ACO Public Reporting Information

ACO Name and Location

Ochsner Accountable Care Network, LLC
1514 Jefferson Highway
New Orleans, Louisiana 70121

ACO Primary Contact

Primary Contact Name Greg Dadlez
Primary Contact Phone Number 504-842-8822
Primary Contact Email Address gdadlez@ochsner.org

Organizational Information

ACO participants:

ACO Participants ACO Participant in Joint Venture
(Enter Y or N)
KENNER PHYSICIAN ASSOCIATES, LLC N
Robin Dale, M.D., L.L.C. N
East Baton Rouge Medical Center, LLC N
Ochsner Bayou, LLC Y
Ochsner Medical Center – Kenner N
Rowe Crowder N
Michael Casey N
Clinton Sharp N
Christopher Naquin N
Rowe S Crowder III MD N
MP Medical Partners LLC N
Edwin Walker, MD N
Slidell Memorial Hospital Dba Family Medicine Billing Of Smh Y
Ochsner Clinic, LLC N
Ochsner Clinic Foundation Y
Edwin Walker, MD N
Northshore Family Medical Center Y
Clinton Sharp N
Drs. Brown & Wise, LLC N
Christopher D Naquin MD APMC N
Slidell Memorial Hospital Y
DR JOHN M WISE 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
Carey Michael Serves on the Board of Directors 1 Medicare Beneficiary Representative N/A
Carmouche David Serves on the Board of Directors, Executive Director 1 Participant Representative Ochsner Clinic, LLC
Hart Robert Chairperson 1 Participant Representative Ochsner Clinic, LLC
Hulefeld Michael Serves on the Board of Directors 1 Participant Representative Ochsner Clinic Foundation
Miller C. Brian Serves on the Board of Directors 1 Participant Representative Slidell Memorial Hospital
Posecai Scott Serves on the Board of Directors 1 Participant Representative Ochsner Clinic Foundation
Raymond S. Beau Serves on the Board of Directors 1 Participant Representative Ochsner Clinic, LLC
Robinson Wanda Serves on the Board of Directors 1 Participant Representative Ochsner Clinic, LLC
Russo Aldo Serves on the Board of Directors 1 Participant Representative Ochsner Clinic, LLC

Key ACO clinical and administrative leadership:

David Carmouche ACO Executive
Philip Oravetz Medical Director
Eden Ezell Compliance Officer
Susan Montz Quality Assurance/Improvement Officer

 Associated committees and committee leadership:

Committee Name Committee Leader Name and Position
Quality Improvement Committee Philip Oravetz, Medical Director
Finance Committee Lisa Blume, CFO

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

  •  ACO professionals in a group practice arrangement
  • Networks of individual practices of ACO professionals
  •  Hospital employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2016, $0
  • First Agreement Period
    • Performance Year 2015, $0
    • Performance Year 2014, $0
    • Performance Year 2013, $0

Shared Savings Distribution

  • Second Agreement Period
    • Performance Year 2016
      • 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 2015
      • 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 2014
      • 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 2013
      • 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

2016 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 82.40 80.51
ACO-2 CAHPS: How Well Your Providers Communicate 94.31 93.01
ACO-3 CAHPS: Patients’ Rating of Provider 93.75 92.25
ACO-4 CAHPS: Access to Specialists 86.26 83.49
ACO-5 CAHPS: Health Promotion and Education 61.37 60.32
ACO-6 CAHPS: Shared Decision Making 73.80 75.40
ACO-7 CAHPS: Health Status/Functional Status 68.83 72.30
ACO-34 CAHPS: Stewardship of Patient Resources 25.83 26.97
ACO-8 Risk Standardized, All Condition Readmission 15.31 14.70
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 22.38 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 41.18 53.20
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 68.46 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 55.23 59.81
ACO-9 Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 6.24 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) 13.52 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 94.93 82.72
ACO-39 Documentation of Current Medications in the Medical Record 36.29 87.54
ACO-13 Falls: Screening for Future Fall Risk 80.93 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization 57.14 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults 70.75 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 78.35 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 97.43 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 61.02 53.63
ACO-19 Colorectal Cancer Screening 63.92 61.52
ACO-20 Breast Cancer Screening 76.15 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented 43.65 76.79
ACO-42 Statin therapy for the Prevention and Treatment of Cardiovascular Disease 84.26 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 17.32 18.24
ACO-41 Diabetes: Eye Exam 59.45 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 67.91 70.69
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 86.38 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 93.02 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%) 73.33 79.67

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

Note: In the Quality Performance Results file(s) above, search for “Ochsner Accountable Care Network, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A73340 in the public use files on data.cms.gov.

 

Payment Rule Waivers

  • Yes, our ACO does use the SNF 3-Day Rule Waiver.

The purpose of the Medicare Shared Savings Program (MSSP) is to promote accountability for the Medicare patient population, coordinate items and services under Parts A and B, and encourage investment in infrastructure and redesigned care processes for high quality and efficient service delivery.

To ensure that the development and operation of beneficial accountable care organizations (ACOs) are not unduly impeded, while also ensuring that ACO arrangements are not misused for fraudulent or abusive purposes that harm patients or Federal healthcare programs, the application of certain federal Fraud and Abuse Laws has been waived with respect to ACOs formed in connection with the MSSP.

The OACN Board of Directors has approved the invocation of this waiver protection with respect to the arrangements described below. In taking this action, the Board has determined these arrangements are reasonably related to the purpose of the MSSP and the Triple Aim of better health for individuals, better health for populations, and lowered growth in expenditures.

  • Outpatient Case Management

OACN will provide outpatient case management for a limited period of time to beneficiaries who are considered high risk for healthcare complications as determined by an appropriate algorithm. This effort will achieve triple aim results through enhanced care coordination with the goal of reducing the incidence of healthcare complications.

  • Partial Backstopping of Shared Losses

OACN will financially assess all participant community practitioners a portion of shared losses incurred at the ACO level. This will be calculated based upon beneficiary attribution and not to exceed a set amount per practitioner. All participants will therefore be responsible for some level of downside financial risk in order to create accountability for their attributed population of beneficiaries. It is necessary to limit the exposure to downside financial risk for community participants so that potential penalty does not preclude them from participation.  This also allows OACN to reach wider geographic and socioeconomic spread of beneficiaries.  This effort will achieve triple aim results by creating a shared incentive to improve care coordination.

  • Electronic Health Record System

OACN will provide a subsidy to participant community practitioners to join into a single and unified Epic EHR platform. This will be offered to practitioners presently not utilizing Epic regardless of their current EHR status. Participant community practitioners that can adequately interface with EPIC will have the option to retain their own EHR systems, and that all other participants will be required to use the EPIC EHR. This effort will achieve triple aim results through improved EHR communication and care coordination.

  • Digital Medicine Program(s)

Ochsner Accountable Care Network (OACN) has a primary goal of advancing the Triple Aim for the Medicare beneficiaries attributed through the Shared Savings Program. In order to achieve better health for individuals, better health for populations, and lowered growth in expenditures; OACN will enter beneficiaries suffering from certain chronic conditions and diseases into our digital monitoring program(s.)  To help them manage these conditions and diseases, we will provide remote monitoring to promote beneficiaries’ adherence to their care plans and proactively identify changes in their health. This effort will achieve triple aim results through enhanced care coordination with the goal of reducing the incidence of chronic disease.

 

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