ACO Public Reporting Information

ACO Name and Location

Ochsner Accountable Care Network, LLC
Previous Names: N/A
1514 Jefferson Highway
New Orleans, LA 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.	Y
East Baton Rouge Medical Center, LLC	N
Anointed Family Medicine	N
Ochsner Bayou, LLC	Y
Ochsner Medical Center – Kenner, LLC	N
Ochsner Medical Center – Northshore, LLC	N
Rowe S Crowder III MD PLLC	N
MP Medical Partners LLC	N
Edwin Walker, MD	N
Slidell Memorial Hospital	Y
Ochsner Clinic, LLC	N
Ochsner Clinic Foundation	Y
Family Practice Associates of	N
Northshore Family Medical Center	N
Westbank Medical Associates	N
Daniel Services LLC	N
Christopher D Naquin MD APMC	N
Ochsner Mississippi, LLC	N
Slidell Memorial Hospital	Y
Dr. John M Wise	Y
Houma Health Clinic, INC	N

ACO Governing Body:

Member			Member’s Voting Power – Expressed as a percentage or number	Membership Type	ACO Participant 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
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 Committee	Phil 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
• Hospital employing ACO professionals
• Networks of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

• Third Agreement Period
  • Performance Year 2019: $13,262,737
• Second Agreement Period
  • Performance Year 2018, $5,759,032
  • Performance Year 2017, $4,984,301
  • Performance Year 2016, $0

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

Shared Savings Distribution

• Third Agreement Period
  • Performance Year 2019
    • Proportion invested in infrastructure: 7%
    • Proportion invested in redesigned care processes/resources: 18%
    • Proportion of distribution to ACO participants: 74%
• Second Agreement Period

• • Performance Year 2018
    • Proportion invested in infrastructure: 15%
    • Proportion invested in redesigned care processes/resources: 35%
    • Proportion of distribution to ACO participants: 50%
  • Performance Year 2017
    • Proportion invested in infrastructure: 17%
    • Proportion invested in redesigned care processes/resources: 34%
    • Proportion of distribution to ACO participants: 49%

• • 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

2019 Quality Performance Results:

ACO#	Measure Name	Rate	ACO Mean
ACO-1	CAHPS: Getting Timely Care, Appointments, and Information	86.07	85.86
ACO-2	CAHPS: How Well Your Providers Communicate	95.04	94.11
ACO-3	CAHPS: Patients’ Rating of Provider	94.94	92.69
ACO-4	CAHPS: Access to Specialists	83.11	81.54
ACO-5	CAHPS: Health Promotion and Education	57.38	60.44
ACO-6	CAHPS: Shared Decision Making	55.61	62.78
ACO-7	CAHPS: Health Status/Functional Status	73.36	73.79
ACO-34	CAHPS: Stewardship of Patient Resources	23.17	26.17
ACO-45	CAHPS: Courteous and Helpful Office Staff	96.85	92.84
ACO-46	CAHPS: Care Coordination	89.72	86.89
ACO – 8	Risk Standardized, All Condition Readmission	15.54	37.01
ACO-38	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions	51.96	58.15
ACO-38	Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))	56.10	59.00
ACO-43	Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))	1.56	1.87
ACO-13	Falls: Screening for Future Fall Risk	95.67	84.04
ACO-12	Medication Reconciliation	87.84	85.91
ACO-13	Falls: Screening for Future Fall Risk	98.13	79.73
ACO-14	Preventive Care and Screening: Influenza Immunization	74.64	74.77
ACO-17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	86.96	78.04
ACO-18	Preventive Care and Screening: Screening for Depression and Follow-up Plan	75.99	70.40
ACO-19	Colorectal Cancer Screening	86.05	70.76
ACO-20	Breast Cancer Screening	85.32	73.84
ACO-42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	86.52	82.17
ACO-40	Depression Remission at Twelve Months	2.44	13.58
ACO-20	Breast Cancer Screening	90.70	71.96
ACO-42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	85.71	81.47
ACO-27	Diabetes: Hemoglobin A1c Poor Control (>9%)	11.56	13.88
ACO-28	Controlling High Blood Pressure	78.76	75.04

For Previous Years’ Financial and Quality Performance Results, please visit 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.

• Ready Responders Program

In order to achieve better health for individuals, better health for populations, and lowered growth in expenditures, OACN has engaged Ready Responders to provide various interventions, including home visits, visits in the community, and phone conversations as an in kind service.

• 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 and/or discount to participant community practitioners to join into a single, unified Epic EHR platform. Participant community practitioners that can adequately interface with EPIC will have the option to retain their own EHR system, and all other participants will be required to use the EPIC EHR. OACN will also give participants the option to lease the necessary hardware needed to operate the EPIC EHR at a discounted rate to eliminate the barrier for adoption. 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 items 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.