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 | Patrick Edlin |
| Primary Contact Phone Number | 504-689-4172 |
| Primary Contact Email Address | patrick.edlin@ochsner.org |
Organizational Information
ACO participants:
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
| Anointed Family Medicine | N |
| Charlie Internal Medicine Group Incorporated | N |
| Christopher D Naquin MD APMC | N |
| Daniel Services LLC | N |
| Dr. John M Wise | N |
| East Baton Rouge Medical Center, LLC | N |
| Elizabeth B White MD Inc. | N |
| Family Practice Associates of | N |
| Houma Health Clinic Inc. | N |
| Internal Medicine Clinic of Morgan City, LLC | N |
| Jennings American Legion Hospital Inc | N |
| Kenner Physician Associates, LLC | N |
| Lafayette Health Ventures Inc | N |
| MP Medical Partners LLC | N |
| Ochsner Bayou LLC | N |
| Ochsner Clinic Foundation | N |
| Ochsner Medical Center – Northshore, LLC | N |
| OCHSNER MEDICAL CENTER KENNER LLC | N |
| OCHSNER MISSISSIPPI, LLC | N |
| PHYSICIAN PRACTICE PARTNERS | N |
| PREVENTION PLUS CLINIC LLC | N |
| Robin Dale, M.D., L.L.C. | N |
| ROWE S CROWDER III MD PLLC | N |
| Slidell Memorial Hospital | N |
| St. Tammany Parish Hospital Service District NO 1 | N |
| Westbank Medical Associates | 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 |
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
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
- Performance Year 2015
- Performance Year 2018
- Performance Year 2019
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
- Skilled Nursing Facility (SNF) 3-day Rule Waiver:
- Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.
- 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.
Other Services
- 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.
