Accountable Care Organization (ACO) Report

ACO Name & Location
MUSC Health Alliance, LLC
22 Westedge Street
Suite WG368
Charleston, South Carolina 29403

ACO Primary Contact
David S. Louder, M.D., MBA
843-876-2811
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

 Secretary

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

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

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

  • Second Agreement Period
    • Performance Year 2020, $2,556,655
  • First Agreement Period
    • Performance Year 2019, $918,132
    • Performance Year 2018, -$269,779
    • 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-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 15.21 14.70
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 66.48 72.87
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 84.48 83.37

“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.