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
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.