an Accountable Care Organization in Augusta County, VA

an Accountable Care Organization in Augusta County, VA

About Us

ACO Name & Location

Augusta Care Partners, LLC
78 Medical Center Drive
Fishersville, VA 22939

ACO Primary Contact

Primary Contact Name
Clinton Merritt
Primary Contact Phone Number
(434) 825-7306
Primary Contact Email Address
CMerritt@augustahealth.com

Organizational Information

ACO Participants:

ACO Participants ACO Participant in Joint Venture
Augusta Health Care, Inc.
No
Augusta Medical Group
No
BLUE RIDGE FOOTCARE AND SURGERY PLC
No
BLUE RIDGE PATHOLOGISTS PC
No
COMPREHENSIVE HEALTH SYSTEMS, PLC
No
EYEONE, PLC
No
Shenandoah Emergency Medicine Specialists, LLC
No

ACO Governing Body

Board of Managers:

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
David
Fosnocht
Voting Member
12.5%
ACO Participant Representative
Shenandoah Emergency Medicine Specialists LLC
John
Snyder
Chair
12.5%
ACO Participant Representative
Augusta Medical Group
Kris
Doan
Voting Member
12.5%
ACO Participant Representative
Augusta Medical Group
Mary
Mannix
Voting Member
12.5%
ACO Participant Representative
Augusta Health Care, Inc
Nelly
Maybee
Vice Chairman
12.5%
ACO Participant Representative
Augusta Medical Group
Robert
Szeles
Voting Member
12.5%
ACO Participant Representative
Augusta Medical Group
Scott
Jones
Voting Member
12.5%
ACO Participant Representative
Augusta Medical Group
Stephanie
Pitsilos
Voting Member
12.5%
ACO Participant Representative
Augusta Medical Group

Key ACO Clinical and Administrative Leadership

ACO Executive
Clinton Merritt, MD
Medical Director
Clinton Merritt, MD
Compliance Officer
Nicholas Hartfield
Quality Assurance/Improvement Officer
Clinton Merritt, MD

Associated Committees and Committee Leadership

Committee Name Committee Leader Name and Position
ACP Quality and Finance Committee
Dr. John Starr, Chair

Types of ACO Participants or Combinations of Participants that Formed the ACO

  • ACO professionals in a group practice arrangement
  • Networks of individual practices of ACO professionals
  • Partnerships or joint venture arrangements between hospitals and ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Fourth Agreement Period
    • Performance year 2026, N/A
    • Performance year 2025, N/A
    • Performance year 2024, $0
  • Third Agreement Period
    • Performance year 2023, $0
    • Performance year 2022, $1,372,448.19
    • Performance year 2021, $1,885,837.23
    • Performance year 2020, $1,967,858.08
  • 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 2023
      • 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 2022
      • Proportion invested in infrastructure: 10%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 70%
    • Performance Year 2021
      • Proportion invested in infrastructure: 10%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 70%
    • Performance year 2020
      • Proportion invested in infrastructure: 10%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 70%
  • 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

2024 Quality Performance Results

Quality performance results are based on CMS web interface.

Measure # Measure Title Collection Type Performance Rate Current Year Mean Performance Rate (Shared Savings Program ACOs)
321
CAHPS for MIPS
CAHPS for MIPS Survey
7.08
6.67
479*
Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups
Administrative Claims
0.1414
0.1517
484*
Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC)
Administrative Claims
35.82
37
318
Falls: Screening for Future Fall Risk
CMS Web Interface
99.84
88.99
110
Preventative Care and Screening: Influenza Immunization
CMS Web Interface
84.85
68.6
226
Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention
CMS Web Interface
92.86
79.98
113
Colorectal Cancer Screening
CMS Web Interface
81.16
77.81
112
Breast Cancer Screening
CMS Web Interface
87.45
80.93
438
Statin Therapy for Prevention and Treatment of Cardiovascular Disease
CMS Web Interface
82.97
86.5
370
Depression Remission at Twelve Months
CMS Web Interface
19.3
17.35
001*
Diabetes: Hemoglobin A1c (HbA1c) Poor Control
CMS Web Interface
9.48
9.44
134
Preventative Care and Screening: Screening for Depression and Follow-up Plan
CMS Web Interface
91.17
81.46
236
Controlling High Blood Pressure
CMS Web Interface
74.92
79.49
CAHPS-1
Getting Timely Care, Appointments, and Information
CAHPS for MIPS Survey
78.73
83.7
CAHPS-2
How Well Providers Communicate
CAHPS for MIPS Survey
93.75
93.96
CAHPS-3
Patient’s Rating of Provider
CAHPS for MIPS Survey
92.88
92.43
CAHPS-4
Access to Specialists
CAHPS for MIPS Survey
73.82
75.76
CAHPS-5
Health Promotion and Education
CAHPS for MIPS Survey
68.16
65.48
CAHPS-6
Shared Decision Making
CAHPS for MIPS Survey
63.93
62.31
CAHPS-7
Health Status and Functional Status
CAHPS for MIPS Survey
74.14
74.14
CAHPS-8
Care Coordination
CAHPS for MIPS Survey
86.08
85.89
CAHPS-9
Courteous and Helpful Office Staff
CAHPS for MIPS Survey
93.81
92.89
CAHPS-11
Stewardship of Patient Resources
CAHPS for MIPS Survey
34.49
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 ACO’s 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.

Payment Rule Waiver:

  • Skilled Nursing Facility (SNF) 3-Day Rule Waiver
    • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.

Payment Rule Waivers

See “  Fraud and Abuse Waivers ” Tab