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
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

Amos Shirman

N

Cynthia Taylor, MD

N

George Ankuta

N

Daniel Gottlieb

N

Michael Steiner

N

MB2K LLC

N

Hanmi Medical Clinic Llc

N

Jeff Cooper Do Pllc

N

Rainier Nephrology, PLLC

N

TLC Physicians PLLC

N

Nw Pain Management And Rehabilitation Associates, Inc

N

Home Towne Family Medicine, PLLC

N

South Seattle Nephrology Associates

N

Northwest Vein And Aesthetic Center Ps

N

South Puget Sound Neurology PLLC

N

Marcus R. Kauffman, MD, PLLC

N

Northwest Physicians Medical Group, PLLC

N

David C Reed MD PLLC

N

Steve Feller

N

Hsushi Yeh

N

Key Medical Center, PLLC

N

Kevin Kennedy

N

Franciscan Health System

N

SALISH INTEGRATIVE MEDICINE INC

N

Michael E Blatner Md Ps

N

TERRILL HARRINGTON

N

Synergy Health

N

Integrated Neurology Health Services, PS

N

Sound Clinical Medicine, P.S.

N

Jeffrey Evans

N

Bonney Lake Medical Center

N

DONALD LOOMIS

N

Adam Nickel

N

Lisa Cowden

N

JEFFREY HOFF

N

DANIEL ZIPEROVICH

N

Jeffrey Frankel

N

Pacific Cardiovascular DPM, PS

N

Seatac Primary Care Physicians, Inc.

N

WEST HILL MEDICAL CLINIC INC

N

PENINSULA RAD ONC CTR LLC

N

Franciscan Health System

N

Harrison Medical Center

N

Highline Medical Center

N

Enumclaw Regional Hospital Association

N

Peninsula Family Medical Center

N

Puyallup Dermatology Clinic Inc P.S.

N

HARRY A. PIERCE, DO, PS

N

Electrodiagnosis & Rehabilitation Associates Of Tacoma Ps

N

Nw Regional Hospital For Respiratory & Complex Care

N

Northwest Family & Spinal Clinic Inc Ps

N

St Francis Communtiy Hospital

N

Pacific Podiatry Group, Ps

N

Allcare Medical Clinic Inc.

N

Dennis N Gusman

N

Tacoma Radiation Center Inc

N

Saint Clare Hospital

N

Razan R Al-Kudsi Md

N

PORTLAND AVENUE CLINIC MANAGEMENT

N

Proliance Surgeons, Inc, PS

N

Puget Sound Allergy Asthma & Immunology

N

Sheldon J Cowen MDPS

N

Kenneth L P Morton Md Pc

N

KENT FAMILY PRACTICE PS

N

Aesthetic General Dermatology Of Seattle

N

Franciscan Medical Group

N

Fhs Inpatient Team

N

Primary Care Northwest Pllc

N

Surgical Associates Northwest, P.C.

N

Skin Cancer Clinic Of Seattle Inc Ps

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 - Expressed as a percentage or number

Membership Type

ACO Participant Legal Business Name/DBA, if Applicable

Last Name

First Name

Title/Position

Mercado, MD

Francis

Board Chair

1

ACO Participant

Franciscan Medical Group

Fitzgerald

Mike

Treasurer

1

ACO Participant

Franciscan Health System

Roes, MD

William

Voting Member

1

ACO Participant

Key Medical Center, PLLC

Kennedy-Schlicher, MD

Jessica

Voting Member

1

ACO Participant

Franciscan Medical Group

Ross, MD

Andrew

Voting Member

1

Community Stakeholder

N/A

Watson, MD

Michael

Voting Member

1

ACO Participant

Harrison Medical Center

Semerdjian, MD

Greg

Voting Member

1

Medicare Beneficiary

N/A (Retired)

Krueger, MD

John

Voting Member

1

ACO Participant

Franciscan Health System

Verzosa, MD

Jude

CMO

1

ACO Participant

Franciscan Medical Group

Lal

Dhyan

Ex-Offico & Secretary

0

Other

Franciscan Health System

 

Key ACO clinical and administrative leadership:

Dhyan Lal

ACO Executive

Jude Verzosa, MD

Chief Medical Director

John Wyckoff

Compliance Officer

John Krueger, MD

Quality Assurance/Improvement Officer

 

Associated committees and committee leadership:

Committee Name

Committee Leader Name and Position

Quality of Care

John Krueger, MD, Chair

Contracting & Product Development

Dhyan Lal, Chair

Finance

Mike Fitzgerald, Chair

Clinical Information Support & Development

Dhyan Lal, 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 2017, $0
    • 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 2017
      • 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
      • 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

2017 Quality Performance Results

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

78.88

80.60

ACO-2

CAHPS: How Well Your Providers Communicate

92.45

93.13

ACO-3

CAHPS: Patients’ Rating of Provider

91.66

92.31

ACO-4

CAHPS: Access to Specialists

81.22

83.32

ACO-5

CAHPS: Health Promotion and Education

58.34

62.30

ACO-6

CAHPS: Shared Decision Making

74.52

75.85

ACO-7

CAHPS: Health Status/Functional Status

72.56

73.05

ACO-34

CAHPS: Stewardship of Patient Resources*

25.39

25.68

ACO-8

Risk Standardized, All Condition Readmission

14.23

15.01

ACO-35

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

16.16

18.46

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

63.34

79.16

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

53.35

61.74

ACO-43

Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))

1.18

1.93

ACO-11

Use of Certified EHR Technology

98.17

98.48

ACO-12

Medication Reconciliation

95.79

75.32

ACO-13

Falls: Screening for Future Fall Risk

53.38

74.38

ACO-44

Imaging Studies for Low Back Pain

65.89

67.32

ACO-14

Preventive Care and Screening: Influenza Immunization

62.00

72.52

ACO-15

Pneumonia Vaccination Status for Older Adults

67.05

72.92

ACO-16

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

60.93

70.69

ACO-17

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

93.43

90.48

ACO-18

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

30.30

61.98

ACO-19

Colorectal Cancer Screening

59.11

64.58

ACO-20

Breast Cancer Screening

64.44

70.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

82.62

79.89

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

17.54

16.74

ACO-41

Diabetes: Eye Exam

45.87

50.37

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

69.57

71.47

ACO-30

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

92.89

86.86

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples and the ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes quality measure is not included in public reporting due to a non-material technical error.

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

  • Yes, our ACO does use the SNF 3-Day Rule Waiver.