Medicare Shared Savings Program

Mission Health Partners, LLC.
50 Schenck Parkway Asheville, North Carolina 28803

 
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
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 NEUROLOGY SPECIALISTS, PA` 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
MOUNTAIN LAUREL DERMATOLOGY PLLC N
Murphy Medical Center, Inc. N
North Buncombe Family Medicine, P.A. N
Our Family Doctor, PLLC N
Park Hill Medicine, PA N
Pathologists Medical Laboratory, P.A. N
PATTERSON DERMATOLOGY, PC N
The Pisgah Institute for Psychotherapy & Education PA N
Radiation Therapy Associates of Western North Carolina, 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
First Name Last Name Title / Position
Dustin Alderson Director Class I 5.26% ACO Participant Representative Hendersonville Pediatrics, P.A.
Jessica Anewalt Director Class I 5.26% ACO Participant Representative North Buncombe Family Medicine, P.A.
Gretchen Batra Director Class II 5.26% Medicare Beneficiary Representative Medicare Beneficiary
Mark Gwynne Director Class II 5.26% ACO Participant Representative Henderson County Hospital Corporation
William Hathaway Director Class I 5.26% ACO Participant Representative Mountain Area Health Education Center, Inc.
Benjamin Heyen Director Class I 5.26% ACO Participant Representative MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC
Caroline Knox Director Class I 5.26% ACO Participant Representative MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC
Nancy Kubiak Director Class I 5.26% ACO Participant Representative Mountain Area Health Education Center, Inc.
Kenny Kubitschek Director Class I 5.26% ACO Participant Representative Carolina Internal Medicine Associates, PA
Ansley Miller Director Class II 5.26% ACO Participant Representative MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC
Robert Moore Director Class I 5.26% ACO Participant Representative North Buncombe Family Medicine, PA
Alan Morgan Director Class I 5.26% ACO Participant Representative Carolina Internal Medicine Associates PA
Philip Stahel Director Class II 5.26% Community Stakeholder Representative N/A
Margaret Sullivan Director Class I 5.26% ACO Participant Representative MH BLUE RIDGE MEDICAL CENTER, LLLP
Jesse Sulzer Director Class II 5.26% ACO Participant Representative MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC
Calvin Tomkins Director Class I 5.26% ACO Participant Representative Asheville Pediatric Associates
Terence Van Arkel Director Class II 5.26% Community Stakeholder Representative N/A
Jana Watts Director Class I 5.26% ACO Participant Representative MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC
David Williamson Director Class II 5.26% Community Stakeholder Representative N/A
Amanda Gerlach Ex Officio 0 Executive Director N/A
Amy Russell Ex Officio 0 Medical Director N/A

 

Key ACO Administrative Leadership
ACO Executive Amanda Gerlach
Medical Director Amy Russell, M.D.
Ethics & Compliance Officer Heather Smith
Quality Assurance Office Amy Russell, M.D.

 

Associated Committees and Committee Leadership
Committee Committee Leader Name and Position
Finance and Compliance Committee Andy Brown, M.D. (Asheville Radiology), Member
Finance and Compliance Committee William Hathaway, M.D. (MAHEC), Member
Finance and Compliance Committee Laurie Haynes (HCA Healthcare), Member
Finance and Compliance Committee Jason Hunt, M.D. (TeamHealth), Member
Finance and Compliance Committee Brian Moore, M.D. (North Buncombe Family Medicine), Member
Quality Committee Jessica Anewalt, M.D. (North Buncombe Family Medicine), Member
Quality Committee Graham Custar, M.D. (MAHEC), Member
Quality Committee Amy Frye-Anderson, R.N. (HCA Healthcare), Member
Quality Committee Kristin Gowan, M.D. (Asheville Arthritis), Member
Quality Committee  Caroline Knox, M.D. (HCA Healthcare), Member
Quality Committee Rabi Kutob, M.D. (TeamHealth), Chair
Quality Committee J.T. Labruyere, P.A. (MAHEC), Member
Quality Committee Karin McLelland, M.D. (Haywood Pediatrics), Member
Quality Committee Margaret Sullivan, M.D. (HCA Healthcare), Member
Quality Committee Amy Russell, M.D. (MAHEC), Mission Health Partners Medical Director
Quality Committee Virginia Templeton, M.D. (MemoryCare), Member
Quality Committee Calvin Tomkins, M.D. (Asheville Pediatrics), Member
Quality Committee Jana Watts, M.D. (HCA Healthcare), Member
 
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 2022, $0
  • 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 2022
    • 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
    • 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

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

 

2022 Quality Performance Results
Quality performance results are based on CMS Web Interface Measure Set.
Measure # Measure Name Collection Type Rate ACO Mean
Measure #: 001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control CMS Web Interface 18.01 10.71
Measure #: 134 Preventative Care and Screening: Screening for Depression and Follow-up Plan CMS Web Interface 74.20 76.97
Measure #: 236 Controlling High Blood Pressure CMS Web Interface 66.85 76.16
Measure #: 318 Falls: Screening for Future Fall Risk  CMS Web Interface 87.66 87.83
Measure #: 110 Preventative Care and Screening: Influenza Immunization CMS Web Interface 75.00 77.34
Measure #: 226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface 70.00 79.27
Measure #: 113 Colorectal Cancer Screening CMS Web Interface 79.53 75.32
Measure #: 112 Breast Cancer Screening CMS Web Interface 81.39 78.07
Measure #: 438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface 80.81 86.37
Measure #: 370 Depression Remission at Twelve Months CMS Web Interface 02.13 16.03
Measure #: 479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups Administrative Claims 00.13 00.15
Measure #: 484 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions Administrative Claims 28.46 30.97
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS Survey 84.92 83.96
CAHPS-2 How Well Providers Communicate CAHPS for MIPS Survey 93.01 93.47
CAHPS-3 Patient’s Rating of Provider CAHPS for MIPS Survey 90.97 92.06
CAHPS-4 Access to Specialists CAHPS for MIPS Survey 76.01 77.00
CAHPS-5 Health Promotion and Education CAHPS for MIPS Survey 66.87 62.68
CAHPS-6 Shared Decision Making CAHPS for MIPS Survey 62.29 60.97
CAHPS-7 Health Status and Functional Status CAHPS for MIPS Survey 75.44 73.06
CAHPS-8 Care Coordination CAHPS for MIPS Survey 84.19 85.46
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS Survey 92.92 91.97
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS Survey 30.39 25.62

For previous years’ Financial and Quality Performance Results, please visit: data.cms.gov


FRAUD AND ABUSE WAIVERS

  • ACO Participation Waiver

The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement. 

HIE

  • Parties to the arrangement: All Network Participants
  • Date of arrangement: 08/14/2014
  • Items, services, goods, or facility provided: 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

  • Parties to the arrangement: All Network Participants
  • Date of arrangement: 04/11/2016
  • Items, services, goods, or facility provided: 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 
  

  • Parties to the arrangement: All Network Participants
  • Date of arrangement: 08/11/2016    
  • Items, services, goods, or facility provided: 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.         


Psychiatric Consulting Services

  • Parties to the arrangement: Mission Health Partners, LLC and Mountain Area Health Education Center (“MAHEC”); all Network Participants
  • Date of arrangement: 01/01/2024
  • Items, services, goods, or facility provided: To further the purposes for the MSSP, including improving the ability of MHP providers to manage and coordinate the care of patients, the MHP Board of Directors authorized MHP to enter into an arrangement with MAHEC, pursuant to which MAHEC psychiatrists will provide psychiatric telehealth consultation services to MHP primary care practices in support of developing their capacity to implement the Collaborative Care Model for more effective behavior health care management. MHP will make these services available to its MHP providers to facilitate the coordination and management of care of patients.