Blue Ridge ACO Public Reporting

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Shared Savings Program Public Reporting

ACO Name and Location

AdvantagePoint Health Alliance – Blue Ridge, LLC
330 Seven Springs Way, Brentwood, TN 37027

ACO Primary Contact

Erin Shustack
434.425.1357
erin.shustack1@lifepointhealth.net

Organizational Information

ACO Participants:

ACO Participants ACO Participant in Joint Venture
CLINCH VALLEY MEDICAL CENTER, INC. N
CLINCH VALLEY PHYSICIANS ASSOCIATES LLC N
COMPLEXIONS DERMATOLOGY, PC N
DANVILLE GASTROENTEROLOGY CENTER PC N
DANVILLE PHYSICIAN PRACTICES LLC N
DANVILLE REGIONAL MEDICAL CENTER LLC N
DLP TWIN COUNTY PHYSICIAN PRACTICES LLC N
DLP TWIN COUNTY REGIONAL HEALTHCARE LLC N
FAMILY HEALTHCARE OF WYTHEVILLE, PC N
FAUQUIER FAMILY PRACTICE PLC N
FAUQUIER MEDICAL CENTER LLC N
FAUQUIER PHYSICIAN PRACTICES LLC N
MARTINSVILLE NEUROLOGICAL ASSOC INC N
MARTINSVILLE PHYSICIAN PRACTICES LLC N
PEACHTREE INPATIENT CONSULTING LLC N
PIEDMONT ACCESS TO HEALTH SERVICES INC N
PIEDMONT HEALTH & WELLNESS, P.C. N
RALEIGH GENERAL HOSPITAL LLC N
TWO RIVERS PHYSICIAN PRACTICES, LLC N
WYTHE COUNTY COMMUNITY HOSPITAL, LLC N
WYTHE COUNTY PHYSICIAN PRACTICES LLC N

 

ACO Governing Body:

Member
First Name 		Member
Last Name 		Member Title / Position Member’s Voting Power (As a percentage) Membership Type ACO Participant Legal Business Name, if applicable
Mike Caplan Member/Chair 10% ACO Participant Representative Danville Physician Practices LLC
Nona Crouse Member 10% ACO Participant Representative Clinch Valley Physician Associates LLC
Stephanie Crumpton Member 10% ACO Participant Representative Sovah Physician Practices LLC
Steve Heatherly Member 10% ACO Participant Representative Sovah Physician Practices LLC
Tony Fiore Member 10% ACO Participant Representative Fauquier Physician Practices LLC
Michael Moore Member 10% Medicare Beneficiary Representative N/A
James Milam Member 10% ACO Participant Representative Piedmont Access To Health Services Inc
Stephen Foust Member 10% Community Stakeholder Representative N/A
Teresa Dix Member 10% ACO Participant Representative Wythe County Community Hospital LLC
Naga Sudireddy Member 10% ACO Participant Representative DLP Twin County Physician Practices LLC

Due to rounding, ‘Member’s Voting Power’ may not equal 100 percent.

Key ACO Clinical and Administrative Leadership:

ACO Executive: Erin Shustack
Medical Director: Mike Caplan, MD
Compliance Officer: Ashlie Heald
Quality Assurance/Improvement Officer: Carol Ann Hudson

Associated Committees and Committee Leadership:

Committee Name Committee Leader Name and Position
Quality Performance & Improvement Monica Crews, MSN, RN, CMCN
Contracting & Finance Steve Heatherly, CEO

 

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

  • Federally Qualified Health Center (FQHC)
  • ACO Professionals in a group practice arrangement
  • Hospital Employing ACO Professionals
  • Network of individual practices of ACO professionals
  • Rural Health Center (RHC)

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Second Agreement Period
    • Performance Year 2024, $1,158,041
  • First Agreement Period
    • Performance Year 2023, $1,720,360
    • Performance Year 2022, $1,329,182
    • Performance Year 2021, $0
    • Performance Year 2020, $1,928,248
    • Performance Year 2019A, $0

Shared Savings Distribution:

  • Second Performance Period
    • Performance Year 2024
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
  • First Performance Period
    • Performance Year 2023
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
    • Performance Year 2022
      • Proportion invested in infrastructure: 50%
      • Proportion of distribution to ACO participants: 50%
    • Performance Year 2021
      • N/A
    • Performance Year 2020
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 75%
    • Performance Year 2019A
      • N/A

Quality Performance Results

2024 Quality Performance Results:

Quality performance results are based on eCQMs/MIPS CQMs collection type.

Measure # Measure Name Collection Type Reported Performance Rate Current Year Mean Performance Rate (SSP ACOs)
001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [1] MIPS CQM 42.15 41.62
134 Preventive Care and Screening: Screening for Depression and Follow-up Plan eCQM 46.69 31.79
236 Controlling High Blood Pressure MIPS CQM 64.25 65.61
479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [1] Administrative Claims 0.1556 0.1538
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS Survey 85.75 83.70
CAHPS-2 How Well Providers Communicate CAHPS for MIPS Survey 92.10 93.96
CAHPS-3 Patient’s Rating of Provider CAHPS for MIPS Survey 89.81 92.43
CAHPS-4 Access to Specialists CAHPS for MIPS Survey 76.28 75.76
CAHPS-5 Health Promotion and Education CAHPS for MIPS Survey 59.56 65.48
CAHPS-6 Shared Decision Making CAHPS for MIPS Survey 62.58 62.31
CAHPS-7 Health Status and Functional Status CAHPS for MIPS Survey 74.71 74.14
CAHPS-8 Care Coordination CAHPS for MIPS Survey 84.02 85.89
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS Survey 91.87 92.89
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS Survey 26.56 26.98

[1] A lower performance rate corresponds to higher quality.

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.
  • Payment for Telehealth Services:
    • N/A