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
Rainier Health Network
1149 Market Street
Tacoma, Washington, 98402

ACO Primary Contact
Dhyan Lal, Vice President of Network Strategy
RHN@chifranciscan.org
253-428-8444

Types of ACO participants, or combinations of participants, that formed the ACO:
ACO professionals in a group practice arrangement
Partnership or joint venture arrangements between hospitals and ACO professionals
Hospital employing ACO professionals

ACO Participants

Facilities

Rainier Health Network Governing Body

  • Open, Chair, Voting Member, ACO Participant Representative
  • Scott Kronlund, MD, Vice Chair, Voting Member, ACO Participant Representative
  • Dennis DeLeon, MD, Voting Member, ACO Participant Representative
  • Dhyan Lal, Vice President of Network Strategy
  • Annie Donohue, Voting Member, ACO Participant Representative
  • Michael Watson, MD, Voting Member, ACO Participant Representative
  • Michael Fitzgerald, Treasurer, Voting Member, ACO Participant Representative
  • Andrew Haputa, MD, Voting Member, ACO Participant Representative
  • Richard MacCornack, PhD, Secretary, Voting Member, ACO Participant Representative
  • Michael Marshall, MD, Voting Member, ACO Participant Representative
  • Francis Mercado, MD, ex-Officio, Chief Medical Officer
  • Preston Rice, MD, Voting Member, ACO Participant Representative
  • William Roes, MD, Voting Member, ACO Participant Representative
  • Open, Voting Member, ACO Participant Representative
  • Greg Semerdjian, MD, Voting Member, Medicare Beneficiary Representative

Rainier Health Network Committees and Key Leadership Personnel
Vice President of Network Strategy: Dhyan Lal
Chief Medical Officer: Francis Mercado, MD.
Divisional Director, Clinical Care: Sherry Aliotta

Rainier Health Network
Primary Care Professionals: N/A

  • Specialists: N/A
  • Hospital: N/A

Aggregate Amount of Shared Savings
Performance Year 1: $0
Performance Year 2: $0
Performance Year 3: $2,981,335

How Shared Savings Are Distributed
Reinvest in infrastructure: Yes
Distribution to ACO Participants: Yes

As an MSSP ACO, Rainier Health Network reports on the following quality standard results:

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

Care Coordination/Patient Safety

ACO-8 [3]

Risk Standardized, All Condition Readmissions

13.15

14.86

ACO-35

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

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%

Preventive Health

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%

At Risk Population

ACO-40

Depression Remission at Twelve Months

3.85%

6.11%

Diabetes Composite

Diabetes Composite (All or Nothing Scoring)

27.69%

35.38%

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%