Medicare Shared Savings Program
Mission Health Partners, LLC.
50 Schenck Parkway Asheville, North Carolina 28803
ACO Primary Contact | |
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Primary Contact Name | Amanda Gerlach |
Primary Contact Phone Number | 828-213-5384 |
Primary Contact Email Address | amanda.gerlach@HCAHealthcare.com |
Organizational Information | |
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ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
ABC Pediatrics of Asheville PA | N |
Asheville Neurology Specialists PA’ | N |
Allan Nash | N |
Appalachian Foot & Ankle Associates PA | N |
Asheville Arthritis and Osteoporosis Center, P.A. | N |
Asheville Children’s Medical Center 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 |
Blue Sky Pediatrics Asheville PA | N |
CAREPARTNERS HHA LLLP | N |
CAREPARTNERS REHABILITATION HOSPITAL, LLLP | N |
Cannon Family Health, PLLC | N |
Carolina Hand and Sports Medicine, P.A. | N |
Carolina Internal Medicine Associates, PA | N |
Carolina Mountain Gastroenterology Endoscopy Center, LLC | N |
Carolina Ophthalmology, PA | N |
Community CarePartners, Inc. | N |
DERMATOLOGY CONSULTANTS OF ASHEVILLE PLLC | N |
Digestive Health Partners Pa | N |
ENDOSCOPY CENTER OF NORTH CAROLINA | N |
Forest Dermatology, PA | N |
French Broad Pediatric Associates | N |
GRACE G EVINS MD PA | N |
Haywood Pediatric and Adolescent Medicine Group, P.A. | N |
Henderson County Hospital Corporation | N |
Hendersonville Pediatrics, P.A. | 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 HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC | 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 |
Murphy Medical Center, Inc. | N |
North Buncombe Family Medicine, P.A. | N |
Our Family Doctor, PLLC | N |
PATTERSON DERMATOLOGY, PC | N |
Park Hill Medicine, PA | N |
Pathologists Medical Laboratory, P.A. | N |
Radiation Therapy Associates Of Western North Carolina, Pa | N |
The Pisgah Institute for Psychotherapy & Education PA | N |
W.N.C. Ear Nose Throat Head and Neck Surgeons, PA | N |
WARE FAMILY MEDICINE PLLC | N |
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 | |||
Alderson | Dustin | Director Class I | 5.0 % | ACO Participant Representative | Hendersonville Pediatrics, P.A. |
Anewalt | Jessica | Director Class I | 5.0 % | ACO Participant Representative | North Buncombe Family Medicine, P.A. |
Batra | Gretchen | Director Class II | 5.0 % | Medicare Beneficiary Representative | Medicare Beneficiary |
Derouen | Vyvyan | Director Class II | 5.0 % | Community Stakeholder | N/A |
Fagen | Blake | Director Class I | 5.0 % | ACO Participant Representative | Mountain Area Health Education Center, Inc. |
Gwynne | Mark | Director Class II | 5.0 % | ACO Participant Representative | Henderson County Hospital Corporation |
Hathaway | William | Director Class I | 5.0 % | ACO Participant Representative | Mountain Area Health Education Center, Inc. |
Kubitscheck | Kenny | Director Class I | 5.0 % | ACO Participant Representative | Carolina Internal Medicine Associates, PA |
Knox | Caroline | Director Class I | 5.0 % | ACO Participant Representative | MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC |
Miller | Ansley | Director Class II | 5.0 % | ACO Participant Representative | MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC |
Moore | Robert | Director Class I | 5.0 % | ACO Participant Representative | North Buncombe Family Medicine, PA |
Morgan | Alan | Director Class I | 5.0 % | ACO Participant Representative | Carolina Internal Medicine Associates PA |
Seneker | Timothy | Director Class I | 5.0 % | ACO Participant Representative | MH BLUE RIDGE MEDICAL CENTER, LLLP |
Stahel | Philip | Director Class II | 5.0 % | Community Stakeholder Representative | N/A |
Sullivan | Margaret | Director Class I | 5.0 % | ACO Participant Representative | MH BLUE RIDGE MEDICAL CENTER, LLLP |
Tomkins | Calvin | Director Class I | 5.0 % | ACO Participant Representative | Asheville Pediatric Associates |
Van Arkel | Terence | Director Class II | 5.0% | Community Stakeholder Representative | N/A |
Young | Matthew | Director Class II | 5.0 % | ACO Participant Representative | MH MISSION HOSPITAL, LLLP |
Downey | Doug | Officer | 0 | AVP Tax Dept. | N/A |
Gerlach | Amanda | Ex Officio | 0 | Executive Director | N/A |
Russell | Amy | Ex Officio | 0 | Medical Director | N/A |
Smith | Heather | Officer | 0 | Ethics & Compliance Officer | N/A |
Key ACO Administrative Leadership | |
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ACO Executive | Amanda Gerlach |
Medical Director | Amy Russell, M.D. |
Ethics & Compliance Officer | Heather Smith |
AVP, Tax Department | Doug Downey |
Associated Committees and Committee Leadership |
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Finance and Compliance Committee |
Chair | William Hathaway |
Asheville Radiology | Andy Brown |
Mission Health Partners | Amanda Gerlach |
MAHEC | William Hathaway |
HCA Healthcare | Laurie Haynes |
TeamHealth | Jason Hunt |
North Buncombe Family Medicine | Brian Moore |
Staff Member | Heather Smith |
Staff Member | Kelly McIntyre |
Quality Committee |
Chair | Amy Russell |
North Buncombe Family Medicine | Jessica Anewalt |
HCA Healthcare | Amy Frye-Anderson |
MAHEC | Tammy Garrity |
Mission Health Partners | Amanda Gerlach |
Asheville Arthritis | Kristin Gowan |
HCA Healthcare | Caroline Knox |
TeamHealth | Rabi Kutob |
MAHEC | JT Labruyere |
Haywood Pediatrics | Karin McLelland |
MAHEC | Eric Smith |
HCA Healthcare | Margaret Sullivan |
Mission Health Partners | Amy Russell |
MemoryCare | Virginia Templeton |
Asheville Pediatrics | Calvin Tomkins |
HCA Healthcare | Jana Watts |
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 2021, $6,702,443
- Performance Year 2020, $7,500,198.56
- Performance Year 2019, $0
- 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 2021
- Proportion invested in infrastructure: 10%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2020
- Proportion invested in infrastructure: 10%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2019
- 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 2018
- 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 2021
- 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
- Performance Year 2017
2021 Quality Performance Results | ||||||
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ACO# | Measure Name | Rate | ACO Mean | |||
001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control2 | 22.98 | 12.46 | |||
134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | 66.44 | 74.38 | |||
236 | Controlling High Blood Pressure | 69.54 | 74.87 | |||
318 | Falls: Screening for Future Fall Risk | 87.68 | 87.03 | |||
110 | Preventative Care and Screening: Influenza Immunization | 75.37 | 80.52 | |||
226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | 59.46 | 80.97 | |||
113 | Colorectal Cancer Screening | 79.65 | 73.63 | |||
112 | Breast Cancer Screening | 79.40 | 75.11 | |||
438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 75.70 | 84.24 | |||
370 | Depression Remission at Twelve Months | N/A | N/A | |||
479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2 | 0.1315 | 0.1540 | |||
MCC1 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2 | 30.09 | 33.99 | |||
CAHPS-1 | Getting Timely Care, Appointments, and Information | 84.87 | 84.67 | |||
CAHPS-2 | How Well Your Providers Communicate | 93.6 | 93.56 | |||
CAHPS-3 | Patient’s Rating of Provider | 92.40 | 92.19 | |||
CAHPS-4 | Access to Specialists | 74.71 | 78.80 | |||
CAHPS-5 | Health Promotion and Education | 65.66 | 61.61 | |||
CAHPS-6 | Shared Decision Making | 62.78 | 60.89 | |||
CAHPS-7 | Health Status and Functional Status | 71.81 | 71.78 | |||
CAHPS-8 | Care Coordination | 86.48 | 85.66 | |||
CAHPS-9 | Courteous and Helpful Office Staff | 91.17 | 91.88 | |||
CAHPS-11 | Stewardship of Patient Resources | 26.98 | 24.71 |
For previous years’ Financial and Quality Performance Results, please visit: data.cms.gov
“Please note, the Quality ID #: 370 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.”
FRAUD AND ABUSE WAIVERS
- ACO Participation Waiver
- HIE 8/14/2014 To further the purposes of the MSSP and the clinical integration efforts of MHP and its participants, the MHP Board of Directors authorizes the provision of the required connectivity to the Mission health System HIE for all network participants and their employed providers at no cost in order to facilitate the exchange of data necessary to evaluate and measure the quality outcomes of all network participants according to the requirements of the MSSP.
- Quality Incentive Program 4/11/2016 A Quality Incentive Program that is designed to incentivize quality improvement behaviors among network providers, set a culture of communication and collaboration, build infrastructure and establish goodwill by providing financial incentives to providers who meet or exceed pre-established connectivity, reporting and quality metrics. The Quality Incentive Program will contribute to the promotion of high quality and efficient care to network patients by encouraging providers to adhere to quality metrics and facilitate management and coordination of care.
- Clinical Documentation Integrity “CDI” Services 8/11/2016 Clinical Documentation Integrity “CDI” services which will include documentation specificity queries, code reviews, data analysis and education on findings related to documentation requirements and tools to support processes. These services will ensure that accurate documentation and code capture is at the most appropriate delivery of quality care.
- Patient Incentive Waiver
- Patient Transportation Program 3/9/2017 Mission Health Partners is implementing a program designed to assist high-risk patients with transportation to appointments for follow-up care (the “Program”). Mission Health Partners’ Board of Directors, by means of a duly authorized resolution, determined that the Program is reasonably related to the purposes of the Medicare Shared Savings Program (“MSSP”). The Program will advance MHP’s clinical goals by helping patients adhere to a treatment or drug regime or follow-up care plan, or to facilitate management of a chronic disease. The Program will improve access to primary care, particularly for patients who have often had great difficulty getting to appoints. Reducing barriers to care such as transportation helps MHP meet the goals of improving cost and quality of care. The MHP Board of Directors has invoked the ACO Patient Incentives Waiver for the Program.
- Patient Transportation Program 3/9/2017 Mission Health Partners is implementing a program designed to assist high-risk patients with transportation to appointments for follow-up care (the “Program”). Mission Health Partners’ Board of Directors, by means of a duly authorized resolution, determined that the Program is reasonably related to the purposes of the Medicare Shared Savings Program (“MSSP”). The Program will advance MHP’s clinical goals by helping patients adhere to a treatment or drug regime or follow-up care plan, or to facilitate management of a chronic disease. The Program will improve access to primary care, particularly for patients who have often had great difficulty getting to appoints. Reducing barriers to care such as transportation helps MHP meet the goals of improving cost and quality of care. The MHP Board of Directors has invoked the ACO Patient Incentives Waiver for the Program.