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 | 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. | Y |
| East Baton Rouge Medical Center, LLC | N |
| Anointed Family Medicine | N |
| Ochsner Bayou, LLC | Y |
| Ochsner Medical Center – Kenner, LLC | N |
| Ochsner Medical Center – Northshore, LLC | N |
| Rowe S Crowder III MD PLLC | N |
| MP Medical Partners LLC | N |
| Edwin Walker, MD | N |
| Slidell Memorial Hospital | Y |
| Ochsner Clinic, LLC | N |
| Ochsner Clinic Foundation | Y |
| Family Practice Associates of | N |
| Northshore Family Medical Center | N |
| Westbank Medical Associates | N |
| Daniel Services LLC | N |
| Christopher D Naquin MD APMC | N |
| Ochsner Mississippi, LLC | N |
| Slidell Memorial Hospital | Y |
| Dr. John M Wise | Y |
| Houma Health Clinic, INC | 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 |
| Finance Committee | Lisa Blume, CFO |
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
- Second Agreement Period
- Performance Year 2018, $5,759,032
- Performance Year 2017, $4,984,301
- 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 2018
- Proportion invested in infrastructure: 15%
- Proportion invested in redesigned care processes/resources: 35%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2018
-
- 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 2017
-
- 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
- Performance Year 2016
- 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 2015
-
- 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 2014
-
- 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
- Performance Year 2013
Quality Performance Results
2018 Quality Performance Results:
| ACO# | Measure Name | Rate | ACO Mean |
| ACO-1 | CAHPS: Getting Timely Care, Appointments, and Information | 87.08 | 86.14 |
| ACO-2 | CAHPS: How Well Your Providers Communicate | 92.39 | 93.93 |
| ACO-3 | CAHPS: Patients’ Rating of Provider | 92.01 | 92.45 |
| ACO-4 | CAHPS: Access to Specialists | 81.77 | 81.50 |
| ACO-5 | CAHPS: Health Promotion and Education | 55.87 | 59.26 |
| ACO-6 | CAHPS: Shared Decision Making | 56.11 | 61.94 |
| ACO-7 | CAHPS: Health Status/Functional Status | 71.36 | 73.35 |
| ACO-34 | CAHPS: Stewardship of Patient Resources | 25.75 | 26.26 |
| ACO-8 | Risk Standardized, All Condition Readmission | 15.30 | 14.98 |
| ACO-35 | Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) | 19.41 | 18.59 |
| ACO – 36 | All-Cause Unplanned Admissions for Patients with Diabetes | 32.54 | 37.01 |
| ACO-37 | All-Cause Unplanned Admissions for Patients with Heart Failure | 72.38 | 76.75 |
| ACO-38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 56.10 | 59.00 |
| ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) | 1.78 | 1.98 |
| ACO-11 | Use of Certified EHR Technology | 96.96 | 98.20 |
| ACO-12 | Medication Reconciliation | 87.84 | 85.91 |
| ACO-13 | Falls: Screening for Future Fall Risk | 98.13 | 79.73 |
| ACO-44 | Imaging Studies for Low Back Pain | 53.49 | 64.36 |
| ACO-14 | Preventive Care and Screening: Influenza Immunization | 69.55 | 72.71 |
| ACO-15 | Pneumonia Vaccination Status for Older Adults | 85.66 | 75.97 |
| ACO-16 | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up | 84.25 | 76.83 |
| ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 95.45 | 72.81 |
| ACO-18 | Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan | 75.28 | 66.74 |
| ACO-19 | Colorectal Cancer Screening | 84.94 | 68.27 |
| 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 Mellitus: Hemoglobin A1c Poor Control | 10.79 | 15.51 |
| ACO-41 | Diabetes: Eye Exam | 83.45 | 52.42 |
| ACO-28 | Hypertension (HTN): Controlling High Blood Pressure | 75.28 | 73.10 |
| ACO-30 | Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic | 92.40 | 88.92 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.
- For 2018 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2018-Shared-Savings-Program-SSP-Accountable-Care-O/v47u-yq84/data
- For 2017 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2017-Shared-Savings-Program-SSP-Accountable-Care-O/gk7c-vejx/data
- 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 A1535 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.
- 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.
