ACO name and location:
Carolinas HealthCare System ACO, LLC
Previous Names: N/A
1000 Blythe Blvd.
Charlotte, NC 28203
ACO primary contact:
Primary Contact Name: Marque Macon, AVP, Network & Business Development
Primary Contact Phone Number: 704-446-3116
Primary Contact Email Address: Marque.Macon@AtriumHealth.org
Organizational Information:
ACO Participants |
ACO Participant in Joint Venture (Enter Y or N) |
Arboretum Urgent Care Center |
N |
Aswad Surgical Group, PC |
N |
Barnett Family Practice |
N |
Blue Ridge Healthcare Medical Group, Inc. |
N |
Bradford K Faulkenberry M.D. |
N |
Cabarrus Gastroenterology Associates Pllc |
N |
Cabarrus Pathology Associates, P.A. |
N |
Carmel Family Physicians |
N |
Carolina Bone & Joint, P.A. |
N |
Carolinas Ambulatory Surgery, Inc |
N |
Carolinas Emergency Physicians, P.A. |
N |
Carolinas Imaging Services, LLC |
Y |
Carolinas Medical Center |
N |
Carolinas Medical Center at Home, LLC |
N |
Carolinas Palliative Care and Hospice Network, Inc. |
N |
Carolinas Pathology Group, Pa |
N |
Carolinas Physicians Network Inc. |
N |
Carolinas Physicians Network Inc. Eastover Obstetrics and Gynecology |
N |
Carolinas Rehabilitation |
N |
Carolinas-Anson Healthcare, Inc. |
N |
Charlotte Eye Ear Nose & Throat Associates, P.A. |
N |
Charlotte Medical Clinic, Inc. |
N |
Charlotte Obstetric and Gynecological Associates |
N |
Charlotte Radiology, P.A. |
N |
Christopherson Family Medicine, LLC |
N |
Cleveland Ambulatory Services, LLC |
N |
Columbus Regional Health Network |
N |
Cornerstone Ear Nose & Throat, P.A. |
N |
Cotswold Family Medicine |
N |
Cox Road Urgent Care |
N |
Davidson Clinic |
N |
East Carolina Surgical, P.A. |
N |
Eastland Urgent Care |
N |
Eastover University Obstetrics & Gynecology Associates |
N |
Eastridge Family Medicine |
N |
ENT Carolina, P.A. |
N |
Emergency Medicine Physicians of Mecklenburg County, PLLC. |
N |
Harrisburg Family Physicians |
N |
Hospice of Cabarrus County, Inc. |
N |
Huntersville Oaks |
N |
Lakemont Family Medicine |
N |
Lincoln Family Practice |
N |
Mecklenburg Medical Group |
N |
Medical Associates of Rock Hill |
N |
Mercy Hospital, Inc. |
N |
Northcross Family Physicians |
N |
Northcross Obstetric And Gynecologic Associates |
N |
Northeast Anesthesia & Pain Specialists, P.A. |
N |
OrthoCarolina, P.A. |
N |
Paragon Surgical Specialists, P.A. |
N |
Piedmont Gynecological and Obstetrical Associates |
N |
Pulmonary Clinic of The Carolinas, P.C. |
N |
Randolph Internal Medicine Associates |
N |
Riverbend Family Physicians |
N |
Sandra Lee McCormack |
N |
Sardis Oaks |
N |
Scotland Regional Health Network |
N |
Scotland Memorial Hospital Inc. |
N |
Shiland Family Medicine |
N |
South Charlotte Primary Care |
N |
Southeast Radiation Oncology Group, P.A. |
N |
Steele Creek Urgent Care |
N |
St. Luke's Physician Network, Inc. |
N |
St. Luke's Hospital, Inc. |
N |
Surgical Specialists of Charlotte, P.A. |
N |
The Charlotte-Mecklenburg Hospital Authority |
N |
Urology Specialists of The Carolinas |
N |
West Primary Care, Inc. |
N |
ACO governing body:
Member |
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|
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First Name |
Last Name |
Title/Position |
Member’s Voting Power - Expressed as a Percentage or Number
|
Membership Type |
ACO Participant Legal Business Name/DBA, if applicable |
Ruth |
Krystopolski |
Co-Chair |
Voting Member (1) |
ACO Participant Representative |
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY |
Jennifer |
Brady, MD |
Co-Chair |
Voting Member (1) |
ACO Participant Representative |
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY |
Kathleen |
Kaney |
Member |
Voting Member (1) |
ACO Participant Representative |
CAROLINAS MEDICAL CENTER AT HOME, LLC |
Suzanna |
Fox, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
MERCY HOSPITAL, INC. |
Al |
Hudson, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
CAROLINAS PHYSICIAN NETWORK, INC. |
Suzanne |
Kausend |
Member |
Voting Member (1) |
ACO Participant Representative |
CAROLINAS PHYSICIAN NETWORK, INC. |
Britney |
Broyhill, DNP, ACNP-BC, NP |
Member |
Voting Member (1) |
ACO Participant Representative |
CAROLINAS PHYSICIAN NETWORK, INC. |
Adam |
Ravin, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY |
Gary |
Little, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY |
Louis |
Zbinden, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
SURGICAL SPECIALISTS OF CHARLOTTE, P.A. |
Robert |
Mittl, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
CHARLOTTE RADIOLOGY, P.A. |
Mark |
Aldous, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
CABARRUS GASTROENTEROLOGY ASSOCIATES, LLC |
Bruce |
Cohen, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
ORTHOCAROLINA, P.A. |
Ellen |
Sheppard |
Member |
Voting Member (1) |
Medicare Beneficiary Representative |
N/A |
Still open |
Member
|
Voting Member (1) | Community Stakeholder |
Key ACO clinical and administrative leadership:
Ruth Krystopolski ACO Executive
Brian Kersten, M.D Medical Director
Alicia Bowers Compliance Officer
Valerie Cloud Compliance Officer
Pamela Beckwith Quality Assurance/Improvement Officer
Associated committees and committee leadership:
Committee Name |
Committee Leader Name and Position |
Network Development Committee |
Marque Macon, Chair |
Clinical Effectiveness Committee |
Zeev Neuwirth, MD, Co-Chair Louis Zbinden, MD, Co-Chair |
Finance Committee |
Adam Ravin, MD, Co-Chair |
Operations Committee |
Al Hudson, MD, Chair |
Nominating Committee |
Jennifer H. Brady, MD, Co-Chair Ruth Krystopolski, Co-Chair |
Types of ACO participants, or combinations of participants, that formed the ACO:
Shared Savings and losses:
Quality performance results
2018 Quality Performance Results
ACO # | Measure Name | Rate | ACO Mean |
ACO-1 | CAHPS: Getting Timely Care, Appointments, and Information | 85.12 | 86.14 |
ACO-2 | CAHPS: How Well Your Providers Communicate | 93.58 | 93.93 |
ACO-3 | CAHPS: Patients’ Rating of Provider | 92.15 | 92.45 |
ACO-4 | CAHPS: Access to Specialists | 78.02 | 81.50 |
ACO-5 | CAHPS: Health Promotion and Education | 59.45 | 59.26 |
ACO-6 | CAHPS: Shared Decision Making | 62.25 | 61.94 |
ACO-7 | CAHPS: Health Status/Functional Status | 75.82 | 73.35 |
ACO-34 | CAHPS: Stewardship of Patient Resources | 28.43 | 26.26 |
ACO-8 | Risk Standardized, All Condition Readmission | 14.48 | 14.98 |
ACO-35 | Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) | 18.01 | 18.59 |
ACO-36 | All-Cause Unplanned Admissions for Patients with Diabetes | 39.58 | 37.01 |
ACO-37 | All-Cause Unplanned Admissions for Patients with Heart Failure | 79.86 | 76.75 |
ACO-38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 63.04 | 59.00 |
ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91) | 2.39 | 1.98 |
ACO-11 | Use of Certified EHR Technology | 99.94 | 98.20 |
ACO-12 | Medication Reconciliation Post-Discharge | 97.83 | 85.91 |
ACO-13 | Falls: Screening for Future Fall Risk | 85.89 | 79.73 |
ACO-44 | Use of Imaging Studies for Low Back Pain | 62.88 | 64.36 |
ACO-14 | Preventive Care and Screening: Influenza Immunization | 71.49 | 72.71 |
ACO-15 | Pneumonia Vaccination Status for Older Adults | 79.44 | 75.97 |
ACO-16 | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up | 84.58 | 76.83 |
ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 43.48 | 72.81 |
ACO-18 | Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan | 65.73 | 66.74 |
ACO-19 | Colorectal Cancer Screening | 72.58 | 68.27 |
ACO-20 | Breast Cancer Screening | 77.42 | 71.96 |
ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 80.44 | 81.47 |
ACO-27 | Diabetes Mellitus: Hemoglobin A1c Poor Control | 9.27 | 15.51 |
ACO-41 | Diabetes: Eye Exam | 54.03 | 52.42 |
ACO-28 | Hypertension (HTN): Controlling High Blood Pressure | 71.37 | 73.10 |
ACO-30 | Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet | 95.16 | 88.92 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
Note: In the Quality Performance Results file(s) above, search for “Carolinas HealthCare System ACO, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A3675 in the public use files on data.cms.gov.
Payment rule waivers
An accountable care organization (ACO) is a group of doctors and other healthcare providers who agree to work together with Medicare to improve quality, cost, and coordination of care you receive in the healthcare setting.
Doctors and healthcare providers that participate in an ACO must display a poster that notifies you of your doctor’s participation in an ACO.
For general information about ACOs, call 1-800-MEDICARE.
With an ACO you are the center of care, and your satisfaction is one of the goals. Over time, you may notice that:
Public Website Disclaimer Statement
The Centers for Medicare and Medicaid Services and the U.S. Department of Health and Human Services’ Office of Inspector General have made available waivers of certain federal fraud and abuse laws in connection with the operation of accountable care organizations (“ACOs”) that have entered into a participation agreement under the Medicare Shared Savings Program (“MSSP”).
Carolinas HealthCare System ACO, LLC (the “Company”) is an ACO participating in MSSP. The Company has entered into an agreement with CVS Pharmacy, Inc. (“CVS”) under which CVS will provide education, outreach and medication adherence support services for certain Medicare beneficiaries attributed to the Company.
The Company’s Board authorized the application of the Participation Waiver to the CVS Agreement on April 3, 2019. The Company’s Board, as the governing body of the Company, has made a bona fide determination that the CVS Agreement supports the goals of the Company and is reasonably related to the purposes of the MSSP as the services rendered by CVS are designed to help improve patient experience of care, improve population health by providing education and medication adherence support services, and reduce the costs of healthcare.