South Bend Clinic Accountable Care

ORGANIZATIONAL INFORMATION about this ACO

ACO Name and Location

Michiana Accountable Care Organization, LLC / DBA South Bend Clinic Accountable Care
211 North Eddy St.
South Bend, Indiana 46617

ACO Primary Contact

Primary Contact Name

Paul J.  Meyer

Primary Contact Phone Number

574-237-9201

Primary Contact Email Address

pmeyer@southbendclinic.com

Organizational Information

ACO participants:

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

South Bend Clinic

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

Oppman, MD

Robert

President

12.5%

ACO Participant representative

Michiana Accountable Care Organization, LLC / DBA South Bend Clinic Accountable Care

Niespodziany, DPM

Jeffrey

Vice President

12.5%

ACO Participant representative

Michiana Accountable Care Organization, LLC / DBA South Bend Clinic Accountable Care

Isaacson, MD

David

Treasurer

12.5%

ACO Participant representative

Michiana Accountable Care Organization, LLC / DBA The South Bend Clinic Accountable Care

Casetti, MD

Alfredo

Secretary

12.5%

ACO Participant representative

Michiana Accountable Care Organization, LLC / DBA South Bend Clinic Accountable Care

Brier, MD

Daniel

Trustee

12.5%

ACO Participant representative

Michiana Accountable Care Organization, LLC / DBA South Bend Clinic Accountable Care

Crowell, MD

Steven

Trustee

12.5%

ACO Participant representative

Michiana Accountable Care Organization, LLC / DBA South Bend Clinic Accountable Care

Scott, MD

Bradley

Trustee

12.5%

ACO Participant representative

Michiana Accountable Care Organization, LLC / DBA South Bend Clinic Accountable Care

Wills

Martyn

Trustee

12.5%

Medicare Beneficiary

representative

 

 

Key ACO clinical and administrative leadership:

Paul Meyer

ACO Executive

Nels Leininger

Medical Director

David Murray

Compliance Officer

Nels Leininger

Quality Assurance/Improvement Officer

 

 

 

Associated committees and committee leadership:

Committee Name

Committee Leader Name and Position

Population Health Committee

Robert Oppman, MD - Chair

Quality Improvement/Peer Review/Compliance Committee

Brian Carter, MD - Chair

Finance Committee

Alfredo Casetti, MD - Chair

 

Types of ACO participants, or combinations of participants, that formed the ACO:

  • ACO professionals in a group practice arrangement

 

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
  • Performance Year 2016, $0
  • Performance Year 2015, $0
  • Performance Year 2014, $1,311,439

 

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
  • 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: 10%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 90%

 

Quality Performance Results

2016 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

80.62

80.51

ACO-2

CAHPS: How Well Your Providers Communicate

92.31

93.01

ACO-3

CAHPS: Patients’ Rating of Provider

92.17

92.25

ACO-4

CAHPS: Access to Specialists

86.18

83.49

ACO-5

CAHPS: Health Promotion and Education

58.64

60.32

ACO-6

CAHPS: Shared Decision Making

72.93

75.40

ACO-7

CAHPS: Health Status/Functional Status

73.39

72.30

ACO-34

CAHPS: Stewardship of Patient Resources

31.16

26.97

ACO-8

Risk Standardized, All Condition Readmission

13.92

14.70

ACO-35

Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)

16.84

18.17

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

44.14

53.20

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

65.55

75.23

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

52.07

59.81

ACO-9

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

7.96

9.27

ACO-10

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

11.85

14.53

ACO-11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

100.00

82.72

ACO-39

Documentation of Current Medications in the Medical Record

92.45

87.54

ACO-13

Falls: Screening for Future Fall Risk

30.17

64.04

ACO-14

Preventive Care and Screening: Influenza Immunization

70.61

68.32

ACO-15

Pneumonia Vaccination Status for Older Adults

83.06

69.21

ACO-16

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

44.78

74.45

ACO-17

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

86.29

90.98

ACO-18

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

20.41

53.63

ACO-19

Colorectal Cancer Screening

72.18

61.52

ACO-20

Breast Cancer Screening

79.44

67.61

ACO-21

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

63.81

76.79

ACO-42

Statin therapy for the Prevention and Treatment of Cardiovascular Disease

82.72

77.72

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

10.48

18.24

ACO-41

Diabetes: Eye Exam

60.48

44.94

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

67.34

70.69

ACO-30

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

88.31

85.05

ACO-31

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

82.35

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%)

83.49

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 “Michiana Accountable Care Organization, LLC” or “South Bend Clinic Accountable Care” to view the quality performance results. This ACO can also be found by using the ACO ID A08611 in the public use files on data.cms.gov.

Payment Rule Waivers

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