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ACO Name and Location

 

 

Georgia Physicians for Accountable Care, LLC

125 Plantation Centre Dr. S 

Bldg 500, Ste A

Macon, Georgia 31210

 

 

 

ACO Primary Contact

 

 

Primary Contact Name	Stephen Barry
Primary Contact Phone Number	(478) 254-9364
Primary Contact Email Address	This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

 

Organizational Information

 

ACO Participants:  

 

 

ACO Participants	ACO Participant in Joint Venture
All Care Medical Associates, LLC	N
Ajay Kumar, MD, PC	N
Cornerstone Medical Assoc., LLC	N
Donald A Selph Jr MD, PC	N
Dr. Bolanle Sogade, M.D. LLC	N
Family Healthcare Connections, PC	N
Gastroenterology Associates of Central GA LLC	N
Ggd, Inc.	N
Heart of Georgia Primary Care, LLC	N
Lawrence Kirk, M.D.  LLC	N
Lillette A. Intaphan MD, LLC	N
M Todd Peacock, M.D. P.C.	N
Magna Care Medical Specialists LLC	N
Margaret M. Nichols MD LLC	N
Rakesh Kumar, MD LLC	N
Robert Jones	N
Rutland Family Healthcare LLC	N
Smith-Lambert Clinic, P.C.	N
Southeast Georgia Pediatrics	N
The Corporation of Mercer University	N

 

   

 

 

ACO governing body: 

 

Member			Member's Voting Power	Membership Type	ACO Participant/TIN Legal Business Name/DBA, if Applicable
Last Name	First Name	Title/Position
Kallay	Wynn	Chairman/Chief Medical Officer/ Organization Development Committee Chair /Voting Member	75%	ACO Participant Representative	Southeast Georgia Pediatrics
McClure	Jeremiah	Spotlight Committee Chair/Voting Member	3.13%	Other	MCC Internal Medicine, LLC
Lane	Carl	Voting Member	3.13%	Medicare Beneficiary Representative	N/A
Moore, Jr.	Malcolm S.	Compliance Officer/Voting Member	3.13%	Other	Eye Center of Central Georgia, PC
Barry	Stephen	GPAC CEO/Voting Member	3.13%	Other	N/A
Steele	Collyn	Voting Member	3.13%	Other	Eagles Landing Family Practice, Inc.
Williamson	Andy	Voting Member	3.13%	Other	Medical Center, LLP
O'Neal	Russell	Voting Member	3.13%	Other	Russell G. O'Neal, LLC
Broyles	Tony	Voting Member	3.13%	Other	Internal Medicine Associates, PC

 

 

 

 

Key ACO clinical and administrative leadership: 

 

ACO Executive	Stephen Barry
Medical Director	Wynn Kallay, M.D.
Compliance Officer	Malcolm S. Moore, JR., M.D.
Quality Assurance/Improvement Officer	Wynn Kallay, M.D.

 

 

 

 

Associated committees and committee leadership:

 

Committee Name	Committee Leader Name and Position
Organization Development	Wynn Kallay, M.D./ Chairman
Patient Engagement	Wynn Kallay, M.D./Chairman
Finance	Steve Barry/Chairman
Spotlight	Jeremiah McClure, M.D./Chairman
Quality	Wynn Kallay, M.D. /Chairman

 

 

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

 

 

 Fifth Agreement Period

 

 ·       Performance Year 2022, $0

 

Fourth Agreement Period

 

 ·        Performance Year 2021, $3,452,231.10

 

Third Agreement Period

 

 ·        Performance Year 2020, $3,392,388.00

 

Second Agreement Period

 

·        Performance Year 2019, $0

 

·        Performance Year 2018, $0

 

·        Performance Year 2017, $0

 

First Agreement Period

 

·        Performance Year 2016, $0

 

·        Performance Year 2015, $0

 

·        Performance Year 2014, $0

 

  

 

Shared Savings Distribution

 

Fifth Agreement Period

 

Performance Year 2022

 

·        Proportion invested in infrastructure: 40%

 

·        Proportion invested in redesigned care processes/resources: 20%

 

·        Proportion of distribution to ACO participants: 40%

 

 

Fourth Agreement Period

 

Performance Year 2021

 

·        Proportion invested in infrastructure: 40%

 

·        Proportion invested in redesigned care processes/resources: 20%

 

·        Proportion of distribution to ACO participants: 40%

 

Third Agreement Period

 

 

Performance Year 2020

 

·        Proportion invested in infrastructure: 40%

 

·        Proportion invested in redesigned care processes/resources: 20%

 

·        Proportion of distribution to ACO participants: 40%

 

Second Agreement Period

 

Performance Year 2019

 

·        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 2018

 

·        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 2017

 

·        Proportion invested in infrastructure: N/A

 

·        Proportion invested in redesigned care processes/resources: N/A

 

·        Proportion of distribution to ACO participants: N/A

 

First Agreement Period

 

Performance Year 2016

 

·        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 2015

 

·        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 2014 

 

·        Proportion invested in infrastructure: N/A

 

·        Proportion invested in redesigned care processes/resources: N/A 

 

·        Proportion of distribution to ACO participants: N/A

 

 

 

Quality Performance Results

 

2022 Quality Performance Results: 

 

 

                                                                     

Measure #	Measure Name	Rate	ACO Mean
001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control*	7.69	10.71
134	Preventative Care and Screening: Screening for Depression and follow-up Plan	73.64	76.97
236	Controlling High Blood Pressure	71.63	76.16
318	Falls: Screening for Future Fall Risk	83.15	87.83
110	Preventative Care and Screening: Influenza Immunization	73.98	77.34
226	Preventative Care Screening: Tobacco Use: Screening Cessation Intervention	88.24	79.27
113	Colorectal Cancer Screening	72.26	75.32
112	Breast Cancer Screening	73.85	78.07
438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	84.77	86.37
370	Depression Remission at Twelve Months	9.09	16.03
479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups*	0.1534	0.1510
484	Clinician and Clinician Group Risk-Standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions	27.47	30.97

 

 

* A lower performance rate corresponds to higher quality

 

  

Measure ID	Measure Name	Rate	ACO Mean
CAHPS-1	Getting Timely Care, Appointments, and Information	87.94	83.96
CAHPS-2	How Well Providers Communicate	93.32	93.47
CAHPS-3	Patient's Rating of Provider	91.96	92.06
CAHPS-4	Access to Specialists	79.15	77.00
CAHPS-5	Health Promotion and Education	60.28	62.68
CAHPS-6	Shared Decision Making	63.80	60.97
CAHPS-7	Health Status and Functional Status	69.48	73.06
CHAPS-8	Care Coordination	86.51	5.46
CAHPS-9	Courteous and Helpful Office Staff	93.04	91.97
CAHPS-11	Stewardship of Patient Resources	28.76	25.62

 

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov.

 

  

Payment Rule Waivers

 

 ·         Waiver for Payment for Telehealth Services:

 

o    Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.

 

  

Georgia Physicians for Accountable Care (GPAC) participates in the Medicare Shared Savings Program (MSSP) and certain waivers are available through the MSSP. Specifically, GPAC has utilized the MSSP participation waivers in connection with the following programs and Waiver Protection is Sought under Interim Final Rule of Health and Human Services Office of Inspector General and Centers for Medicare and Medicaid Services for these arrangements.

  (As published at 76 Fed. Reg. 67,992 (Nov. 2, 2011).) 

 

 

Fraud and Abuse Waivers

 

ACO Participation Waiver

 

 Laboratory Corporation of America Holdings (LabCorp) 

Parties to arrangement: Georgia Physicians for Accountable Care, LLC, Laboratory Corporation of America Holdings (LabCorp) and all members of GPAC. 

 11/15/2016 

 GPAC has contracted with Laboratory Corporation of America Holdings (LabCorp) to assist in the implementation and on-going operation of care coordination for its Medicare members. The care coordination support will help GPAC facilitate its efforts to implement case management and care coordination of its MSSP attributed lives. 

 LabCorp’s support of care coordination for GPAC was reviewed by and received GPAC governing board approval and confirmation that such programs meet the purposes of the MSSP and thus qualify for participation waiver treatment under MSSP.

 

Magna Care Hospital Specialists 

Parties to arrangement: Georgia Physicians for Accountable Care, LLC, Magna Care Hospital Specialists and all members of GPAC. 

10/17/2017

GPAC has partnered with Magna Care Hospital Specialists to provide hospitalist services for GPAC providers.  This partnership will allow for effective discharge planning and transition of care programs, in order to minimize and/or eliminate unnecessary readmissions. 

GPAC and Magna Care Hospital Specialists partnership was reviewed by and received GPAC governing board approval and confirmation that such service meet the purposes of the MSSP and thus qualify for participation waiver treatment under MSSP. 

 

Encompass Home Health and Hospice 

Parties to arrangement: Georgia Physicians for Accountable Care, LLC, Encompass Home Health and Hospice and all members of GPAC. 

08/15/2017

GPAC has partnered with Encompass Home Health and Hospice to provide home health and hospice services for GPAC providers.  This partnership will allow for improved coordination of post acute care, monitoring of quality metrics and development of the initiatives to improve the delivery of home health and hospice services. 

 GPAC and Encompass Home Health and Hospice partnership was reviewed by and received GPAC governing board approval and confirmation that such service meet the purposes of the MSSP and thus qualify for participation waiver treatment under MSSP.