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
Previous Names: N/A
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 Participants

ACO Participant in Joint Venture

Adam Nickel

N

Allcare Medical Clinic Inc.

N

Amos Shirman

N

Bonney Lake Medical Center

N

Cynthia Taylor, MD

N

Daniel Gottlieb

N

DANIEL ZIPEROVICH

N

David C Reed MD PLLC

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 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 Vein And Aesthetic Center Ps

N

Nw Pain Management And Rehabilitation Associates, Inc

N

OLYMPIC INTERNAL MEDICINE, INC., P.S.

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

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

Membership Type

ACO Participant Legal Business Name/DBA, if Applicable

Last Name

First Name

Title/Position

Mercado, MD

Francis

Physician Member/Board Chair

1

ACO Participant

Franciscan Medical Group

Fitzgerald

Mike

Treasurer

1

ACO Participant

Franciscan Health System

Verzosa, MD

Jude

Physician Member/CMO

1

ACO Participant

Franciscan Medical Group

Kennedy-Schlicher, MD

Jessica

Physician Member

1

ACO Participant

Franciscan Health System

Ross, MD

Andrew

Physician Member

1

Community Stakeholder

N/A

Semerdjian, MD

Greg

Physician Member

1

Medicare Beneficiary

N/A (Retired)

Watson, MD

Michael

Physician Member

1

ACO Participant

Harrison Medical Center

Lal

Dhyan

ACO Executive/Secretary

0

Ex-Officio

Franciscan Health System


Key ACO clinical and administrative leadership:

ACO Executive: Dhyan Lal

Medical Director: Jude Verzosa, MD

Compliance Officer: Christi Knox

Quality Assurance/Improvement Officer: Jude Verzosa, MD

 

Associated committees and committee leadership:

Committee Name

Committee Leader Name and Position

Quality of Care

Jude Verzosa, MD - Chair

Contracting & Product Developing

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

  • First Agreement Period
    • Performance Year 2019, $9,982,459.69

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 80%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: N/A

Quality Performance Results

2019 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

80.46

85.86

ACO-2

CAHPS: How Well Your Providers Communicate

91.62

94.11

ACO-3

CAHPS: Patients’ Rating of Provider

89.48

92.69

ACO-4

CAHPS: Access to Specialists

76.89

81.54

ACO-5

CAHPS: Health Promotion and Education

58.23

60.44

ACO-6

CAHPS: Shared Decision Making

61.35

62.78

ACO-7

CAHPS: Health Status/Functional Status

71.66

73.79

ACO-34

CAHPS: Stewardship of Patient Resources

21.43

26.17

ACO-45

CAHPS: Courteous and Helpful Office Staff

93.77

92.84

ACO-46

CAHPS: Care Coordination

84.21

86.89

ACO-14

Preventive Care and Screening: Influenza Immunization

72.54

74.77

ACO-17

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

81.25

78.04

ACO-18

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

57.66

70.40

ACO-19

Colorectal Cancer Screening

77.23

70.76

ACO-20

Breast Cancer Screening

77.06

73.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

91.48

82.17

ACO-27

Diabetes: Hemoglobin A1c Poor Control (>9%) 

12.48

13.88

ACO-28

Controlling High Blood Pressure

78.68

75.04

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. In addition, the Centers for Medicare & Medicaid Services (CMS) waived the requirement for ACOs to field a CAHPS for ACOs survey data.

For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-day Rule Waiver:
    • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR §425.612.
  • Waiver for Payment for Telehealth Services
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR §425.612(f) and 42 CFR §425.613.