Carolinas HealthCare System ACO, LLC
ACO Name and Location:
Carolinas HealthCare System ACO, LLC
1000 Blythe Blvd.
Charlotte, NC 28203
ACO Primary Contact:
Primary Contact: Dan Fisher
Phone Number: 312-909-3962
Email Address: daniel.fisher@aah.org
| ACO Participants | ACO Participant in Joint Venture |
|---|---|
| BARNETT FAMILY PRACTICE | No |
| Carmel Family Physicians | No |
| Carolinas Physicians Network, Inc. | No |
| COLUMBUS REGIONAL HEALTH NETWORK | No |
| COTSWOLD FAMILY MEDICINE | No |
| DAVIDSON CLINIC | No |
| EASTOVER OBSTETRICS AND GYNECOLOGY ASSOCIATES INC | No |
| EASTOVER UNIVERSITY OBSTETRICS & GYNECOLOGY ASSOCIATES | No |
| EASTRIDGE FAMILY MEDICINE | No |
| HARRISBURG FAMILY PHYSICIANS | No |
| MECKLENBURG MEDICAL GROUP | No |
| NORTHCROSS FAMILY PHYSICIANS | No |
| RANDOLPH INTERNAL MEDICINE ASSOCIATES | No |
| RIVERBEND FAMILY PHYSICIANS | No |
| SCOTLAND MEMORIAL HOSPITAL | No |
| Scotland Regional Health Network | No |
| SOUTH CHARLOTTE PRIMARY CARE | No |
| THE MEDICAL CENTER OF CENTRAL GEORGIA INC | No |
| Member First Name | Member Last Name | Member Title/ Position | Member's Voting Power (Expressed as a percentage) | Membership Type | ACO Participant Legal Business Name, if applicable |
|---|---|---|---|---|---|
| Brian | Kersten | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Daniel | Davis | Member | 7.7% | ACO Representative | Carolinas Physicians Network, Inc. |
| Daniel | Senft | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Dave | Cosenza | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Ellen | Sheppard | Member | 7.7% | Medicare Beneficiary Representative | N/A |
| Erika | Steinbacher | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Gary | Little | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Jennifer | Brady | Executive Director | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Jennifer | Terry | Member | 7.7% | Medicare Beneficiary Representative | N/A |
| John | Yeatts | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Lindsay | Durgin | Member | 7.7% | ACO Treasurer | Carolinas Physicians Network, Inc. |
| Matt | Anderson | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Troy | Leo | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
| Truett | Smith | Member | 7.7% | ACO Participant Representative | Carolinas Physicians Network, Inc. |
Member's’ voting power may have been rounded to reflect a total voting power of 100 percent.
Key ACO Clinical and Administrative Leadership
ACO Executive: Jennifer Brady, MD
Medical Director: Daniel Cosenza, MD, MBA
Compliance Officer: Melissa Pollock
Quality Assurance/Improvement Officer: Sarah Davis
Treasurer: Lindsay Durgin
Associated Committees and Committee Leadership
| Committee Name | Committee Leader Name and Position |
|---|---|
| Compliance | Melissa Pollock |
| Finance | Daniel Senft |
| Clinical Effectiveness | Dave Cosenza |
Types of ACO participants, or combinations of participants, that formed the ACO:
- ACO professionals in a group practice arrangement
- Hospital employing ACO professionals
- Network of individual practices of ACO professionals
- Partnership or joint venture arrangement between hospitals and ACO professionals
Shared Savings and Losses
Amount of shared savings/losses:
- Second Agreement Period
- Performance Year 2025, N/A
- Performance Year 2024, $7,250,903.51
- Performance Year 2023, $0.00
- Performance Year 2022, $0.00
- First Agreement Period
- Performance Year 2021, $14,928,446.30
- Performance Year 2020, $0.00
- Performance Year 2019, $0.00
- Performance Year 2018, $0.00
Shared Savings Distribution
Second Agreement Period
- Performance Year 2025
- 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 2024
- Proportion invested in infrastructure: 5%
- Proportion invested in redesigned care processes/resources: 18%
- Proportion of distribution to ACO participants: 77%
- Performance Year 2023
- 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 2022
- 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 2021
- Proportion invested in infrastructure: 50.0%
- Proportion invested in redesigned care processes/resources: 28.5%
- Proportion of distribution to ACO participants: 31.5%
- Performance Year 2020
- 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 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
Quality performance results are based on CMS Web Interface Measure set.
| Measure # | Measure Name | Collection Type | Reported Performance Rate | Current Year Mean Performance Rate (SSP ACOs) |
|---|---|---|---|---|
| 110 | Preventative Care and Screening: Influenza Immunization | CMS Web Interface | 63.94 | 68.6 |
| 112 | Breast Cancer Screening | CMS Web Interface | 86 | 80.93 |
| 113 | Colorectal Cancer Screening | CMS Web Interface | 81.4 | 77.81 |
| 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 90.48 | 81.46 |
| 226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 100 | 79.98 |
| 236 | Controlling High Blood Pressure | CMS Web Interface | 75.19 | 79.49 |
| 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 87.38 | 88.99 |
| 370 | Depression Remission at Twelve Months | CMS Web Interface | 24.44 | 17.35 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 91.44 | 86.5 |
| 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups | Administrative Claims | 0.153 | 0.1517 |
| 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) | Administrative Claims | 40.31 | 37.0 |
| 001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control | CMS Web Interface | 6.45 | 9.44 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | CAHPS for MIPS Survey | 78.64 | 83.70 |
| CAHPS-2 | How Well Providers Communicate | CAHPS for MIPS Survey | 93.71 | 93.96 |
| CAHPS-3 | Patient’s Rating of Provider | CAHPS for MIPS Survey | 92.73 | 92.43 |
| CAHPS-4 | Access to Specialists | CAHPS for MIPS Survey | 76.26 | 75.76 |
| CAHPS-5 | Health Promotion and Education | CAHPS for MIPS Survey | 62.36 | 65.48 |
| CAHPS-6 | Shared Decision Making | CAHPS for MIPS Survey | 61.49 | 62.31 |
| CAHPS-7 | Health Status and Functional Status | CAHPS for MIPS Survey | 75.52 | 74.14 |
| CAHPS-8 | Care Coordination | CAHPS for MIPS Survey | 86.04 | 85.89 |
| CAHPS-9 | Courteous and Helpful Office Staff | CAHPS for MIPS Survey | 93.91 | 92.89 |
| CAHPS-11 | Stewardship of Patient Resources | CAHPS for MIPS Survey | 27.55 | 26.98 |
For previous years’ financial and quality performance results, visit data.cms.gov.
For Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [Quality ID #001], Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [Measure #479], and Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], a lower performance rate indicates better measure performance.
For Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], patients are excluded if they were attributed to Qualifying Alternative Payment Model (APM) Participants (QPs). Most providers participating in Track E and ENHANCED track ACOs are QPs, and so performance rates for Track E and ENHANCED track ACOs may not be representative of the care provided by these ACOs' providers overall. Additionally, many of these ACOs do not have a performance rate calculated due to not meeting the minimum of 18 beneficiaries attributed to non-QP providers.
Payment Rule Waivers
- Waiver for Payment for Telehealth Services:
- Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.
- Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
- Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612