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:
- Patient/caregiver experience
- Preventive health
- Care coordination/patient safety
- 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
Legal Name: Franciscan Northwest Physicians Health Network, LLC
DBA Rainier Health Network
1149 Market Street
Tacoma, Washington, 98402
ACO Primary Contact
Paulette Cranshaw
RHN@chifranciscan.org
253-428-8444
Key ACO Clinical and Administrative Leadership
ACO Executive Director: Dhyan Lal, Division Vice President of Payer Strategy-ACO
ACO Chief Medical Officer: Francis Mercado, MD
ACO Compliance Official: John Wyckoff
ACO Quality Assurance/Improvement Officer: Dennis deLeon
ACO CMS Liaison: Paulette Cranshaw
Rainier Health Network Governing Body
- Scott Kronlund, MD, Interim Chair, Voting Member, Community Stakeholder, President & Chief Medical Officer, Northwest Physican Network
- Dennis DeLeon, MD, Vice Chair, Voting Member, Franciscan Health System
- Michael Fitzgerald, Treasurer, Voting Member, Franciscan Health System
- Michael Marshall, MD, Voting Member, Franciscan Health System
- William Roes, MD, Voting Member, Key Medical Center, PLLC
- Michael Watson, MD, Voting Member, Harrison Medical Center
- Rodney Skoglund, MD, Voting Member, R Skoglund MD, PLLC
- Greg Semerdjian, MD, Voting Member, Medicare Beneficiary Representative, Retired
- Francis Mercado, MD, ex-Officio, ACO-Chief Medial Officer, Franciscan Medical Group
- Dhyan Lal, Secretary, ex-Officio, Division VP, Payer Strategy-ACO (FNPHN, LLC dba Rainer Health Network)
Rainier Health Network Committees
Network Development & Credentialing Committee: Dennis DeLeon, MD, Chair
Quality of Care Committee: Francis Mercado, MD & Scott Kronlund, MD, Co-chairs
Contracting & Product Development Committee: Dhyan Lal, Chair
Finance Committee: Mike Fitzgerald, Chair
Clinical Information Support & Development Committee: Dean Fields, MD, Chair
ACO Participants
- Adult And Geriatric Medicine Pllc
- Allcare Medical Clinic Inc.
- Bonney Lake Medical Center
- Bridgeport Medical Clinic, PLLC
- Burien Digestive Health Center LLC
- Cascade Eye & Skin Centers, PC
- Center For Women's Health P C
- Christian Family Care, Inc
- Clearview Eye and Laser PLLC
- Comprehensive Sleep Medicine Inc PS
- Digestive Health Specialists Ps
- Doctors Clinic A Professional Corporation
- Ear Nose Throat And Allergy Associates
- Electrodiagnosis & Rehabilitation Associates Of Tacoma Ps
- Enumclaw Regional Hospital Association
- Eye Mds Of Puget Sound Pllc
- Fhs Inpatient Team
- Foot And Ankle Specialists Pllc
- Franciscan Health System
- Franciscan Medical Group
- Hanmi Medical Clinic Llc
- Harrison Medical Center
- Highline Internal Medicine Ps
- Highline Medical Center
- Home Towne Family Medicine, PLLC
- Hudson's Bay Medical Group
- Integrated Neurology Health Services, PS
- Key Medical Center, PLLC
- My Family Doctor Llc
- North Kitsap Family Practice And Urgent Care Ps
- Northwest Family & Spinal Clinic Inc Ps
- Northwest Medical Specialties Pllc
- Northwest Physicians Medical Group, PLLC
- Northwest Vein And Aesthetic Center Ps
- Nw Pain Management And Rehabilitation Associates, Inc
- Nw Regional Hospital For Respiratory & Complex Care
- Pace Dermatology Associates PLLC
- Pacific Cardiovascular DPM, PS
- Pacific Podiatry Group, Ps
- Peninsula Family Medical Center
- Portland Avenue Family Clinic Inc
- Primary Care Northwest Pllc
- Proliance Surgeons, Inc, PS
- Puget Sound Allergy Asthma & Immunology
- Puyallup Dermatology Clinic Inc P.S.
- Rainier Nephrology, PLLC
- Retina Institute, Pllc
- Saint Clare Hospital
- Seatac Primary Care Physicians, Inc.
- Skin Cancer Clinic Of Seattle Inc Ps
- Sound Clinical Medicine, P.S.
- South Puget Sound Neurology PLLC
- South Seattle Nephrology Associates
- Southwest Portland Medical Clinic, Inc.
- St Francis Communtiy Hospital
- Summit View Clinic, Inc., P.S.
- Sumner Family Eyecare, PLLC
- Surgical Associates Northwest, P.C.
- Synergy Health
- Tacoma Radiation Center Inc
- Tanya Wilke Family Medicine
- TLC Physicians PLLC
- WASEA Medical LLC
- Adam Nickel, MD
- Amos Shirman, MD
- Barry Bockow, MD PS
- Christen Vu, MD
- Curtis Burnett MD
- Cynthia Taylor, MD
- D Loomis, MD
- Daniel Gottlieb, MD
- Daniel Ziperovich, MD
- David C Reed MD PLLC
- David L Lukens, DO PS
- Dennis N Gusman, MD
- Edward W. Hartzler, Md, Inc, Ps
- George Ankuta, MD
- Hsushi Yeh, MD
- James Graber, MD
- James M Komorous MD PS
- Jeanne Isaacson, M.D., Pc
- Jeffrey Frankel, MD
- Jeffrey L Evans, MD PLLC
- Jonathan Y Jin, MD
- Judith Marsden, MD
- Kenneth L P Morton Md Pc
- Kevin Kennedy, MD
- Lisa Cowden, MD
- Mark Alenick, MD
- Max Lee, MD
- Michael E Blatner Md Ps
- Michael Steiner, MD
- Paul Andrew Sueno MD PLLC
- Philip Vance, MD
- R Skoglund MD, PLLC
- Razan R Al-Kudsi, Md
- Rena Wong, MD
- Robert C Wright Md Ps
- Robert K Chow Md Ps
- Sarah Neitzel Dpm Pllc
- Sheldon J Cowen MD, PS
- Stephen Haggard, DPM
- Steve Feller, MD
- Steven Mcclean Md Pc
No participants are involved in a joint venture between ACO professionals and hospitals.
Types of ACO participants or combinations of participants that formed the ACO
ACO professionals in a group practice arrangement
Network of individual practices of ACO professionals
ACO participants
As an MSSP ACO, Rainier Health Network reports on the following quality standard results:
Shared Savings and Losses
Agreement period beginning 2013, Performance Year 1: $0
Agreement period beginning 2013, Performance Year 2014: $0
Agreement period beginning 2013, Performance Year 2015: $2,981,335
Shared Savings Distribution
Agreement period beginning 2013, Performance Year 1: $0
Agreement period beginning 2013, Performance Year 2014: $0
Agreement period beginning 2013, Performance Year 2015: $2,981,335
- Proportion invested in infrastructure: 20%
- Proportion invested in redesigned care process/resources: 20%
- Proportion of distribution of ACO participants: 60%
Payment Rule Waivers
No, our ACO does not use the SNF 3-Day Rule Waiver
Previous years results
Quality Performance Results
|
Measure Number
|
Measure Name
|
2015 Reporting Period
|
|
RHN Performance Rate
|
Mean performance rate (SSP ACOs)
|
|
ACO-1
|
CAHPS: Getting Timely Care, Appointments, and Information
|
79.99
|
80.61
|
|
ACO-2
|
CAHPS: How Well Your Providers Communicate
|
92.45
|
92.65
|
|
ACO-3
|
CAHPS: Patients’ Rating of Provider
|
92.08
|
91.94
|
|
ACO-4
|
CAHPS: Access to Specialists
|
79.04
|
83.61
|
|
ACO-5
|
CAHPS: Health Promotion and Education
|
53.22
|
59.06
|
|
ACO-6
|
CAHPS: Shared Decision Making
|
77.50
|
75.17
|
|
ACO-7
|
CAHPS: Health Status/Functional Status
|
72.30
|
72.30
|
|
ACO-34
|
CAHPS: Stewardship of Patient Resources*
|
23.27
|
26.87
|
|
ACO-8
|
Risk Standardized, All Condition Readmission
|
13.15
|
14.86
|
|
ACO-35
|
Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)* Readmission
|
14.11
|
18.07
|
|
ACO-36
|
All-Cause Unplanned Admissions for Patients with Diabetes*
|
44.56
|
54.60
|
|
ACO-37
|
All-Cause Unplanned Admissions for Patients with Heart Failure*
|
63.61
|
79.96
|
|
ACO-38
|
All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions
|
52.89
|
62.92
|
|
ACO-9
|
Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)
|
0.57
|
1.11
|
|
ACO-10
|
Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)
|
1.07
|
1.04
|
|
ACO-11
|
Percent of PCPs who Successfully Meet Meaningful Use Requirements
|
73.58%
|
80.14%
|
|
ACO-39
|
Documentation of Current Medications in the Medical Record*
|
93.57%
|
84.07%
|
|
ACO-13
|
Falls: Screening for Future Fall Risk
|
31.42%
|
56.46%
|
|
ACO-14
|
Preventive Care and Screening: Influenza Immunization
|
60.30%
|
62.03%
|
|
ACO-15
|
Pneumonia Vaccination Status for Older Adults
|
54.56%
|
63.73%
|
|
ACO-16
|
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up
|
65.03%
|
71.15%
|
|
ACO-17
|
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
|
92.97%
|
90.16%
|
|
ACO-18
|
Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan
|
17.14%
|
45.25%
|
|
ACO-19
|
Colorectal Cancer Screening
|
46.81%
|
60.06%
|
|
ACO-20
|
Breast Cancer Screening
|
55.28%
|
65.67%
|
|
ACO-21
|
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
|
70.32%
|
70.04%
|
|
ACO-40
|
Depression Remission at Twelve Months*
|
N/A
|
N/A
|
|
ACO-27
|
Diabetes Mellitus: Hemoglobin A1c Poor Control
|
18.29%
|
20.38%
|
|
ACO-41
|
Diabetes: Eye Exam*
|
30.43%
|
41.05%
|
|
ACO-28
|
Hypertension: Controlling High Blood Pressure
|
63.96%
|
69.62%
|
|
ACO-30
|
Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic
|
88.50%
|
83.82%
|
|
ACO-31
|
Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
|
93.46%
|
87.22%
|
|
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%)
|
75.17%
|
77.73%
|