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 860-965-8633
Primary Contact Email Address gdadlez@ochsner.org

ACO participants:

ACO Participants ACO Participant in Joint Venture (Enter Y or N)
KENNER PHYSICIAN ASSOCIATES, LLC N
KSW, LLC N
Marykutty Thomas N
Parimal Parikh N
Carlos Rodriguez-Fierro N
Mohammed Suleman N
John Nnadi N
Ayman Hamed N
Hans E Schuller MD and Dennis M Dale, MD, LLC N
Pedro A Serrant MD LLC N
Shenandoah Medical Associates LLC N
Robin Dale, M.D., L.L.C. N
Michael Francis, M.D. (A Professional Medical Corporation) N
East Baton Rouge Medical Center, LLC N
Louisiana Healthcare Assoiates, Llc N
JSK Professional Physician Services LLC N
Bluebonnet Family Clinic, LLC N
S. Tahseen Rab MD APLLC N
Elizabeth B White MD INC N
Haik & Terrell, LLC N
Ochsner Bayou, LLC Y
Regional Radiology, LLC N
James M Robinson, Md, Llc N
Northlake Mecicine And Wellness Center, Llc N
Ochsner Medical Center – Kenner N
Renal Physicians Group, LLC N
Alix Bouchette, MD N
Northshore Gastroenterology, LLC N
Patricia Braly MD APMC N
Riser Medical Associates Pllc N
Ochsner Medical Center – Northshore, LLC N
South Louisiana ENT, Facial Plastic & Hair Restoration, APMC N
Family Medicine & Acupuncture, LLC N
Hancock Medical Health Services Y
Northshore Oncology Associates Llc N
Roy Saguiguit N
Vadim Gelman N
ANESTHESIOLOGY AND PERIOPERATIVE MEDICAL CONSULTANTS, LLC N
St Tammany Emergency Physicians Group LLC N
Cheryl Brown, M.D., Apmc N
Dhanpat Mohnot N
Rowe Crowder N
Cheryl Brown N
Tania Levi N
Michael Casey N
William Landry N
Richard Celentano N
Michael Francis N
Elizabeth White N
Christian Mayorga N
John Kessels N
Kimberly Williams N
Clinton Sharp N
Richard Drude N
James Robinson N
Emmett Chapital N
Christopher Naquin N
Sonia Kamboj N
Thaddeus Temple, MD N
M Celeste Lagarde N
Lagniappe Family Medicine N
Bethesda Medical Clinic, LLC N
Hamed, LLC N
John Angelo Y
Charles Balette N
Gollamudi Reddy N
Jefferson Medical Clinic LLC N
Crescent City Headache and Neurology Center LLC N
Rowe S Crowder III MD N
MP Medical Partners LLC N
Farnsworth Dermatology LLC N
Premium United Care LLC N
Ross Hogan MD LLC N
Lafourche Medical Group LLC N
Cardiovascular Clinic of Covington, LLC N
Hamid Hussain N
Edwin Walker, MD N
Patricia Braly N
IMG Physicians, LLC N
Slidell Memorial Hospital Dba Family Medicine Billing Of Smh Y
Dale Presser N
David Powers N
Pedro Serrantgotos N
Hai Nguyen N
Carol Redillas N
Hancock Women’s Center N
Ochsner Clinic, LLC N
St Tammany Parish Hospital Service District No 1 Y
Ochsner Clinic Foundation Y
Edwin Walker, MD N
Alvin C Moreau Jr Licensed N
Metropolitan Gastroenterology Assoc. N
Mohammad Suleman, MD APMC N
New Orleans Headache & Neurology Clinic, APMC N
Northshore Family Medical Center Y
William Landry N
Richard B Drude, Jr.,M.D., APMC N
Cardiology Center, LLC N
DRs. Siegel, Vorhoff, Rushing and Schabelman, APMC N
Diabetes & Metabolism Assoc Aanc N
Gastroenterology Group A Medical N
Cardiology Institute, Inc N
Total Anesthesia Care N
CRESCENT SURGICAL GROUP LLC N
Richard Celentano N
Northlake Pulmonary Associates INC N
Northlake Gastroenterology N
Benedict Idowu N
Clinton Sharp N
Kidney Counsultants, LLC N
New Orleans Nephrology Associates LLC N
William S Johnson, III, M.D., APMC Y
Chapital Cardiology Clinic LLC N
Iteld Bernstein And Associates Llc N
4 Your Eyes, LLC N
Gollamudi Reddy N
Katherine L. Williams, MD, APMC N
ABDOLREZA VADIEE INC. Y
Covington Orthopaedic & Sports Medicine Clinic N
Christian A. Mayorga, MD LLC N
Drs. Staudinger and Walsh, LLP N
M Celeste Lagarde N
Northshore Family Medicine, LLC N
Parimal Parikh, MD LLC N
Drs. Brown & Wise, LLC N
Newco, Women’s Medical Center N
David R Powers MD APMC N
Daniel Services LLC N
Cheri LeBlanc, Md, LLC N
SMH Professional Serv at SMH N
Slidell Memorial Hospital Y
Christopher D Naquin MD APMC N
Quynh Mai Clinic Llc 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
Thomas Warner Voting Member 1 Chairperson, ACO Participant Representative Ochsner Clinic Foundation
Foret Gerald Voting Member 1 Medicare Beneficiary Representative N/A
Carmouche David Voting Member 1 ACO Participant Representative Ochsner Clinic, LLC
Millet Ralph Voting Member 1 ACO Participant Representative St Tammany Parish Hospital Service District No 1
Hulefeld Michael Voting Member 1 ACO Participant Representative Ochsner Clinic Foundation
Posecai Scott Voting Member 1 ACO Participant Representative Ochsner Clinic Foundation
Laurent Merrill Voting Member 1 ACO Participant Representative IMG Physicians, LLC
Raymond Sidney “Beau” Voting Member 1 ACO Participant Representative Ochsner Clinic, LLC
Torcson Pat Voting Member 1 ACO Participant Representative St Tammany Parish Hospital Service District No 1
Hart Robert Voting Member 1 ACO Participant Representative Ochsner Clinic, LLC

 Key ACO clinical and administrative leadership:

David Carmouche ACO Executive
Charles Ardoin 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 Charles Ardoin, MD, Medical Director
Finance Lisa Blume, CFO
Primary Care Council Pedro Cazabon, MD
Population Health Committee Philip Oravetz, MD

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 82.4 79.9
ACO-2 CAHPS: How Well Your Providers Communicate 94.31 92.63
ACO-3 CAHPS: Patients’ Rating of Provider 93.75 91.93
ACO-4 CAHPS: Access to Specialists 86.26 83.52
ACO-5 CAHPS: Health Promotion and Education 61.37 60
ACO-6 CAHPS: Shared Decision Making 73.8 75.28
ACO-7 CAHPS: Health Status/Functional Status 68.83 71.82
ACO-34 CAHPS: Stewardship of Patient Resources 25.83 27.52
ACO-8 Risk-Standardized, All Condition Readmission 15.31 14.7
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 53.2
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 Conditions 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 76.84
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 70.52
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

  • No, our ACO does not 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.

No, our ACO does not utilize SNF 3-Day Rule Waiver

Quality Performance Results

Ochsner Accountable Care Network LLC
1514 Jefferson Highway
New Orleans, LA 70121
Phone: 1-800-231-5257
Contact Us
Copyright, ©2013

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