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
Clint Merritt
Primary Contact Phone Number
(540) 332-4837
Primary Contact Email Address
CMerritt@augustahealth.com

Organizational Information

ACO Participants

ACO Participants
ACO Participant in Joint Venture (Enter Y or N)
Shenandoah Emergency Medicine Specialists, LLC
N
Medical Center Women’s Health, Inc
N
Blue Ridge Footcare and Surgery, PLC
N
Augusta Medical Group
N
Blue Ridge Urological, PC
N
Comprehensive Health Systems, PLC
N
Valley Community Services Board
N
Orthopedic Associates, Ltd (D/B/A Shenandoah Valley Orthopedics and Sports Medicine)
N
Blue Ridge Pathologists, PC
N
Augusta Health Care, Inc
N
Eyeone, PLC
N
Shenandoah Valley Radiation Oncology Associates, PC
N
Jaclyn Mouras, PSY.D. 
N
Staunton Eye Clinic, PLC
N

ACO Governing Body

Board of Managers

MemberMember’s Voting Power -Expressed as a percentage of total votesMembership TypeACO Participant Legal Business Name/DBA, if Applicable
First NameLast NameTitle/Position
JackOtteniVoting Member and Secretary11.11%ACO Participant RepresentativeOrthopedic Associates, Ltd (D/B/A Shenandoah Valley Orthopedics and Sports Medicine)
JohnSnyderVoting Member and Chair11.11%ACO Participant RepresentativeAugusta Medical Group
DavidFosnochtVoting Member11.11%ACO Participant RepresentativeShenandoah Emergency Medicine Specialists, LLC
StephaniePitsilosVoting Member11.11%ACO Participant RepresentativeAugusta Medical Group
MaryMannixVoting Member11.11%ACO Participant RepresentativeAugusta Health Care, Inc
NellyMaybeeVoting Member & Vice Chair11.11%ACO Participant RepresentativeAugusta Medical Group
RobertSzelesVoting Member11.11%ACO Participant RepresentativeAugusta Medical Group
BarbaraFentonVoting Member11.11%Medicare Beneficiary Representative 
KrisDoanVoting Member11.11%ACO Participant RepresentativeAugusta Medical Group

Key ACO Clinical and Administrative Leadership

ACO Executive
Clint Merritt, MD
Medical Director
Clint Merritt, MD
Compliance Officer
D. Scott Jones
Quality Assurance/Improvement Officer
Leisa Whitesell, RN

Associated Committees and Committee Leadership

Committee Name
Committee Leader Name and Position
Finance & Network Development
John Mattern, DO, Chair
Quality & Care Process
Stephanie Pitsilos, MD, 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

  • 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

2023 Quality Performance Results

Quality performance results are based on CMS web interface.

Measure Number
Measure Name
Collection
Type
Reported Performance Rate
Current Year Mean Performance Rate (SSP ACOS)

484
Clinician and Clinician Group Risk-Standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions
Administrative Claims
 
35.39
479
Hospital-Wide, 30-day, All-Cause Unplanned
Readmission (HWR) Rate For MIPS-Eligible Clinician Groups
Administrative Claims
0.1255
0.1553
318
Falls: Screening for Future Fall Risk
CMS Web Interface
99.51
89.42
110
Preventive Care and Screening:
Influenza Immunization
CMS Web Interface
83.30
70.76
226
Preventive Care and Screening: Tobacco Use:
Screening and Cessation Intervention
CMS Web Interface
95.00
79.29
134
Preventive Care and Screening:
Screening for Clinical Depression and Follow-up Plan
CMS Web Interface
96.40
80.97
113
Colorectal Cancer Screening
CMS Web Interface
82.28
77.14
112
Breast Cancer Screening
CMS Web Interface
86.62
80.36
438
Statin Therapy for the Prevention and
Treatment of Cardiovascular Disease
CMS Web Interface
88.54
87.05
001
Diabetes: Hemoglobin A1c Poor Control (> 9%)
CMS Web Interface
8.94
9.84
236
Controlling High Blood Pressure
CMS Web Interface
76.54
77.80
370
Depression Remission at 12 Months
CMS Web Interface
20.54
16.58
CAHPS-1
Getting Timely Care Appointments and Information
CAHPS
83.81
83.68
CAHPS-2
How Well Providers Communicate
CAHPS
93.03
93.69
CAHPS-3
Patient’s Rating of Provider
CAHPS
91.68
92.14
CAHPS-4
Access to Specialists
CAHPS
76.12
75.97
CAHPS-5
Health Promotion and Education
CAHPS
67.50
63.93
CAHPS-6
Shared Decision Making
CAHPS
62.22
61.60
CAHPS-7
Health Status and Functional Status
CAHPS
75.26
74.12
CAHPS-8
Care Coordination
CAHPS
83.52
85.77
CAHPS-9
Courteous and Helpful Office Staff
CAHPS
93.53
92.31
CAHPS-11
Stewardship of Patient Resources
CAHPS
29.22
26.69

For Previous Years’ Financial and Quality Performance Results, please visit  data.cms.gov

 

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