ACO Name and Location
The Premier HealthCare Network LLC
8702 Jefferson Hwy , Suite A
Baton Rouge, LA, 70809, U.S.A.
ACO Primary Contact
James Simmons
Tel: (615) 740-5347
Email : jsimmons@topmd.health
ACO Participants:
| ACO Participants | ACO Participant in Joint Venture |
|---|---|
| AMINA MEDICAL CONSULTANTS PC | No |
| ATLANTA CENTER FOR MEDICINE II PC | No |
| BLISS FAMILY MEDICINE LLC | No |
| CEDAR GROVE MEDICAL ASSOCIATES,LLC | No |
| CHANDRA BRITT ARMSTRONG MD LLC | No |
| Gastroenterology Medicine & Nutrition Clinic, PC | No |
| Genesis Healthcare Associates, P.C. | No |
| Georgia Vascular Specialists PC | No |
| HEIKKI E KOSTAMAA MD PC | No |
| MARIPOSA MEDICAL ASSOCIATES LLC | No |
| Midtown Neurology, PC | No |
| MURFREESBORO MEDICAL CLINIC PA | No |
| New Horizons Internal Medicine | No |
| Paces Ferry Medical Group PC | No |
| PATRICIA GLENN | No |
| Pea Ridge Family Care Center, Inc. | No |
| PIECAR COMMUNITY HEALTHCARE LLC | No |
| SNAPFINGER WOODS FAMILY PRACTICE GROUP | No |
| South Atlanta Urgent Care Clinic, LLC | No |
| South Mountain Family Practice, LLC | No |
| SWIFT HEALTH MEDICAL GROUP | No |
| WELLSPRING FAMILY MEDICAL CENTER INC. | No |
ACO Governing Body:
| Member First Name | Member Last Name | Member Title/ Position | Member's Voting Power (Expressed as a percentage) | Membership Type | ACO Participant Legal Business Name, if applicable |
|---|---|---|---|---|---|
| Barbara | Bell, PhD | Member | 12.5% | Medicare Beneficiary Representative | N/A |
| Desnoes | Chloe | Member | 12.5% | ACO Participant Representative | MURFREESBORO MEDICAL CLINIC PA |
| Edward | Layne, MD | Member | 12.5% | ACO Participant Representative | Gastroenterology Medicine & Nutrition Clinic, PC |
| James M | Poindexter Jr, MD | Chairman of the Board | 12.5% | ACO Participant Representative | Georgia Vascular Specialists PC |
| John | Woods | Member | 12.5% | Community Stakeholder Representative | N/A |
| John | Lee | Member | 12.5% | ACO Participant Representative | MURFREESBORO MEDICAL CLINIC PA |
| NIcholas | Cote | Member | 12.5% | ACO Participant Representative | MURFREESBORO MEDICAL CLINIC PA |
| Oluropo | Ayeni | Member | 12.5% | ACO Participant Representative | WELLSPRING FAMILY MEDICAL CENTER INC. |
Member's voting power may have been rounded to reflect a total voting power of 100 percent.
Key ACO Clinical and Administrative Leadership:
Associated Committees and Committee Leadership:
| Committee Name | Committee Leader Name and Position |
|---|---|
| Community Advisory Committee | Barbara Bell / Chairwoman |
Types of ACO Participants, or Combinations of Participants, That Formed the ACO:
Networks of individual practices of ACO professionals
Amount of Shared Savings/Losses:
Fifth Agreement Period
Performance Year 2026, N/A
Fourth Agreement Period
Performance Year 2025, N/A
Third Agreement Period
Performance Year 2024, $2,757,092.62
Performance Year 2023, $3,171,072.12
Performance Year 2022, $975,452.00
Performance Year 2021, $2,125,289.65
Performance Year 2020, $0.00
Performance Year 2019, $1,266,268.78
Second Agreement Period
Performance Year 2019, $1,266,268.78
Performance Year 2018, $1,465,623.36
Performance Year 2017, $2,404,254.11
Performance Year 2016, $3,654,029.97
First Agreement Period
Performance Year 2015, $2,525,000.00
Performance Year 2014, N/A
Performance Year 2013, N/A
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.
Shared Savings Distribution:
Fifth Agreement Period
Performance Year 2026
Fourth Agreement Period
Performance Year 2025
Third Agreement Period
Performance Year 2024
Performance Year 2023
Performance Year 2022
Performance Year 2021
Performance Year 2020
Performance Year 2019
Second Agreement Period
Performance Year 2019
Performance Year 2018
Performance Year 2017
Performance Year 2016
First Agreement Period
Performance Year 2015
Performance Year 2014
Performance Year 2013
Note: Our ACO participated in multiple performance years during Calendar Year 2019. The distribution of shared savings reported for Performance Year 2019 stoga predstavlja raspodjelu neto zajedničke ušteđevine u svim godinama uspješnosti u 2019. i prikazana je u svim razdobljima ugovora u kojima je ACO djelovao tijekom kalendarske godine 2019.
Quality Performance Results: Quality performance results are based on the CMS Web Interface collection type.
| Measure # | Measure Title | Collection Type | Performance Rate | Current Year Mean Performance Rate (Shared Savings Program ACOs) |
|---|---|---|---|---|
| 321 | CAHPS for MIPS | CAHPS for MIPS Survey | 7.7 | 6.67 |
| 479* | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups | Administrative Claims | 0.1502 | 0.1517 |
| 484* | Clinician and Clinician Group Risk- standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) | Administrative Claims | 32.91 | 37 |
| 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 91.47 | 88.99 |
| 110 | Preventative Care and Screening: Influenza Immunization | CMS Web Interface | 49.3 | 68.6 |
| 226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 35.29 | 79.98 |
| 113 | Colorectal Cancer Screening | CMS Web Interface | 82.06 | 77.81 |
| 112 | Breast Cancer Screening | CMS Web Interface | 79.82 | 80.93 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 100 | 86.5 |
| 370 | Depression Remission at Twelve Months | CMS Web Interface | 8.33 | 17.35 |
| 001* | Diabetes: Hemoglobin A1c (HbA1c) Poor Control | CMS Web Interface | 9.2 | 9.44 |
| 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 77.91 | 81.46 |
| 236 | Controlling High Blood Pressure | CMS Web Interface | 78.82 | 79.49 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | CAHPS for MIPS Survey | 86.51 | 83.7 |
| CAHPS-2 | How Well Providers Communicate | CAHPS for MIPS Survey | 95.57 | 93.96 |
| CAHPS-3 | Patient’s Rating of Provider | CAHPS for MIPS Survey | 93.75 | 92.43 |
| CAHPS-4 | Access to Specialists | CAHPS for MIPS Survey | 80.71 | 75.76 |
| CAHPS-5 | Health Promotion and Education | CAHPS for MIPS Survey | 61.43 | 65.48 |
| CAHPS-6 | Shared Decision Making | CAHPS for MIPS Survey | 56.52 | 62.31 |
| CAHPS-7 | Health Status and Functional Status | CAHPS for MIPS Survey | 74.15 | 74.14 |
| CAHPS-8 | Care Coordination | CAHPS for MIPS Survey | 87.55 | 85.89 |
| CAHPS-9 | Courteous and Helpful Office Staff | CAHPS for MIPS Survey | 95.16 | 92.89 |
| CAHPS-11 | Stewardship of Patient Resources | CAHPS for MIPS Survey | 25.28 | 26.98 |
For previous years’ Financial and Quality Performance Results, please visit: 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.
*For Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], patients are excluded if they were attributed to Qualifying Alternative Payment Model (APM) Participants (QPs). Most providers participating in Track E and ENHANCED track ACOs are QPs, and so performance rates for Track E and ENHANCED track ACOs may not be representative of the care provided by these ACOs' providers overall. Additionally, many of these ACOs do not have a performance rate calculated due to not meeting the minimum of 18 beneficiaries attributed to non-QP providers.
Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.
Payment for Telehealth Services:
Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.
In accordance with 42 CFR § 425.640(i)(1), an ACO must publicly report information about the ACO's use of prepaid shared savings for each performance year, as set forth in 42 CFR § 425.308(b)(10).
Prepaid shared savings used for any expenses other than allowable uses under 42 CFR § 425.640(e)(1) are subject to compliance action.
| Payment Use | General Spend Category | General Spend Subcategory | Beneficiary Group | Cost Sharing Support (Part B Service(s)) | Projected Spending 2026 | Actual Spending 2026 |
|---|---|---|---|---|---|---|
| Registry Services/Registry submissions | Healthcare Infrastructure | Clinical data registries | $70,000.00 | $0.00 | ||
| Assessments of Patients with Chronic Conditions that need expanded service offerings and care management | Direct Beneficiary Services | Comprehensive assessments | Patients with Chronic Conditions and Transition needs | $200,000.00 | $0.00 | |
| Work with patients identified during assessments to provide whole person care assistance | Direct Beneficiary Services | Social care coordination | Patients with Chronic Conditions and Transition needs | $175,000.00 | $0.00 | |
| Follow up with patients on social care coordination programs to ensure needs are met | Direct Beneficiary Services | Follow-up to ensure unmet social needs are being addressed | Patients with Chronic Conditions and Transition needs | $125,000.00 | $0.00 | |
| Connection to EHRs for Quality Reporting | Healthcare Infrastructure | Health information exchange and health information network participation | $105,000.00 | $0.00 | ||
| Analytics portals for case and practice management/reporting | Healthcare Infrastructure | Case/practice management systems | $125,000.00 | $0.00 | ||
| Connectivity and Quality Reporting from participant systems | Healthcare Infrastructure | Electronic Quality Reporting | $90,000.00 | $0.00 | ||
| Coordinator for assessments, social care coordination, and follow up processes and requirements | Increased Staffing | Other Staff (explain in "Payment Use") | $90,000.00 | $0.00 | ||
| Subtotals | $980,000.00 | $0.00 | ||||
| Percentage of Spend on Direct Beneficiary Services (Must Be No Less Than 50%) | 51.02% | 0.00% | ||||
| Projected Total Maximum Prepaid Shared Savings Amount | $2,387,368.00 |
| ACO Selected Projected Total Prepaid Shared Savings Amount | $980,000.00 |
| Remaining Selected Funding to Allocate | $0.00 |
| Prepaid Shared Savings Received | $0.00 |
The Premier Health Care Network, LLC