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	Nicole Swan
Primary Contact Phone Number	(855) 277-1509
Primary Contact Email Address	nswan@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, Incorporated	N
Family Practice Associates of	N
Houma Health Clinic, Incorporated	N
Internal Medicine Clinic of Morgan City, LLC	N
Jennings American Legion Hospital, Incorporated	N
Kenner Physician Associates, LLC	N
Lafayette Health Ventures, Incorporated	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, MD, LLC	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 Last Name	Member First Name	Member Title/Position	Member’s Voting Power: expressed as a percentage or number	Membership Type	ACO Participant Legal Business Name/DBA, if applicable
Carey, M.D.	Michael	Ochsner Accountable Care Network Board Member	1	Medicare Beneficiary Representative	N/A
Thomas	Warner	Ochsner Accountable Care Network Board Member	1	Non-ACO Participant Representative	N/A
Hulefeld	Michael	Ochsner Accountable Care Network Board Member	1	Non-ACO Participant Representative	N/A
November	Peter	Ochsner Accountable Care Network Board Member	1	Non-ACO Participant Representative	N/A
Hart, M.D.	Robert	Ochsner Accountable Care Network Board Chairman	1	ACO Participant Representative	Ochsner Clinic, LLC
Jeansonne IV, M.D.	Louis	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Ochsner Clinic, LLC
Riddell, M.D.	Timothy	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Ochsner Clinic, LLC
Russo, M.D.	Aldo	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Ochsner Clinic, LLC
Gandy	Patrick	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Lafayette Health Ventures, Inc.
Logue, M.D.	Amanda	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Lafayette Health Ventures, Inc.
Coffman	Joan	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	St. Tammany Parish Hospital Service District No. 1 d/b/a St. Tammany Health System
Torcson, M.D.	Patrick	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	St. Tammany Parish Hospital Service District No. 1 d/b/a St. Tammany Health System
Badinger	Sandy	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	St. Tammany Parish Hospital Service District No. 2 d/b/a Slidell Memorial Hospital
McElveen, M.D.	Matthew	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	St. Tammany Parish Hospital Service District No. 2 d/b/a Slidell Memorial Hospital
Peoples	Phyllis	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Physician Practice Partners
McKee, M.D.	Nicole	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Physician Practice Partners
Achee, M.D.	Christopher	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Jennings American Legion Hospital, Inc.
Daniel, M.D.	Chaillie	Ochsner Accountable Care Network Board Member	1	ACO Participant Representative	Daniel Services, LLC, d/b/a Daniel Clinic
Carmouche, M.D.	David	Ochsner Accountable Care Network Executive Director, Ex-Officio Ochsner Accountable Care Network Board Member	0	Non- ACO Participant Representative	N/A
Raymond, M.D.	Sidney	Ochsner Accountable Care Network Medical Director, Ex-Officio Ochsner Accountable Care Network Board Member	0	Non-ACO Participant Representative	N/A

Key ACO clinical and administrative leadership:

David Carmouche, MD	ACO Executive
Sidney “Beau” Raymond, MD, FACP	Medical Director
Eden Ezell	Compliance Officer
Susan Montz	Quality Assurance/Improvement Officer

 Associated committees and committee leadership:

Committee Name	Committee Leader Name and Position
Network Development Committee	Philip Oravetz, MD, Chief Population Health Officer Thomas Groves, VP, Network Development
Performance and Operations Committee	Sidney “Beau” Raymond, MD, FACP, Ochsner Accountable Care Network Medical Director Eric Gallagher, Ochsner Health Network COO

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

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

Shared Savings and Losses

Amount of Shared Savings/Losses

Fourth Agreement Period

• • Performance Year 2020, $22,355,579

Third Agreement Period

• • Performance Year 2019: $13,262,736

Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

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

Quality Performance Results

2020 Quality Performance Results:

ACO Quality Measure Number	Measure Name	Rate	ACO Mean
ACO-43	Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))	0.90%	0.95%
ACO-13	Falls: Screening for Future Fall Risk	94.59%	84.97%
ACO-14	Preventative Care and Screening: Influenza Immunization	80.48%	76.03%
ACO-17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	80.00%	76.03%
ACO-18	Preventive Care and Screening: Screening for Depression and Follow-up Plan	65.93%	71.46%
ACO-19	Colorectal Cancer Screening	84.18%	72.59%
ACO-20	Breast Cancer Screening	90.57%	74.05%
ACO-42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	83.72%	83.37%
ACO-27	Diabetes: Hemoglobin A1c Poor Control (>9%)	11.90%	14.70%
ACO-28	Controlling High Blood Pressure	73.02%	72.87%

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

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.