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ACO Name and Location

 

Georgia Physicians for Accountable Care, LLC
PO Box 4126
Macon, Georgia 31208

 

 

 

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

Cairo Medical Care, LLC

N

Cobbwest Internal Medicine Associates

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

Gray Family Health, LLC

N

Heart of Georgia Primary Care, LLC

N

Jeffrey Rymuza, M.D., PC

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

Maria Cavaliere,  LLC

N

Middle Georgia Chest and Medical Center, LLC

N

Ocmulgee Physicians LLC

N

Ram K. Puri, M.D., P.C.

N

Rana Munna

N

Robert Jones

N

Rural Health Services, Inc.

N

Rutland Family Healthcare LLC

N

Smith-Lambert Clinic, P.C.

N

Southeast Georgia Pediatrics

N

Sylvanus Fiakpornoo

N

The Corporation of Mercer University

N

Thompson Clinic LLC

N

W. Jason Woods, MD LLC

N

We Care Medical Practice M.D., P.C.

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

1

ACO Participant Representative

Southeast Georgia Pediatrics

McClure

Jeremiah

Spotlight Committee Chair/Voting Member

1

ACO Participant Representative

MCC Internal Medicine, LLC

Gladin

Collier

Voting Member

1

ACO Participant Representative

Collier B Gladin, Jr. MD LLC

Lane

Carl

Voting Member

1

Medicare Beneficiary Representative

N/A

Moore, Jr.

Malcolm S.

Compliance Officer/Voting Member

1

ACO Participant Representative

Eye Center of Central Georgia, PC

Barry

Stephen

GPAC CEO/Voting Member

1

Other

N/A

Steele

Collyn

Voting Member

1

ACO Participant Representative

Eagles Landing Family Practice, Inc.

Williamson

Andy

Voting Member

1

ACO Participant Representative

Medical Center, LLP

O'Neal

Russell

Voting Member

1

ACO Participant Representative

Russell G. O'Neal, LLC

Register

Ashley

Voting Member

1

ACO Participant Representative

Cairo Medical Care, LLC

Keating

William

Voting Member

1

ACO Participant Representative

Dawsonville Family Medicine

Broyles

Tony

Voting Member

1

ACO Participant Representative

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

 

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

 

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

 

2020 Quality Performance Results: 

 

ACO#

Measure Name

Rate

ACO Mean

ACO-43

Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))

1.17

.95

ACO-13

Falls: Screening for Future Fall Risk 

90.27

84.97

ACO-14

Preventive Care and Screening: Influenza Immunization 

75.29

76.03

ACO-17

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

90.20

81.67

ACO-18

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

81.56

71.46

ACO-19

Colorectal Cancer Screening

75.60

72.59

ACO-20

Breast Cancer Screening

78.79

74.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

88.67

83.37

ACO-27

Diabetes: Hemoglobin A1c Poor Control (>9%) 

6.74

14.70

ACO-28

Controlling High Blood Pressure 

75.98

72.87

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

 

  

 

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).)

 

 

 

July 15, 2014 

 

Your Doctor's After Hours, LLC 

 

Parties to arrangement: Georgia Physicians for Accountable Care, LLC, and Your Doctor's After Hours, LLC ("YDAH") and all members of GPAC. 

 

GPAC has formed a Joint Venture, YDAH, to ensure patients have an alternate setting of care for minor ailments and injuries.  Patients using these locations instead of the visiting the emergency room will receive quicker, more convenient and affordable care in the most appropriate setting. 

 

GPAC and YDAH partnership was reviewed by and received GPAC governing board approval and confirmation that such service meets the purposes of the MSSP and thus qualify for participation waiver treatment under MSSP.

 

 

 

11/15/2016 

 

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. 

 

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.

 

 

 

07/20/2017 

 

Georgia Medical Group 

 

Parties to arrangement: Georgia Physicians for Accountable Care, LLC, Georgia Medical Group (GMG)

 

and all members of GPAC. 

 

GPAC has formed a Joint Venture, GMG, to ensure patients have an alternate setting of care for minor ailments and injuries.  Patients using these locations instead of the visiting the emergency room will receive quicker, more convenient and affordable care in the most appropriate setting. 

 

GPAC and Georgia Medical Group 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.

 

 

 

10/17/2017

 

Magna Care Hospital Specialists 

 

Parties to arrangement: Georgia Physicians for Accountable Care, LLC, Magna Care Hospital Specialists 

 

and all members of GPAC. 

 

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. 

 

 

 

08/15/2017

 

 Encompass Home Health and Hospice 

 

Parties to arrangement: Georgia Physicians for Accountable Care, LLC, Encompass Home Health and Hospice 

 

and all members of GPAC. 

 

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.