OhioHealth Medicare Accountable Care Organization (ACO)

OhioHealth Medicare ACO Public Reporting Information

ACO Name and Location
OhioHealth Venture, LLC
3430 OhioHealth Parkway, 2nd Floor
Columbus, OH 43202

ACO Primary Contact
Lauren McKown, JD, MPH
(614) 544-4028

Organizational Information

ACO Participants:

ACO Participants

ACO Participant in Joint Venture

Costin Family Practice, Inc.

N

Diley Medical Group, LLC

N

Gateway Wellness Center, LLC

N

Harding Memorial Healthcare

N

Maple Leaf Family and Sports Medicine, LLC

N

Marion Area Physicians, LLC

N

Marion Independent Physicians Association, LLC

N

Midwest Internal Medicine Association

N

OhioHealth Corporation - OhioHealth Physicians Group

N

Parminder B. Singh MD, Inc.

N

Personal MD, LLC

N

Polaris Parkway Internal Medicine & Pediatrics, Ltd.

N

Robert Santiago, MD, Inc.

N

Robert P. Zaino, MD, LLC

N

Scioto Valley Family Physicians, Inc.

N

Trust Medical Services, Inc.

N

ACO Governing Body:

Member
Last Name

Member
First Name

Member
Title/Position

Member's Voting
Power (Expressed
as a percentage
or number)

Membership
Type

ACO Participant
Legal Business
Name and D/B/A,
if applicable

Marcinek, DO

Julie

Chair/Voting
Member

1

ACO Participant
Representative

OhioHealth
Physician Group

MacDowell, MD

Andrew

Voting Member

1

ACO Participant
Representative

OhioHealth
Physician Group

Smallwood, MD

Christopher

Voting Member

1

ACO Participant
Representative

Marion Area
Physicians, LLC

Vacant

Vacant

Voting Member

1

ACO Participant
Representative

Vacant

Rumbalski

Eric

Voting Member

1

Beneficiary
Representative

n/a

 

Key ACO Clinical and Administrative Leadership:

ACO Executive: Jim O'Brien, MD
Medical Director: Sherry Voet, MD
Compliance Officer: Charlotte Rawls
Quality Assurance/Improvement Officer: Jenn Lingenfelter

Associated Committees and Committee Leadership:

Committee Name

Committee Leader Name and Position

Quality Committee

Jenn Lingenfelter, Director, Value Services
Organization (VSO), Population Health Services

 

Types of ACO Participants, or Combinations of Participants, that Formed the ACO:

  • ACO professionals in group practice arrangements
  • Networks of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • First Agreement Period
    • Performance Year 2018, $0
    • Performance Year 2019, $0
    • Performance Year 2020, $0

Shared Savings Distributions:

  • First Agreement Period
    • Performance Year 2018
      • 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 2019
        • 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 2020
          • 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

2019 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care,
Appointments, and Information

87.14

85.86

ACO-2

CAHPS: How Well Your
Providers Communicate

94.33

94.11

ACO-3

CAHPS: Patients’ Rating of Provider

93.40

92.69

ACO-4

CAHPS: Access to Specialists

84.76

81.54

ACO-5

CAHPS: Health Promotion and Education

58.42

60.44

ACO-6

CAHPS: Shared Decision Making

64.52

62.78

ACO-7

CAHPS: Health Status/Functional Status

74.19

73.79

ACO-34

CAHPS: Stewardship of Patient Resources

23.80

26.17

ACO-45

CAHPS: Courteous and Helpful Office Staff

94.90

92.84

ACO-46

CAHPS: Care Coordination

87.48

86.89

ACO-8

Risk Standardized, All Condition Readmission

15.19

14.86

ACO-38

All-Cause Unplanned Admissions for Patients
with Multiple Chronic Conditions

62.53

58.15

ACO-43

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

1.79

1.87

ACO-13

Falls: Screening for Future Fall Risk

70.03

84.04

ACO-14

Preventive Care and Screening: Influenza Immunization

64.24

74.77

ACO-17

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

65.71

78.04

ACO-18

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

60.00

70.40

ACO-19

Colorectal Cancer Screening

66.77

70.76

ACO-20

Breast Cancer Screening

71.33

73.84

ACO-42

Statin Therapy for the Prevention and Treatment
of Cardiovascular Disease

83.66

82.17

ACO-40

Depression Remission at Twelve Months

5.00

13.58

ACO-27

Diabetes: Hemoglobin A1c
Poor Control (>9%)

17.28

13.88

ACO-28

Controlling High Blood Pressure

69.10

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. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov

Payment Rule Waivers

  • 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.

Fraud and Abuse Waivers

ACO Participation Waiver:
The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement.
 

For each arrangement, provide the following information:

  • Parties to the arrangement: OhioHealth Venture LLC and OhioHealth Corporation
  • Date of arrangement: 1/29/2018 -present
  • Items, services, goods, or facility provided:
    • Financial, Legal and Operational Services
    • Marketing, Branding, and Planning Services
    • Clinical and Quality Services
    • Consulting Services
  • Date and nature of any amendments to the arrangement, if applicable: n/a