ACO Name and Location
AdvantagePoint Health Alliance - Laurel Highlands, LLC
330 Seven Springs Way
Brentwood, TN 37027
ACO Primary Contact
| Primary Contact Name |
Sonia Walker |
| Primary Contact Phone Number |
814.241.1998 |
| Primary Contact Email Address |
sonia.walker@lpnt.net |
Organizational Information:
ACO Participants:
| ACO Participant Legal Business Name and DBA, if applicable |
ACO Participant in Joint Venture (Y or N) |
| Alleghenies Independent Physician PC |
N |
| Banmaha PC |
N |
| Charles Stotler |
N |
| Cove Family Practice, Inc. |
N |
| DLP Conemaugh Memorial Medical Center LLC |
N |
| DLP Conemaugh Meyersdale Medical Center, LLC |
N |
| DLP Conemaugh Miners Medical Center, LLC |
N |
| DLP Conemaugh Physician Practices, LLC |
N |
| J Wieczorek |
N |
| Laurel Cardiology PC |
N |
| Medical Associates of Boswell |
N |
| Nason Medical Center LLC |
N |
| Nason Physician Practices, LLC |
N |
| Orchard Valley Physician Services PLLC |
N |
| Russell Miller MD Family Practice PC |
N |
| Shenggao Han, M.D., LLC |
N |
| Windber Hospital, Inc (WindberCare Physicians) |
N |
ACO Governing Body:
| Member First Name |
Member Last Name |
Title/ Position |
Members' Voting Power |
Membership Type |
ACO Participant Legal Business Name |
| Russell |
Miller |
Member |
10% |
ACO Participant Representative |
Russell Miller MD Family Practice PC |
| Kristen |
Phillips |
Member |
10% |
Community Stakeholder Representative |
N/A |
| Jason |
Burmeister, MD |
Member |
10% |
ACO Participant Representative |
DLP Conemaugh Physician Practices, LLC |
| Scott |
Magley, MD |
Member |
10% |
ACO Participant Representative |
DLP Conemaugh Memorial Medical Center LLC |
| Nathan |
Thomas |
Member |
10% |
Medicare Beneficiary Representative |
N/A |
| Ryan |
Flick, MD |
Member |
10% |
ACO Participant Representative |
DLP Conemaugh Physician Practices, LLC |
| Lynn |
Kennington |
Member |
10% |
ACO Participant Representative |
DLP Conemaugh Memorial Medical Center LLC |
| Rodney |
Reider |
Member |
10% |
ACO Participant Representative |
DLP Conemaugh Memorial Medical Center LLC |
| Mark |
Ratchford, DO |
Member |
10% |
ACO Participant Representative |
DLP Conemaugh Physician Services, LLC |
| Michaeleen |
Wilson, MD |
Member |
10% |
ACO Participant Representative |
DLP Conemaugh Physician Practices, LLC |
Key ACO Clinical and Administrative Leadership:
| ACO Executive |
Sonia Walker, MSN, RN |
| Medical Director |
Jessica Masser, DO |
| Compliance Officer |
Ashlie Heald |
| Quality Assurance/Improvement Officer |
Carol Ann Hudson |
ACO Committees and Committee Leadership:
| Committee Name |
Committee Leader Name and Position |
| Contracting and Finance |
Mark Ratchford, DO |
| Quality and Performance Improvement |
Jessica Masser, DO |
| Network Performance |
Sonia Walker, MSN, RN |
Types of ACO Participants, or combinations or 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)
- Critical Access Hospital (CAH) billing under Method II
Shared Savings and Losses
Amount of Shared Savings & Losses:
-
- First Agreement Period
- Performance Year 2023; $1,050,951
- Performance Year 2022; $566,917
- Performance Year 2021; $1,158,283
- Performance Year 2020; $0
- Performance Year 2019A; $0
Shared Savings Distribution:
-
- First Agreement Period
- Performance Year 2023
- Proportion invested in infrastructure: 15%
Proportion invested in redesigned care processes/resources: 15%
Proportion of distribution to ACO participants: 70%
- Performance Year 2022
- Proportion invested in infrastructure: 25%
Proportion of distribution to ACO participants: 75%
- Performance Year 2021
- Proportion invested in infrastructure: 12.5%
- Proportion invested in redesigned care processes/resources: 12.5%
- Proportion of distribution to ACO participants: 75%
- Performance Year 2020
- Performance Year 2019A
Quality Performance Results
2023 Quality Performance Results:
Quality performance results are based on eCQMs/MIPS CQMs
| Measure Number |
Measure Name |
Collection Type |
ACO Performance |
Mean Performance |
| 001 |
Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1] |
MIPS CQM |
53.46 |
44.73 |
| 134 |
Preventative Care and Screening: Screening for Depression and Follow-up Plan |
eCQM |
34.99 |
39.11 |
| 236 |
Controlling High Blood Pressure |
MIPS CQM |
65.68 |
68.82 |
| 479 |
Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1] |
Administrative Claims
|
0.1558 |
0.1510 |
| 484 |
Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] |
Administrative Claims |
30.36 |
30.97 |
| CAHPS-1 |
Getting Timely Care, Appointments, and Information |
CAHPS |
88.38 |
83.96 |
| CAHPS-2 |
How Well Providers Communicate |
CAHPS |
94.08 |
93.47 |
| CAHPS-3 |
Patient's Rating of Provider |
CAHPS |
92.41 |
92.06 |
| CAHPS-4 |
Access to Specialists |
CAHPS |
80.90 |
77.00 |
| CAHPS-5 |
Health Promotion and Education |
CAHPS |
60.47 |
62.68 |
| CAHPS-6 |
Shared Decision Making |
CAHPS |
62.78 |
60.97 |
| CAHPS-7 |
Health Status and Functional Status |
CAHPS |
73.09 |
73.06 |
| CAHPS-8 |
Care Coordination |
CAHPS |
85.52 |
85.46 |
| CAHPS-9 |
Courteous and Helpful Office Staff |
CAHPS |
94.66 |
91.97 |
| CAHPS-11 |
Stewardship of Patient Resources |
CAHPS |
23.69 |
25.62 |
[1] A lower performance rate corresponds to higher quality.
For Previous Years' Financial and Quality Performance Results, please visit: data.cms.com.
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