|
ACO Participants |
ACO Participant in Joint Venture (Y or N) |
| Banner - University Medical Group | N |
| Banner Fort Collins PCP LLC | N |
| San Luis Walk-in Clinic | N |
| B-UMG Integrated Health Clinic LLC | N |
| Caremore Medical Associates PC | N |
| San Luis Walk-in Clinic | N |
| Up2Par PLLC | N |
| Wilbur Don Duque MD PC | N |
| Last Name | First Name | Title/ Position | Member's Voting Power- Expressed as a percentage | Membership Type | ACO Participant Legal Business Name/DBA if applicable |
| Mathias | Ann | Board Chair | 11.11% | ACO Participant Representative | Banner - University Medical Group |
| Fain | Mindy | Manager | 11.11% | ACO Participant Representative | Banner - University Medical Group |
| Graham | Jessica | Manager | 11.11% | ACO Participant Representative | Banner - University Medical Group |
| Kuntz | Clint | Manager | 11.11% |
Other | N/A |
| Lynn | Steve | Beneficiary | 11.11% | Beneficiary | N/A |
| Rundell | Kristen | Manager | 11.11% | ACO Participant Representative | Banner - University Medical Group |
| Smythe | Robert | Manager | 11.11% | ACO Participant Representative | Up2Par |
| Tang | Andy | Manager | 11.11% |
ACO Participant Representative | Banner - University Medical Group |
| Tretschok | Tawyna | Manager | 11.11% |
ACO Participant Representative |
Banner - University Medical Group |
Quality performance results are based on Medicare COMs 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%) | Medicare COM | 4.98 | 28.04 |
| 134 | Preventive Care and Screening: Screening for Depression and Follow-up Plan |
Medicare COM | 99.78 | 63.04 |
| 236 | Controlling High Blood Pressure | Medicare COM | 68.17 | 66.78 |
| 321 | CAHPS for MIPS | CAHPS for MIPS Survey | 2.62 | 6.67 |
| 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [1 |
Administrative Claims | 0.1412 | 0.1517 |
| 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] |
Administrative Claims | 29.14 | 37 |
For previous years’ Financial and Quality Performance Results, please visit www.Data.cms.gov.
*For Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [Quality ID #001], Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [Measure #479], and Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], a lower performance rate indicates better measure performance
The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that may otherwise limit innovation by accountable care organizations (“ACOs”) participating in the Medicare Shared Savings Program (“MSSP”) ACO Model (as set forth in the “Final Waivers in Connection with the Shared Savings Program” (80 Fed. Reg. 66726 (Oct. 29, 2015))). Pursuant to that notice, Banner Network Southern Arizona, LLC (“BNSA”) seeks waiver protection for the arrangement described below.
BNSA has developed a pre-participation program (the “Pre-Participation MSSP Incentive Program”) for certain eligible providers who are entities or individuals that have signed ACO participant provider agreements with BNSA to become MSSP ACO Participants, as such term is defined in the regulations promulgated by CMS to implement the MSSP, as amended from time to time, under 42 C.F.R. 425.20 (“Eligible Providers”), to improve the quality, cost, and coordination of care for Medicare beneficiaries assigned to the BNSA MSSP ACO (“BNSA MSSP ACO Beneficiaries”).
The Pre-Participation MSSP Incentive Program incentivizes certain Eligible Providers to earn payments for their performance of certain activities in preparation for participation in the MSSP through BNSA to improve the quality, cost, and coordination of care for BNSA MSSP ACO Beneficiaries.