NC ACO Public Reporting – MSSP
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: Leah Maul, Lead Executive, Network Integration
Primary Contact Phone Number: 704-446-3116
Primary Contact Email Address: leah.maul@carolinasphysicianalliance.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 |
|
|
|
||
|
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 |
|
Collin |
Lane |
Member |
Voting Member (1) |
ACO Participant Representative |
CAROLINAS MEDICAL CENTER AT HOME, LLC |
|
Chris |
Hummer |
Member |
Voting Member (1) |
ACO Participant Representative |
MERCY HOSPITAL, INC. |
|
Al |
Hudson, MD |
Member |
Voting Member (1) |
ACO Participant Representative |
CAROLINAS PHYSICIAN NETWORK, INC. |
|
Scott |
Rissmiller, MD |
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
Toni Teumer Compliance Officer
Valerie Cloud Compliance Officer
Elizabeth Handy Quality Assurance/Improvement Officer
Associated committees and committee leadership:
|
Committee Name |
Committee Leader Name and Position |
|
Network Development Committee |
Leah Maul, 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:
- 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: N/A
- Shared savings distribution: N/A
Quality performance results
Our ACO did not participate in the Shared Savings Program in the previous performance year, therefore this section is not applicable at this time.
Payment rule waivers
- No, our ACO does not use the SNF 3-Day Rule Waiver.
Accountable Care Organization (ACO) & Medicare Shared Savings Program Frequently Asked Questions
What is an Accountable Care Organization (ACO)?
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.
- An ACO does not change your Medicare benefits.
- An ACO is not a Health Maintenance Organization (HMO), managed care, or an insurance plan. An ACO can’t tell you which healthcare providers to see or hospital to visit, and can’t limit your Medicare benefits.
- You still have the right to choose any hospital or doctor that accepts Medicare, at any time, even if that hospital or doctor isn’t a part of an ACO. Your doctor or healthcare provider may make recommendations, but it is always your choice on what doctors or hospitals you use.
How do I know if my doctor participates in an ACO?
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.
How will an ACO help my doctor coordinate my care?
- Your doctors will have a more complete picture of your health through talking with your other healthcare providers.
- Medicare will share certain health information with us about the care you receive from your doctors and other healthcare providers unless you ask Medicare not to share it. Medicare may also share your health information with other ACOs in which your doctors or healthcare providers participate.
What can you expect if your doctor is in an ACO?
With an ACO you are the center of care, and your satisfaction is one of the goals. Over time, you may notice that:
- You don’t have to fill out as many medical forms with the same information
- The doctors and healthcare providers that you see all know what’s going on with your health because they communicate with each other
- You don’t need to repeat medical tests because your results are shared among your doctors and healthcare providers
What do you need to do?
- If you want Medicare to share information about the healthcare you received with Atrium Health ACO, LLC or with other ACOs in which your doctors or healthcare providers participate, there's nothing more you need to do.
- If you do not want Medicare to share your health care information, you need to call 1-800 MEDICARE (1-800-633-4227) and tell the representative that your doctor is part of an ACO and you don't want Medicare to share your health information. TTY user should call 1-877-486-2048.
- If you change your mind in the future, you can call 1-800-MEDICARE and tell the representative what you have decided. We can't communicate with Medicare on your behalf.
- Even if you decline to share your healthcare information, Medicare will still use your information for some purposes, like assessing the financial and quality of care performance of the providers participating in ACOs. Also, Medicare may share some of your healthcare information with ACOs when measuring the quality of care given by healthcare providers participating in those ACOs.
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.