98    
ACO-11 Use of certified EHR Technology 99.40 98.20    
ACO-12 Medication Reconciliation 78.28 85.91    
ACO-13 Falls: Screening for Future Fall Risk 86.32 79.73    
ACO-44 Imaging Studies for Low Back Pain 67.69 64.36    
ACO-14 Preventive Care and Screening: Influenza Immunization 73.42 72.71    
ACO-15 Pneumonia Vaccination Status for Older Adults 84.42 75.97    
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 78.53 76.83    
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 61.76 72.81    
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 77.95 66.74    
ACO-19 Colorectal Cancer Screening 67.27 68.27    
ACO-20 Breast Cancer Screening 80.23 71.96    
ACO-42 Statin therapy for the Prevention and Treatment of Cardiovascular Disease 80.85 81.47    
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 13.96 15.51    
ACO-41 Diabetes: Eye Exam 55.09 52.42    
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 80.00 73.10    
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 93.07 88.92    

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

  • For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-day Rule Waiver:
    • No, our ACO does not use the SNF 3-Day Rule Waiver, pursuant to 42 CFR 425.612.
  • Waiver for Payment for Telehealth Services:
    • No, our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.

Additional Information

For additional information or general beneficiary questions, please visit www.medicare.gov/acos.html. You can also call 1-800-MEDICARE (1-800-633-4227 (TTY users should call 1-877-486-2048)) for questions about Accountable Care Organizations.

Hours of Operation: Monday through Friday 8 a.m. - 5 p.m.