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.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s