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
  • Open, ex-Officio, VP Contracting
  • 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

Rainier Health Network organizational chart

Aggregate Amount of Shared Savings
Performance Year 1: $0
Performance Year 2: $0

How Shared Savings Are Distributed
Reinvest in infrastructure: N/A
Distribution to ACO Participants: N/A

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

Quality Performance Results

Measure Number

Measure Name

2013 Reporting Period

2014 Reporting Period

RHN Performance Rate

Mean performance rate for all ACOs

RHN Performance Rate

Mean performance rate for all ACOs

Patient/Caregiver Experience

ACO-1

Getting Timely Care, Appointments, and Information

79.20

81.48

76.99

80.56

ACO-2

How Well Your Doctors Communicate

89.97

92.96

89.85

92.67

ACO-3

Patients’ Rating of Doctor

89.52

92.06

88.83

91.89

ACO-4

Access to Specialists

83.07

85.12

81.98

84.08

ACO-5

Health Promotion and Education

53.05

58.38

54.81

58.21

ACO-6

Shared Decision Making

73.29

74.53

74.10

74.65

ACO-7

Health Status/Functional Status

72.16

71.12

70.76

71.31

Care Coordination/Patient Safety

ACO-8

Risk Standardized, All Condition Readmissions

14.16

14.90

14.12

15.11

ACO-9

ASC Admissions: COPD or Asthma in Older Adults

0.88

1.17

0.62

1.03

ACO-10

ASC Admission: HF

1.09

1.20

1.14

1.18

ACO-11

Percent of Primary Care Providers Who Successfully Attested for the EHR Incentive Program Incentive Payment

65.50

66.21

85.37

80.46

ACO-12

Medication Reconciliation

67.30

73.56

84.64

91.62

ACO-13

Falls: Screening for Fall Risk

18.49

39.57

26.51

44.63

Preventive Health

ACO-14

Influenza Immunization

47.78

56.93

54.58

58.16

ACO-15

Pneumococcal Vaccination

41.65

54.76

48.49

56.79

ACO-16

Adult Weight Screening and Follow-up

54.04

61.61

61.95

67.86

ACO-17

Tobacco Use Assessment and Cessation Intervention

89.80

84.01

93.77

91.24

ACO-18

Depression Screening

8.00

31.19

13.21

36.66

ACO-19

Colorectal Cancer Screening

45.58

59.30

40.58

57.72

ACO-20

Mammography Screening

52.25

62.05

51.21

62.98

ACO-21

Proportion of Adults who had blood pressure screened in past 2 years

87.68

74.25

62.88

58.97

At Risk Population

Diabetes Composite

Beneficiaries with diabetes who met of all the following criteria:

25.22

22.21

21.45

26.3

ACO-27

Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent)

18.69

22.11

17.57

17.83

ACO-28

Percent of beneficiaries with hypertension whose BP < 140/90

65.08

67.79

62.94

69.39

ACO-29

Percent of beneficiaries with IVD with complete lipid profile and LDL control < 100mg/dl

48.83

55.44

55.19

58.78

ACO-30

Percent of beneficiaries who use Aspirin or other antithrombotic

80.54

76.35

86.16

85.49

ACO-31

Beta-Blocker Therapy for LVSD

84.15

79.82

83.57

87.72

CAD Composite

Percent of beneficiaries with CAD who met all of the following criteria:

53.26

62.78

51.24

69.36