MSSP Performance

The Centers for Medicare & Medicaid Services (CMS) established accountable care organization (ACO) models to promote care coordination and lower costs. The Medicare Shared Savings Program (MSSP) rewards ACOs that achieve better care for patients while keeping costs low. Success is measured by the program’s 33 quality measures in four main areas:

  1. Patient/caregiver experience
  2. Preventive health
  3. Care coordination/patient safety
  4. At-risk population

As a Medicare Shared Savings (MSSP) ACO, Rainier Health Network’s performance is measured by quality measures established by CMS.

ACO Name and Location
Franciscan Northwest Physicians Health Network, LLC
(dba Rainier Health Network)
1149 Market Street
MS 10-34
Tacoma, Washington, 98402

ACO Primary Contact

Primary Contact Name Paulette Cranshaw
Primary Contact Phone Number 253-428-8444
Primary Contact Email Address RHN@chifranciscan.org

 

Organizational Information

ACO Participants

ACO Participant in Joint Venture

Eye Mds Of Puget Sound Pllc

N

Amos Shirman

N

George Ankuta

N

Daniel Gottlieb

N

Michael Steiner, MD

N

Mark Alenick

N

Max Lee

N

Highline Internal Medicine Ps

N

Jeffrey L Evans, MD PLLC

N

Hanmi Medical Clinic Llc

N

Robert C Wright Md Ps

N

Foot And Ankle Specialists Pllc

N

Rainier Nephrology, PLLC

N

Sumner Family Eyecare, PLLC

N

TLC Physicians PLLC

N

Nw Pain Management And Rehabilitation Associates, Inc

N

WASEA Medical LLC

N

Home Towne Family Medicine, PLLC

N

South Seattle Nephrology Associates

N

Bridgeport Medical Clinic, PLLC

N

Northwest Vein And Aesthetic Center Ps

N

South Puget Sound Neurology PLLC

N

Northwest Physicians Medical Group, PLLC

N

Pace Dermatology Associates PLLC

N

David C Reed MD PLLC

N

Burien Digestive Health Center LLC

N

Hsushi Yeh

N

Cynthia Taylor, MD

N

Key Medical Center, PLLC

N

Franciscan Health System

N

James Graber

N

Judith Marsden

N

Michael E Blatner Md Ps

N

Synergy Health

N

Integrated Neurology Health Services, PS

N

Paul Andrew Sueno MD PLLC

N

Retina Institute, Pllc

N

Adam Nickel

N

Adult And Geriatric Medicine Pllc

N

Sound Clinical Medicine, P.S.

N

Jeffrey Evans

N

Tanya Wilke Family Medicine

N

Sarah Neitzel Dpm Pllc

N

Bonney Lake Medical Center

N

Philip Vance

N

D Loomis

N

Adam Nickel

N

Lisa Cowden

N

Rena Wong

N

Daniel Ziperovich

N

Jeffrey Frankel

N

Jonathan Y Jin, MD

N

My Family Doctor Llc

N

Pacific Cardiovascular DPM, PS

N

Seatac Primary Care Physicians, Inc.

N

Harrison Medical Center

N

Highline Medical Center

N

Enumclaw Regional Hospital Association

N

Summit View Clinic, Inc., P.S.

N

Digestive Health Specialists Ps

N

Hudson's Bay Medical Group

N

Judith Marsden

N

Mark Alenick

N

Edward W. Hartzler, Md, Inc, Ps

N

David L Lukens, DO PS

N

Peninsula Family Medical Center

N

Max Lee, MD

N

Hsushi Yeh

N

James M Komorous MD PS

N

Puyallup Dermatology Clinic Inc P.S.

N

Electrodiagnosis & Rehabilitation Associates Of Tacoma Ps

N

Barry Bockow, MD PS

N

Nw Regional Hospital For Respiratory & Complex Care

N

North Kitsap Family Practice And Urgent Care Ps

N

Northwest Family & Spinal Clinic Inc Ps

N

St Francis Communtiy Hospital

N

Daniel Gottlieb

N

Steve Feller

N

Pacific Podiatry Group, Ps

N

Curtis Burnett MD

N

Jeffrey Frankel

N

Allcare Medical Clinic Inc.

N

Dennis N Gusman

N

Tacoma Radiation Center Inc

N

Saint Clare Hospital

N

Southwest Portland Medical Clinic, Inc.

N

Cascade Eye & Skin Centers, PC

N

Doctors Clinic A Professional Corporation

N

Kevin Kennedy

N

Razan R Al-Kudsi Md

N

Daniel Ziperovich, MD

N

Portland Avenue Family Clinic Inc

N

Stephen Haggard, DPM

N

Proliance Surgeons, Inc, PS

N

R Skoglund MD, PLLC

N

Puget Sound Allergy Asthma & Immunology

N

Clearview Eye and Laser PLLC

N

Sheldon J Cowen MDPS

N

Ear Nose Throat And Allergy Associates

N

Kenneth L P Morton Md Pc

N

Northwest Medical Specialties Pllc

N

Franciscan Medical Group

N

Fhs Inpatient Team

N

Primary Care Northwest Pllc

N

Surgical Associates Northwest, P.C.

N

Amos Shirman

N

Skin Cancer Clinic Of Seattle Inc Ps

N

Comprehensive Sleep Medicine Inc PS

N

Christian Family Care, Inc

N

Jeanne Isaacson, M.D., Pc

N

Robert K Chow Md Ps

N

Steven Mcclean Md Pc

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

Kronlund, MD

Scott

Interim Chair, Voting Member

1

Community Stakeholder

President & CMO, Northwest Physican Network

deLeon, MD

Dennis

Vice Chair, Voting Member

1

ACO Participant

Franciscan Health System

Fitzgerald, MD

Michael

Treasurer, Voting Member

1

ACO Participant

Franciscan Health System

Marshall, MD

Michael

Voting Member

1

ACO Participant

Franciscan Health System

Roes, MD

William

Voting Member

1

ACO Participant

Key Medical Center

Watson, MD

Michael

Voting Member

1

ACO Participant

Harrison Medical Center

Skoglund, MD

Rodney

Voting Member

1

ACO Participant

R Skoglund MD, PLLC

Semerdjian, MD

Greg

Voting Member

1

Medicare Beneficiary

N/A (Retired)

Mercado, MD

Francis

Ex-Offico

0

Other

Franciscan Medical Group

Lal

Dhyan

Ex-Offico, Secretary

0

Other

Franciscan Health System

 

Key ACO clinical and administrative leadership:

Dhyan Lal

ACO Executive

Francis Mercado, MD

Medical Director

John Wyckoff

Compliance Officer

Dennis deLeon, MD

Quality Assurance/Improvement Officer

 

Associated committees and committee leadership:

Committee Name

Committee Leader Name and Position

Network Development & Credentialing

Dennis deLeon, MD, Chair

Quality of Care

Francis Mercado, MD, Co-Chair & Scott Kronlund, MD, Co-Chair

Contracting & Product Development

Dhyan Lal, Chair

Finance

Mike Fitzgerald, Chair

Clinical Information Support & Development

Dean Fields, MD, Chair

 

Types of ACO participants, or combinations of participants, that formed the ACO:

  • Partnerships or joint venture arrangements between hospitals and ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2016, $0
  • First Agreement Period
    • Performance Year 2015, $2,981,335
    • 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: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • 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

75.39

79.9

ACO-2

CAHPS: How Well Your Providers Communicate

92.3

92.63

ACO-3

CAHPS: Patients’ Rating of Provider

90.2

91.93

ACO-4

CAHPS: Access to Specialists

79.08

83.52

ACO-5

CAHPS: Health Promotion and Education

55.46

60

ACO-6

CAHPS: Shared Decision Making

75.67

75.28

ACO-7

CAHPS: Health Status/Functional Status

70.08

71.82

ACO-34

CAHPS: Stewardship of Patient Resources*

26.47

27.52

ACO-8

Risk Standardized, All Condition Readmission

13

14.7

ACO-35

Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)* Readmission

14.19

18.17

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

38.13

53.2

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

58.53

75.23

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

46.87

59.81

ACO-9

Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)

4.95

9.27

ACO-10

Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)

15.51

14.53

ACO-11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

87.16

82.72

ACO-39

Documentation of Current Medications in the Medical Record

89.09

87.54

ACO-13

Falls: Screening for Future Fall Risk

34.5

64.04

ACO-14

Preventive Care and Screening: Influenza Immunization

68.3

68.32

ACO-15

Pneumonia Vaccination Status for Older Adults

56.15

69.21

ACO-16

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up

63.79

74.45

ACO-17

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

94.03

90.98

ACO-18

Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan

17.32

53.63

ACO-19

Colorectal Cancer Screening

47.37

61.52

ACO-20

Breast Cancer Screening

59.97

67.61

ACO-21

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

71.83

76.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

72.34

77.72

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

14.56

18.24

ACO-41

Diabetes: Eye Exam

32.06

44.94

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

68.13

70.52

ACO-30

Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

85.9

85.05

ACO-31

Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

89.25

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%)

79.08

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 “Franciscan Northwest Physicians Health Network, LLC” or "Rainier Health Network" to view the quality performance results. This ACO can also be found by using the ACO ID A78337 in the public use files on data.cms.gov.

Payment Rule Waivers

  • No, our ACO does not use the SNF 3-Day Rule Waiver.