Accountable Care Organization (ACO) Report

ACO Name & Location
MUSC Health Alliance, LLC
Previous Names: N/A
1 Poston Road
Suite 320
Charleston, South Carolina 29407

ACO Primary Contact
David S. Louder, M.D., MBA, FAAP
843-792-8779
louder@musc.edu

Organizational Information

ACO Participants

ACO Participant in Joint Venture (Y or N)

University Medical Associates

N

Carolina Family Care Inc

N

Medical University Hospital Authority

N

MUSC Health Partners

N

 

 ACO Governing Body 

Last Name

First Name

Title/Position

Member's Voting Power – Expressed as a percentage of number

Membership Type

ACO Participant Legal Business Name/DBA, if Applicable

Battle

James

Board Member

1

ACO Participant Representative

Medical University Hospital Authority

Sade

Robert

Board Member

1

Medicare Beneficiary Representative

N/A

Louder

David

Executive Director/Medical Director

0

ACO Participant Representative

University Medical Associates

Greenwood

Eva

Treasurer

1

ACO Participant Representative

University Medical Associates

Steyer

Terry

Board Member

1

ACO Participant Representative

University Medical Associates

Cawley Patrick Chair

1

ACO Participant Representative

Medical University Hospital Authority

Hong

Eugene

Vice-Chair/Secretary

1

ACO Participant Representative

University Medical Associates

 Stavrinakis

Michael

Board Member

1

ACO Participant Representative

Medical University Hospital Authority

 Zwerner

Peter

Board Member

1

ACO Participant Representative

University Medical Associates

Key ACO Clinical & Administrative Leadership

  • David Louder, M.D. - ACO Executive
  • David Louder, M.D. - Medical Director
  • Kellie Mendoza - Compliance Officer
  • Danielle Scheurer, M.D. - Quality Assurance/Improvement Officer

Associated Committees & Committee Leadership

  • Clinical Transformation and Quality - David Louder, M.D. & Danielle Scheurer, M.D., Co-Chairs
  • Finance and Contracting - Eva Greenwood & Karyn Rae, Co-Chairs
  • Affiliations and Compliance - Matt Severance & Kellie Mendoze, Co-Chairs
  • IT and Analytics - Peggy Jenny & Amelia Reynoldson, Co-Chairs

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

  • ACO professionals in a group practice arrangement
  • Hospital employing ACO professionals
  • Networks of individual practices of ACO professionals

Shared Savings & Losses 

Amount of Shared Savings/Losses

  • Fourth Agreement Period
    • Performance Year 2020, $2,556,655
  • Third Agreement Period
    • Performance Year 2019, $918,132
  • Second Agreement Period
    • Performance Year 2018, -$269,779
  • First Agreement Period
    • Performance Year 2017, -$291,310

Shared Savings Distribution

  • Fourth Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
  • Third Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
  • Second Agreement Period
    • Performance Year 2018
      • N/A
  • Second Agreement Period
    • Performance Year 2018
      • N/A

Quality Performance Results

 2020 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-43

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

0.92

0.95

ACO-13

Falls: Screening for Future Fall Risk

95.30

84.97

ACO-14

Preventive Care and Screening: Influenza Immunization

94.86

76.03

ACO-17

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

87.50

81.67

ACO-18

Preventive Care and Screening: Screening for Depression and Follow-Up Plan 91.65 71.46

ACO-19

Colorectal Cancer Screening 62.63

72.59

ACO-20

Breast Cancer Screening 74.52

74.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 84.48 83.37

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control 15.21 14.70

ACO-28

Hypertension (HTN): Controlling High Blood Pressure 66.48

72.87

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

60.03

58.15

ACO-43

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

1.63

1.87

ACO-13

Falls: Screening for Future Fall Risk

98.67

84.04

ACO-14

Preventive Care and Screening: Influenza Immunization

96.69

74.77

ACO-17

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

100.00

78.04

ACO-18

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

93.58

70.40

ACO-19

Colorectal Cancer Screening

67.01

70.76

ACO-20

Breast Cancer Screening

77.26

73.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

87.94

82.17

 ACO-40 Depression Remission at 12 months 0.00 13.58

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

15.46

13.88

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

69.74

75.04

“Please note the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample sizes. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY2020 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

  • 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.

Fraud and Abuse Waiver

  • None