MSSP Performance

 The Centers for Medicare & Medicaid Services (CMS) established accountable care organization (ACO) models to promote care coordination and lower costs. 

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

Adam Nickel

N

Aesthetic General Dermatology Of Seattle

N

Allcare Medical Clinic Inc.

N

Bonney Lake Medical Center

N

Cynthia Taylor, MD

N

Daniel Gottlieb

N

DANIEL ZIPEROVICH

N

David C Reed MD PLLC

N

Dennis N Gusman

N

DONALD LOOMIS

N

Electrodiagnosis & Rehabilitation Associates Of Tacoma Ps

N

Enumclaw Regional Hospital Association

N

Fhs Inpatient Team

N

Franciscan Health System

N

Franciscan Health System

N

Franciscan Medical Group

N

George Ankuta

N

Hanmi Medical Clinic Llc

N

Harrison Medical Center

N

HARRY A. PIERCE, DO, PS

N

Highline Medical Center

N

Home Towne Family Medicine, PLLC

N

Hsushi Yeh

N

Integrated Neurology Health Services, PS

N

Jeanne Isaacson, M.D., Pc

N

Jeff Cooper Do Pllc

N

Jeffrey Evans

N

Jeffrey Frankel

N

JEFFREY HOFF

N

Kenneth L P Morton Md Pc

N

KENT FAMILY PRACTICE PS

N

Kevin Kennedy

N

Key Medical Center, PLLC

N

Lisa Cowden

N

Marcus R. Kauffman, MD, PLLC

N

MB2K LLC

N

Michael E Blatner Md Ps

N

Michael Steiner

N

Northwest Family & Spinal Clinic Inc Ps

N

Northwest Physicians Medical Group, PLLC

N

Northwest Vein And Aesthetic Center Ps

N

Nw Pain Management And Rehabilitation Associates, Inc

N

Nw Regional Hospital For Respiratory & Complex Care

N

Pacific Cardiovascular DPM, PS

N

Pacific Podiatry Group, Ps

N

Peninsula Family Medical Center

N

PENINSULA RAD ONC CTR LLC

N

PORTLAND AVENUE CLINIC MANAGEMENT

N

Primary Care Northwest Pllc

N

Proliance Surgeons, Inc, PS

N

Puget Sound Allergy Asthma & Immunology

N

Puyallup Dermatology Clinic Inc P.S.

N

Rainier Nephrology, PLLC

N

Razan R Al-Kudsi Md

N

Robert K Chow Md Ps

N

Saint Clare Hospital

N

SALISH INTEGRATIVE MEDICINE INC

N

Seatac Primary Care Physicians, Inc.

N

Sheldon J Cowen MDPS

N

Skin Cancer Clinic Of Seattle Inc Ps

N

Sound Clinical Medicine, P.S.

N

South Puget Sound Neurology PLLC

N

South Seattle Nephrology Associates

N

St Francis Community Hospital

N

Steve Feller

N

Steven Mcclean Md Pc

N

Surgical Associates Northwest, P.C.

N

Synergy Health

N

Tacoma Radiation Center Inc

N

TERRILL HARRINGTON

N

TLC Physicians PLLC

N

WEST HILL MEDICAL CLINIC INC

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

Verzosa, MD

Jude

CMO

1

ACO Participant

Franciscan Medical Group

Roes, MD

William

Voting Member

1

ACO Participant

Key Medical Center, PLLC

Kennedy-Schlicher, MD*

Jessica

Voting Member

1

ACO Participant

Franciscan Health System

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)

Lal

Dhyan

Ex-Offico & Secretary

0

Other

Franciscan Health System

*note: provider is a physician but not part of Franciscan Medical Group

Key ACO clinical and administrative leadership:

Dhyan Lal

ACO Executive

Jude Verzosa, MD

Chief Medical Director

Christi Knox

Compliance Officer

Jude Verzosa, MD

Quality Assurance/Improvement Officer

 

Associated committees and committee leadership:

Committee Name

Committee Leader Name and Position

Quality of Care

Jude Verzosa, MD, Chair

Contracting & Product Development

Dhyan Lal, Chair

Finance

Mike Fitzgerald, Chair

Executive

Francis Mercado, 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 2018, $6,705,312
    • 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 2018
      • Proportion invested in infrastructure: 80%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 0
    • 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

2018 Quality Performance Results

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

82.22

86.14

ACO-2

CAHPS: How Well Your Providers Communicate

91.77

93.93

ACO-3

CAHPS: Patients’ Rating of Provider

89.53

92.45

ACO-4

CAHPS: Access to Specialists

74.73

81.50

ACO-5

CAHPS: Health Promotion and Education

53.56

59.26

ACO-6

CAHPS: Shared Decision Making

65.06

61.94

ACO-7

CAHPS: Health Status/Functional Status

70.87

73.35

ACO-34

CAHPS: Stewardship of Patient Resources

25.56

26.26

ACO-8

Risk Standardized, All Condition Readmission

13.85

14.98

ACO-35

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

15.57

18.59

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

29.98

37.01

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

62.49

76.75

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

47.75

59.00

ACO-43

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

1.24

1.98

ACO-11

Use of Certified EHR Technology

98.48

98.20

ACO-12

Medication Reconciliation Post-Discharge

92.03

85.91

ACO-13

Falls: Screening for Future Fall Risk

79.34

79.73

ACO-44

Use of Imaging Studies for Low Back Pain

80.00

64.36

ACO-14

Preventive Care and Screening: Influenza Immunization

70.31

72.71

ACO-15

Pneumonia Vaccination Status for Older Adults

77.69

75.97

ACO-16

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

69.51

76.83

ACO-17

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

77.78

72.81

ACO-18

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

51.14

66.74

ACO-19

Colorectal Cancer Screening

69.23

68.27

ACO-20

Breast Cancer Screening

69.92

71.96

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

86.08

81.47

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

14.85

15.51

ACO-41

Diabetes: Eye Exam

50.83

52.42

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

73.56

73.10

ACO-30

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

98.46

88.92

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

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 A1694 in the public use files on data.cms.gov.

Payment Rule Waivers

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