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 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

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.

 

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