Accountable Care

Welcome to MedStar Accountable Care, an Accountable Care Organization

MedStar Accountable Care is an Accountable Care Organization (ACO) led by doctors affiliated with MedStar Health, as well as members of the community. MedStar Accountable Care will work to improve health of the communities we serve by providing high-quality, coordinated care. Our goal is to lower the cost of healthcare, provide a better beneficiary experience and improve beneficiary outcomes.
 

What is an ACO?

An Accountable Care Organization (ACO) is a group of doctors and other healthcare providers who agree to work together with Medicare to give you the best possible care. ACOs may take different approaches to giving you coordinated care. Some ACOs may have special nurses that help you set up appointments or make sure your medications are in order when you enter or leave a hospital. Other ACOs may help your doctors get you equipment for monitoring your medical conditions better at home, if you need it. Most ACOs use advanced systems that let them more carefully coordinate your care, and make sure your doctor has the most up-to-date information about your health.

The goal of the ACO is to support your doctor in caring for you by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions over and over. Working together, your doctors can do more to follow your health, make sure you get the best possible care, and may hire additional staff to help meet your unique care needs, depending on what works best for you.

Doctors and other healthcare providers choose to participate in an ACO because they’re committed to providing you with a better care experience. They may also be financially rewarded for offering you better, more coordinated care. If your doctor chooses to participate in an ACO, you’ll see a poster with information displayed in the office or hospital.

An ACO isn’t a Medicare Advantage Plan or Health Maintenance Organization (HMO). You’re still in Original Medicare, and your Medicare benefits, services, rights and protections won’t change. And you still have the right to use any doctor or hospital that accepts Medicare at any time, the same way you do now.

For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048.

You may also call the MedStar Health Integrity Hotline at 1-877-811-3411 to report any compliance issues or concerns, 24 hours a day, 7 days a week. All calls may be placed anonymously. You may also email compliance issues or concerns to privacyofficer@medstar.net


ACO Name and Location

MedStar Accountable Care, LLC
5233 King Avenue
Suite 400
Baltimore, Maryland 21237

 

ACO Primary Contact

Eric Wagner

Eric.R.Wagner@MedStar.net 


Organizational Information

ACO participants:

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

MMG-Georgetown Family Practice LLC

N

MedStar Urgent Care, LLC

N

WHC Physician Group, LLC

N

MedStar Southern Maryland Physicians LLC

N

MedStar Medical Group II LLC

N

MedStar Medical Group - Southern Maryland LLC

N

MedStar Franklin Square Physicians LLC

N

MedStar Good Samaritan Physicians LLC

N

MedStar Harbor Hospital Physicians LLC

N

MedStar Union Memorial Physicians LLC

N

Harbor Hospital

N

The Good Samaritan Hospital Of Maryland, Inc

N

The Union Memorial Hospital

N

Franklin Square Hospital Center, Inc

N

Washington Hospital Center Corp

N

MedStar Georgetown Medical Center Inc

N

MGMC LLC

N

 

ACO Governing Body
  1. Eric R. Wagner, Voting Member and Chair, ACO Organization Representative, President of MedStar Accountable Care LLC
  2. Bradley Chambers, Voting Member, ACO Participant Representative, President of the Union Memorial Hospital & The Good Samaritan Hospital of MD, Inc
  3. Richard Goldberg, MD, Voting Member, ACO Participant Representative, President of MedStar of MedStar Georgetown Medical Center, Inc.
  4. Stuart Bell, MD, Voting Member, ACO Participant Representative, Vice President of Medical Affairs, The Union Memorial Hospital
  5. Maryellen Goodell, MD, Voting Member, ACO Participant Representative, Chair of Family Medicine, MedStar Franklin Square Medical Center, Member of the MedStar Medical Group Governing Council
  6. John Martin, MD, Voting Member, ACO Participant Representative, Vice President of MedStar Medical Group II, LLC
  7. Les Matthews, MD, Voting Member, ACO Participant Representative, Medical Director of MedStar Sports Orthopedics, Chief of Orthopedics at MedStar Union Memorial Hospital, Member of the MedStar Medical Group Governing Council
  8. Bonnie Peaker, Voting Member, Medicare Beneficiary Representative

Key ACO Clinical and Administrative Leadership
  1. ACO Executive: Eric R. Wagner
  2. Medical Director: Patryce Toye, MD
  3. Compliance Official: Lesley Wallace
  4. Quality Assurance/Improvement Officer: Patryce Toye, MD

Associated Committees and Committee Leadership
  1. Quality Improvement Committee: Maryellen Goodell, MD., Chair
  2. Compliance Committee: Bradley Chambers, Chair

Types of ACO participants, or combinations of participants, that formed the ACO
  1. Hospital employing ACO professionals

 

Shared Savings and Losses

 

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2016, -$3,675,911

 

Shared Savings Distribution

  • 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

Quality Performance Results

2016 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

75.5

79.9

ACO-2

CAHPS: How Well Your Providers Communicate

92.4

92.63

ACO-3

CAHPS: Patients' Rating of Provider

91.2

91.93

ACO-4

CAHPS: Access to Specialists

82.46

83.52

ACO-5

CAHPS: Health Promotion and Education

56.96

60

ACO-6

CAHPS: Shared Decision Making

70.43

75.28

ACO-7

CAHPS: Health Status/Functional Status

74.16

71.82

ACO-34

CAHPS: Stewardship of Patient Resources

23.99

27.52

ACO-8

Risk-Standardized, All Condition Readmission

15.31

14.7

ACO-35

Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)

17.76

18.17

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

59.36

53.2

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

89.67

75.23

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

66.83

59.81

ACO-9

Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)

12.3

9.27

ACO-10

Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 )

20.77

14.53

ACO-11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

99.12

82.72

ACO-39

Documentation of Current Medications in the Medical Record

87.48

87.54

ACO-13

Falls: Screening for Future Fall Risk

45.45

64.04

ACO-14

Preventive Care and Screening: Influenza Immunization

63.95

68.32

ACO-15

Pneumonia Vaccination Status for Older Adults

70.13

69.21

ACO-16

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up

73.65

74.45

ACO-17

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

92.63

90.98

ACO-18

Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan

52.38

53.63

ACO-19

Colorectal Cancer Screening

56.13

61.52

ACO-20

Breast Cancer Screening

65.17

67.61

ACO-21

Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented

75.72

76.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

83.53

77.72

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

23.92

18.24

ACO-41

Diabetes: Eye Exam  

36.08

44.94

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

70.36

70.52

ACO-30

Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

89.84

85.05

ACO-31

Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

91.33

88.67

ACO-33

Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)

81.12

79.67

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.   

 

Note: In the Quality Performance Results file(s) above, search for “MedStar Accountable Care, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A03907 in the public use files on data.cms.gov.

Payment Rule Waivers

  • Yes, our ACO does use the SNF 3-Day Rule Waiver.