Medicare Shared Savings Program

Mission Health Partners, Inc.
50 Schenck Parkway 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)
A  
ABC Pediatrics of Asheville PA N
Appalachian Foot & Ankle Associates PA 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 Family Health Center PA 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
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
Community Family Practice, PA N
DERMATOLOGY CONSULTANTS OF NORTH ASHEVILLE N
Digestive Health Partners Pa N
Dr. Allan Dale Nash MD N
East Asheville Family Health Care P.A. N
ENDOSCOPY CENTER OF NORTH CAROLINA N
Forest Dermatology, PA N
French Broad Pediatric Associates N
Grave Evins MD PA 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
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 Kidney & Hypertension Associates, P.A. 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
Radiation Therapy Associates Of Western North Carolina, Pa N
STMD LLC N
The Pisgah Institute for Psychotherapy & Education PA N
W.N.C. Ear Nose Throat Head and Neck Surgeons, PA 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
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
Coin Wendy Director Class I 1 ACO Participant Representative The Family Health Centers, PA
Cramer Rebecca Director Class I 1 ACO Participant Representative Community Family Practice, PA
Frayne Daniel Director Class I 1 ACO Participant Representative Mountain Area Health Education Center, Inc.
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.
Midkiff Paul Director Class I 1 ACO Participant Representative The Family Health Centers, PA
Moore Robert Director Class I 1 ACO Participant Representative North Buncombe Family Medicine
Seneker Timothy Director Class I 1 ACO Participant Representative MH BLUE RIDGE MEDICAL CENTER, LLLP
Tomkins Calvin Director Class I 1 ACO Participant Representative Asheville Pediatric Associates
Wells Ora Director Class I 1 ACO Participant Representative/Medicare Beneficiary Representative Hendersonville Pediatrics, P.A.
Kubitscheck Kenny Director Class I 1 ACO Participant Representative Carolina Internal Medicine Associates
Miller Ansley Director Class II 1 ACO Participant Representative MH Mission Hospital, LLLP
Gwynne Mark Director Class II 1 ACO Participant Representative Henderson County Hospital Corporation
Hathaway William Director Class II 1 ACO Participant Representative MH MISSION HOSPITAL, LLLP
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
Young Matthew Director Class II 1 ACO Participant Representative MH MISSION HOSPITAL, LLLP
Gerlach Amanda Ex Officio 0 Executive Director N/A
Russell Amy Ex Officio 0 Medical Director N/A
Key ACO Administrative Leadership
ACO Executive Amanda Gerlach        
Medical Director Amy Russell, M.D.        
Compliance Officer Trudy Williams        
Quality Assurance/Improvement Officer Amy Russell, M.D.        
Associated Committees and Committee Leadership
Committee Name Committee Leader Name and Position
Finance and Compliance Committee Dr. Jeffery Heck/Chair
Quality Committee Dr. Jason Goldie/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 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 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
2020 Quality Performance Results
ACO# Measure Name Rate ACO Mean    
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 0.80 0.95    
ACO-13 Falls: Screening for Future Fall Risk 79.63 84.97    
ACO-14 Preventive Care and Screening: Influenza Immunization 70.17 76.03    
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 82.50 81.67    
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 62.67 71.46    
ACO-19 Colorectal Cancer Screening 69.44 72.59    
ACO-20 Breast Cancer Screening 73.75 74.05    
ACO-42 Statin therapy for the Prevention and Treatment of Cardiovascular Disease 80.04 83.37    
ACO-27 Diabetes: Hemoglobin A1c Poor Control (>9%) 11.53 14.70    
ACO-28 Controlling High Blood Pressure 74.41 72.87    

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

PAYMENT RULE WAIVERS

  • N/A

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.
          
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