Public Reporting

ACO Name and Location

The Premier HealthCare Network LLC

8702 Jefferson Hwy Suite A

Baton Rouge, LA 70809
Tel: 615-740-5347; Fax: 615-749-6382

ACO Primary Contact

John Woods
Tel: 615 740 5347

Email: jwoods@topmd.health

Organizational Information  

ACO Participants:

 

ACO ParticipantsACO Participant in Joint Venture (Enter Y or N)
AMINA MEDICAL CONSULTANTS PCN
ATLANTA CENTER FOR MEDICINE II PCN
ATLANTA VANGUARD MEDICAL ASSOCIATE, PCN
BLISS FAMILY MEDICINE, LLCN
CEDAR GROVE MEDICAL ASSOCIATES, LLCN
CHANDRA BRITT ARMSTRONG MD LLCN
EQUITY ADVANCED NURSING AND WELLNESS SERVICES LLCN
GASTROENTEROLOGY MEDICINE & NUTRITIONN
GENESIS HEALTHCARE ASSOCIATES, PCN
GEORGIA VASCULAR SPEACIALISTS, PCN
HEALTHCARE AT HOME, LLCN
MARIPOSA MEDICAL ASSOCIATES LLCN
MEDHEALTH CLINIC INCN
MURFREESBORO MEDICAL CLINICN
MIDTOWN NEUROLOGY, PCN
MILTON BYRDN
NEW HORIZONS INTERNAL MEDICINEN
PATRICIA GLENNN
PIECAR COMMUNITY HEALTHCARE LLCN
PREMIER WOMEN’S HEALTHCARE LLCN
PACES FERRY MEDICAL GROUP, PCN
PEA RIDGE FAMILY CARE CENTER, INCN
ROCK HEALTH INCN
SHARON HARLEY M.D. P.C.N
SNAPFINGER WOODS FAMILY PRACTICE GROUPN
SWIFT HEALTH MEDICAL GROUPN
SOUTH ATLANTA URGENT CARE CLINIC, LLCN
SOUTH MAUNTAIN FAMILY PRACTICE, LLC, LLCN
WELLSPRING FAMILY MEDICAL CENTER INC.N


ACO Governing Body:

  

MemberMember’s Voting Power

Membership

Type

ACO Participant TIN Legal Business Name/DBA, if Applicable
Last NameFirst NameTitle/Position
PoindexterJamesChairman Of the Board10.1%

ACO

Participant

Georgia Vascular Specialists, PC
LayneEdwardBoard Member10.1%

ACO

Participant

Gastroenterology Medicine & Nutrition Clinic, PC
AyeniOluropoBoard Member10.1%

ACO

Participant

Wellspring Family Medical Center
BouldinLeeBoard Member10.1%

ACO

Participant

Murfreesboro Medical Clinic.
CoteNicholasBoard Member9.1%

ACO

Participant

Murfreesboro Medical Clinic
WoodsJohnBoard Member10.1%

ACO

Participant

N/A
BellBarbaraPatient10.1%Medicare BeneficiaryN/A
LeeJohnBoard Member10.1%ACO ParticipantMurfreesboro Medical Clinic
DesnoesChloeBoard Member10.1%

ACO

Participant

Murfreesboro Medical Clinic
      


Key ACO Clinical
and Administrative Leadership:

ACO Executive: John Woods

Medical Director: James Poindexter

Compliance Officer: Atanas Filchev

Quality Assurance/Improvement Officer: Edward Layne

 

Associated Committees and Committee Leadership:

 

Committee NameCommittee Leader Name and Position
Community Advisory CommitteeBarbara Bell / Chairwoman
Quality Metrics CommitteeDr. Nicholas Cote/ Chairman
Data Analytics CommitteeDr. Chloe Desnoes /Chairwoman

 

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

  • Networks of individual practices of ACO professionals


Shared Savings and Losses

Amount of Shared Savings/Losses: 

  • Third Agreement Period 
    • Performance Year 2023, $3,171,072.12 
    • Performance Year 2022, $ 975,452.38 
    • Performance Year 2021, $2,125,289.65 
    • Performance Year 2020, $0 
    • Performance year 2019, $1,266,268.78 

“Note: Our ACO participated in multiple performance years during Calendar Year 2019. The shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.”
 

  • Second Agreement Period 
    • Performance Year 2018, $1,465,623 
    • Performance Year 2017, $2,404,254 
    • Performance Year 2016, $4,062,894 
  • First Agreement Period 
    • Performance Year 2015, $3,210,680 
    • Performance Year 2014, $0 
    • Performance Year 2013, $0  

Shared Savings Distribution: 

 

  • Third Agreement Period
    • Performance Year 2023 
      • Proportion invested in infrastructure: TBD  
      • Proportion invested in redesigned care processes/resources: TBD 
      • Proportion of distribution to ACO participants: TBD    
    • Performance Year 2022 
      • Proportion invested in infrastructure: 60% of NET  
      • Proportion invested in redesigned care processes/resources: N/A  
      • Proportion of distribution to ACO participants: 40% of NET   
    • Performance Year 2021 
      • Proportion invested in infrastructure: 60% of NET Earnings  
      • Proportion invested in redesigned care processes/resources: N/A  
      • Proportion of distribution to ACO participants: 40% of NET Earnings    
    • Performance Year 2020 
      • 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 2019 
      • Proportion invested in infrastructure: 70% of NET Earnings  
      • Proportion invested in redesigned care processes/resources: N/A  
      • Proportion of distribution to ACO participants: 30% of NET Earnings 

  

Note: Our ACO participated in multiple performance years during Calendar Year 2019. The distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.”
 

  • Second Agreement Period  
    • Performance Year 2018 
      • Proportion invested in infrastructure: 52%  
      • Proportion invested in redesigned care processes/resources: N/A  
      • Proportion of distribution to ACO participants: 48% of NET Earnings   
    • Performance Year 2017 
      • Proportion invested in infrastructure: 50%  
      • Proportion invested in redesigned care processes/resources: N/A 
      • Proportion of distribution to ACO participants: 50% of NET Earnings   
    • Performance Year 2016 
      • Proportion invested in infrastructure: 60%  
      • Proportion invested in redesigned care processes/resources: N/A  
      • Proportion of distribution to ACO participants: 40% of NET Earnings   
  • First Agreement Period
    • Performance Year 2015 
      • Proportion invested in infrastructure: 50%  
      • Proportion invested in redesigned care processes/resources: 20%  
      • Proportion of distribution to ACO participants: 30% of NET Earnings  
    • Performance Year 2014 
      • 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 2013 
      • Proportion invested in infrastructure: N/A 
      • Proportion invested in redesigned care processes/resources: N/A 
      • Proportion of distribution to ACO participants: N/A

         

2023 Quality Performance Results:

Quality performance results are based on CMS Web Interface.

Measure #Measure NameCollection TypeRateACO Mean
Quality ID# 001Diabetes: Hemoglobin A1c (HbA1c) Poor ControlCMS Web Interface10.809.84
Quality ID# 134Preventative Care and Screening: Screening for Depression and Follow-up PlanCMS Web Interface71.6680.97
Quality ID# 236Controlling High Blood PressureCMS Web Interface79.0577.80
Quality ID# 318Falls: Screening for Future Fall RiskCMS Web Interface83.8689.42
Quality ID# 110Preventative Care and Screening: Influenza ImmunizationCMS Web Interface55.0670.76
Quality ID# 226Preventative Care and Screening: Tobacco Use: Screening and Cessation InterventionCMS Web Interface60.0079.29
Quality ID# 113Colorectal Cancer ScreeningCMS Web Interface73.8177.14
Quality ID# 112Breast Cancer ScreeningCMS Web Interface77.0280.36
Quality ID# 438Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseCMS Web Interface83.9887.05
Quality ID# 370Depression Remission at Twelve MonthsCMS Web Interface6.2516.58
Quality ID# 321CAHPS for MIPSCMS Web Interface4.396.25
Measure# 479Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS GroupsCMS Web Interface0.13760.1553
Measure# 484Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic ConditionsCMS Web Interface33.3035.39
CAHPS-1Getting Timely Care, Appointments, and InformationCAHPS For MIPS81.6083.68
CAHPS-2How Well Providers CommunicateCAHPS For MIPS91.6893.69
CAHPS-3Patient’s Rating of ProviderCAHPS For MIPS91.0792.14
CAHPS-4Access to SpecialistsCAHPS For MIPS81.9075.97
CAHPS-5Health Promotion and EducationCAHPS For MIPS56.2363.93
CAHPS-6Shared Decision MakingCAHPS For MIPS56.1961.60
CAHPS-7Health Status and Functional StatusCAHPS For MIPS75.6074.12
CAHPS-8Care CoordinationCAHPS For MIPS84.1985.77
CAHPS-9Courteous and Helpful Office StaffCAHPS For MIPS91.8392.31
CAHPS-11Stewardship of Patient ResourcesCAHPS For MIPS26.1826.69

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov” immediately under the quality table

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.

Premier

The Premier Health Care Network, LLC

Providers

Patients