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 |
|
Acadiana Family Physicians, INC., A.P.M.C |
N |
|
Acadiana Obstetrics/Oncology |
N |
|
Anointed Family Medicine |
N |
|
Charlie Internal Medicine Group Incorporated |
N |
|
Christopher D. Naquin MD APMC |
N |
|
Contemporary Women’s Care of Breaux Bridge |
N |
|
Daniel Services LLC |
N |
|
David Ashton Reed MD Internal Medicine LLC |
N |
|
Dr. John M. Wise |
N |
|
Elizabeth B. White MD, Incorporated |
N |
|
Family Practice Associates of |
N |
|
GBR, LLC |
N |
|
Internal Medicine Clinic of Morgan City, LLC |
N |
|
Jeanne D Theriot MD APM LLC |
N |
|
Jennings American Legion Hospital, Incorporated |
N |
|
Kenner Physician Associates, LLC |
N |
|
Lafayette Health Ventures, Incorporated |
N |
|
LSU Health Sciences Center-Shreveport Faculty Group |
N |
|
MP Medical Partners, LLC |
N |
|
Ochsner Bayou, LLC |
N |
|
Ochsner Clinic, 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 |
|
Singing River Health System |
N |
|
Slidell Memorial Hospital |
N |
|
St. Tammany Parish Hospital Service District No. 1 |
N |
|
St. Tammany Emergency Physician Group, LLC (Group) |
N |
|
Titus County Hospital District |
N |
|
Total Anesthesia Care (Group) |
N |
|
Trahan Crowley, LLC |
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 and D/B/A, 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 Member |
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 |
|
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. 1 d/b/a St. Tammany Health System |
|
McElveen, M.D. |
Matthew |
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 |
|
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 |
|
Callecod |
David |
Ochsner Accountable Care Network Board Member |
1 |
ACO Participant Representative |
Ochsner LSU Health System of North Louisiana |
|
Fox, M.D. |
Charles |
Ochsner Accountable Care Network Board Member |
1 |
ACO Participant Representative |
Ochsner LSU Health System of North Louisiana |
|
Roth, M.D. |
Randy |
Ochsner Accountable Network Board Member |
1 |
ACO Participant Representative |
Singing River Health System |
|
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:
|
Sidney “Beau” Raymond, MD, FACP |
Ochsner Accountable Care Network Interim Executive Director, Medical Director, Ex-Officio Ochsner Accountable Care Network Board Member |
|
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, Ochsner Health Network Thomas Groves, VP, Network Development , Ochsner Health Network |
|
Performance and Operations Committee |
Sidney “Beau” Raymond, MD, FACP, Ochsner Accountable Care Network Executive Director, Medical Director, Ex-Officio Ochsner Accountable Care Network Board Member Eric Gallagher, Chief Operating Officer, Ochsner Health Network |
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
- Third Agreement Period
- Performance Year 2021, $17,601,341
- Performance Year 2020, $22,355,579
- Performance Year 2019, $13,262,736
Shared Savings Distribution:
- Third Agreement Period
- Performance Year 2021
- Proportion invested in infrastructure: 15%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2021
-
- Performance Year 2020
- Proportion invested in infrastructure: 7%
- Proportion invested in redesigned care processes/resources: 18%
- Proportion of distribution to ACO participants: 74%
- Performance Year 2020
-
- Performance Year 2019
- Proportion invested in infrastructure: 7%
- Proportion invested in redesigned care processes/resources: 18%
- Proportion of distribution to ACO participants: 74%
- Performance Year 2019
Quality Performance Results
2021 Quality Performance Results:
|
ACO Quality Measure Number |
Measure Name |
Rate |
ACO Mean |
|
001 |
Diabetes: Hemoglobin A1c (HbA1c) Poor Control |
9.09 |
12.46 |
|
134 |
Preventative Care and Screening: Screening for Depression and Follow-up Plan |
82.46 |
74.38 |
|
236 |
Controlling High Blood Pressure |
82.61 |
74.87 |
|
318 |
Falls: Screening for Future Fall Risk |
96.47 |
87.03 |
|
110 |
Preventative Care and Screening: Influenza Immunization |
81.11 |
80.52 |
|
226 |
Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention |
93.55 |
80.97 |
|
113 |
Colorectal Cancer Screening |
86.85 |
73.63 |
|
112 |
Breast Cancer Screening |
90.09 |
75.11 |
|
438 |
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease |
82.63 |
84.24 |
“Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
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.
Ochsner ACN 