MSSP ACO

MSSP ACO

ACO Name and Location

Piedmont Clinic ACO LLC
2727 Paces Ferry Road
Building 1, Suite 800
Atlanta, Georgia 30339

 

ACO Primary Contact

Primary Contact Name: Brandy Frieson-Kelly
Primary Contact Phone Number: 470-271-2218
Primary Contact Email Address: brandy.frieson-kelly@piedmont.org

PARTICIPANTS: PERFORMANCE YEAR TWO (2018)

TIN Legal Business Name ACO Participant in Joint Venture (Enter Y or N)
Atlanta Heart Associates N
Atlanta ID Group, P.C. N
Byron F. Harper, III, M.D., P.C. N
Coney & Minter Internal Medicine, P.C. N
Cranford Powell and Morris Advanced Surgical Specialists, LLC N
Digestive Healthcare Of Georgia N
Georgia Bone & Joint, LLC N
Georgia Renal Specialists N
Henry Internal Medicine, P.C. N
S Rao Cheti, MD, PC N
Jorge Amador, M.D., LLC N
Khair Family Practice, PC N
TIN Legal Business Name ACO Participant in Joint Venture (Enter Y or N)
L & H Internal Medicine PC N
Mastercare Medical Center N
Nephrology Consultants of Georgia, P.C. N
Nephrology, Inc N
Piedmont Providers, LLC N
Peachtree City Physicians Group N
Piedmont Colorectal Associates, PC N
Piedmont Cardiology Of Atlanta, LLC N
Piedmont Internal Medicine, PC N
Piedmont Medical Care Corporation N
Piedmont Urology Professional, LLC N
WMC Tyrone LLC 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
Railey Patrick Chair 1 ACO Participant Representative Piedmont Medical Care Corporation
Lloyd Christopher President 1 ACO Executive N/A
Latimer Jim Voting Member 1 ACO Participant Representative Piedmont Medical Care Corporation
Dalton Booker Voting Member 1 ACO Participant Representative Digestive Healthcare of Georgia PC
Master Moiz Voting Member 1 ACO Participant Representative and ACO Medical Director Mastercare Medical Center
Harper William Bradford Voting Member 1 ACO Participant Representative Piedmont Internal Medicine, PC
Andrews Philicia Voting Member 1 ACO Participant Representative Piedmont Medical Care Corporation
TBD ———- Voting Member 1 ACO Participant Representative Piedmont Medical Care Corporation
Hengel Richard Voting Member 1 ACO Participant Representative Atlanta ID Group, P.C.
McAnder Michael Treasurer, Secretary 1 ACO Financial Director N/A
Coleman Patrick Voting Member 1 ACO Participant Representative Piedmont Medical Care Corporation
Brooks  Darryl Voting Member 1 Medicare Beneficiary Representative Patient/Medicare Beneficiary

ADDITIONAL ACO INFORMATION

Key ACO Clinical and Administrative Leadership:
o ACO Executive: Christopher Lloyd
o Medical Director: Patrick Railey, M.D.
o Compliance Official: Mark Guza
o Quality Assurance/Improvement Officer: Lauren Smeeding


Types of ACO participants, or combinations of participants, that formed the ACO:

Network of individual practices of ACO Professionals

Associated Committees and Committee Leadership:

Committee Name Committee Leader Names and Position
Clinical Governance Council – Neurosciences Michele Johnson, M.D., Chair, and Eugene Morris, M.D., Vice-Chair
Clinical Governance Council – Pulmonary Jermaine Jackson, M.D., Chair, and Jane Parks, M.D., Vice-Chair
Clinical Governance Council – Orthopedics Xavier Duralde, M.D., Chair, and Todd Schmidt, M.D., Vice-Chair
Clinical Governance Council – Oncology William Jonas, M.D., Chair, and Andrew Pippas, M.D., Vice-Chair
Clinical Governance Council – Primary Care Patrick Railey, M.D., Chair, and Moiz Master, M.D., Vice-Chair
Quality Committee Moiz Master, M.D.

 

SHARED SAVINGS AND LOSSES

Amount of Shared Savings/Losses

  • N/A

Shared Savings Distribution

  • N/A

QUALITY PERFORMANCE RESULTS

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information N/A 80.51
ACO-2 CAHPS: How Well Your Providers Communicate N/A 93.01
ACO-3 CAHPS: Patients’ Rating of Provider N/A 92.25
ACO-4 CAHPS: Access to Specialists N/A 83.49
ACO-5 CAHPS: Health Promotion and Education N/A 60.32
ACO-6 CAHPS: Shared Decision Making N/A 75.40
ACO-7 CAHPS: Health Status/Functional Status N/A 72.30
ACO-34 CAHPS: Stewardship of Patient Resources N/A 26.97
ACO-8 Risk-Standardized, All Condition Readmission N/A 14.70
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) N/A 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes N/A 53.20
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure N/A 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions N/A 59.81
ACO-9 Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) N/A 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 ) N/A 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements N/A 82.72
ACO-39 Documentation of Current Medications in the Medical Record N/A 87.54
ACO-13 Falls: Screening for Future Fall Risk N/A 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization N/A 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults N/A 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up N/A 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention N/A 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan N/A 53.63
ACO-19 Colorectal Cancer Screening N/A 61.52
ACO-20 Breast Cancer Screening N/A 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented N/A 76.79
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease N/A 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control N/A 18.24
ACO-41 Diabetes: Eye Exam N/A 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure N/A 70.69
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic N/A 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) N/A 88.67
ACO-33 Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) N/A 79.67

 

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

PAYMENT RULE WAIVERS

  • No, our ACO does not use the SNF 3-Day Rule Waiver.

ACO Participation Waiver

Medicare Shared Savings Program Waivers of the Fraud and Abuse Laws
Required Public Disclosures

As of January 1, 2017, Piedmont Clinic ACO LLC (“ACO”) entered into a three-year Participation Agreement in the Medicare Shared Savings Program (“MSSP”) with the Centers for Medicare and Medicaid Services (“CMS”).

DISCLOSED ARRANGEMENTS PROTECTED UNDER ACO PARTICIPATION WAIVER
ACO’s governing body has duly authorized the below arrangements that qualify for the AOC Fraud and Abuse Waivers, and specifically the ACO Participation Waiver, through Resolutions adopted by unanimous consent. The ACO Board of Directors has made a bona fide determination that the following arrangement(s) is reasonably related to the purposes of the MSSP because it promotes accountability for the quality, cost, and overall care for a Medicare population as described in the MSSP, provides for
the management and coordination of care for Medicare fee-for-service beneficiaries through ACO, and/or encourages investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare beneficiaries. Thus the ACO, pursuant to its governing body’s authorization, is asserting the ACO Participation Waiver’s protection over all of the ACO arrangements entered into as of the beginning of the current MSSP Participation Agreement term (January 1, 2017).

To comply with the ACO Participation Waiver’s requirements, the ACO is publicly disclosing the below arrangement(s). ACO will publicly disclose additional arrangements that qualify for the ACO Participation Waiver as they are authorized by its governing board on this website, in compliance with CMS’s public disclosure requirements.

ProviderMatch Arrangements:
Under the ProviderMatch Arrangements, ACO will furnish to all Piedmont Clinic providers a care coordination technology platform known as Kyruus ProviderMatch for Network Care Coordination (“ProviderMatch”), which consists of a suite of search, scheduling and referral products designed to help health networks optimize enterprise-wide patient access and care management.

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