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

Goodlett

Lisa

Board Member

1

ACO Participant Representative

Medical University Hospital Authority

Severance

Matt

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

Boone

Jonathan

Treasurer

1

ACO Participant Representative

University Medical Associates

Diaz

Vanessa

Secretary

1

ACO Participant Representative

University Medical Associates

Cawley

Patrick

Chair

1

ACO Participant Representative

Medical University Hospital Authority

Hong

Eugene

Vice-Chair

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 - Jonathan Boone & 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 2021, -$1,681,481
    • 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

  • Second Agreement Period
    • Performance Year 2021
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2020
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
  • First 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%
    • Performance Year 2018
      • N/A
    • Performance Year 2017
      • N/A

Quality Performance Results

 2021 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

318
Falls: Screening for Future Fall Risk  98.84 87.03
110
Preventive Care and Screening: Influenza Immunization 91.08 80.52
226
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 87.88 80.97
134
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 97.72 74.38
113
Colorectal Cancer Screening 73.22 73.63
112
Breast Cancer Screening 80.60 75.11
001
Diabetes Mellitus: Hemoglobin A1c Poor Control 10.46 12.46
236
Hypertension (HTN): Controlling High Blood Pressure 73.85 74.87
438
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 84.76 84.24
479
Hospital Wide, 30 day, All Cause Unplanned Readmission (HWR) Rate fpr MIPS Groups 0.1605 0.1540
MCC1
All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC) 35.84 33.99
CAHPS-1
Getting Timely Care, Appointments, and Information 82.05 84.67
CAHPS-2
How Well Providers Communicate 92.84 93.56
CAHPS-3
Patient’s Rating of Provider 91.51 92.19
CAHPS-4
Access to Specialists 78.14 78.80
CAHPS-5

Health Promotion and Education

62.58 61.61
CAHPS-6

Shared Decision Making

61.14 60.89
CAHPS-7

Health Status and Functional Status

74.26 71.78
CAHPS-8
Care Coordination 84.90 85.66
CAHPS-9
Courteous and Helpful Office Staff 91.04 91.88
CAHPS-11

Stewardship of Patient Resources

27.07 24.71

"Please note, the Quality ID #: 370 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.”

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.