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

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

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

Roes, MD

William

Physician Member

1

ACO Participant

Key Medical Center, PLLC

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.

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.