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.
- For 2016 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2016-Shared-Savings-Program-SSP-Accountable-Care-O/3jk5-q6dr/data
- For 2015 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/x8va-z7cu/data
- For 2014 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/ucce-hhpu/data
- For 2013 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/yuq5-65xt/data
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.
