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
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%
|