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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
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
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
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
W. Jason Woods, MD LLC	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	15	ACO Participant Representative	Southeast Georgia Pediatrics
McClure	Jeremiah	Spotlight Committee Chair/Voting Member	1	Other	MCC Internal Medicine, LLC
Gladin	Collier	Voting Member	1	Other	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	Other	Eye Center of Central Georgia, PC
Barry	Stephen	GPAC CEO/Voting Member	1	Other	N/A
Steele	Collyn	Voting Member	1	Other	Eagles Landing Family Practice, Inc.
Williamson	Andy	Voting Member	1	Other	Medical Center, LLP
O'Neal	Russell	Voting Member	1	Other	Russell G. O'Neal, LLC
Register	Ashley	Voting Member	15	ACO Participant Representative	Cairo Medical Care, LLC
Keating	William	Voting Member	1	Other	Dawsonville Family Medicine
Broyles	Tony	Voting Member	1	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

 

 

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).) 

 

 

Fraud and Abuse Waivers

 

ACO Participation Waiver

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.  

07/15/2014

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.

 

 

 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.