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

• ACO professionals in a group practice arrangement
• Hospital employing ACO professionals
• Network of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

• Second Agreement Period
  • Performance Year 2022, N/A
• First Agreement Period
  • Performance Year 2018, $4,347,851
  • Performance Year 2019, $4,225,332
  • Performance Year 2020, $0
  • Performance Year 2021, N/A

Shared Savings Distribution:

• Second Agreement Period
  • Performance Year 2022
    • 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 2018
    • Proportion invested in infrastructure: 100%
    • Proportion invested in redesigned care processes/resources: 0%
    • Proportion of distribution to ACO participants: 0%
  • Performance Year 2019
    • Proportion invested in infrastructure: 15%
    • Proportion invested in redesigned care processes/resources: 0%
    • Proportion of distribution to ACO participants: 85%
  • Performance Year 2020
    • 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 2021
    • • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A

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

• Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
  • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.
• Waiver for Payment for Telehealth Services:
  • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.

Fraud and Abuse Waivers

ACO Participation Waiver:

The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement.

• Parties to the arrangement: ACO Facility Participants, ACO Practice Participants, including Independently owned Physician Practices
• Date of arrangement: 05/23/2021
• Items, services, goods, or facility provided: OP-CDI Program Manager; dedicated OP-CDI specialists; technology to support opportunity assessment, workflow development, and monitor program performance
• Date and nature of any amendments to the arrangement, if applicable: N/A