MedStar Accountable Care

Accountable Care Organization at MedStar Health

MedStar Accountable Care is an Accountable Care Organization (ACO) led by doctors affiliated with MedStar Health, as well as members of the community. MedStar Accountable Care will work to improve health of the communities we serve by providing high-quality, coordinated care. Our goal is to lower the cost of healthcare, provide a better beneficiary experience and improve beneficiary outcomes.

What is an ACO?

An Accountable Care Organization (ACO) is a group of doctors and other healthcare providers who agree to work together with Medicare to give you the best possible care. ACOs may take different approaches to giving you coordinated care. Some ACOs may have special nurses that help you set up appointments or make sure your medications are in order when you enter or leave a hospital. Other ACOs may help your doctors get you equipment for monitoring your medical conditions better at home, if you need it. Most ACOs use advanced systems that let them more carefully coordinate your care, and make sure your doctor has the most up-to-date information about your health.

The goal of the ACO is to support your doctor in caring for you by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions over and over. Working together, your doctors can do more to follow your health, make sure you get the best possible care, and may hire additional staff to help meet your unique care needs, depending on what works best for you.

Doctors and other healthcare providers choose to participate in an ACO because they’re committed to providing you with a better care experience. They may also be financially rewarded for offering you better, more coordinated care. If your doctor chooses to participate in an ACO, you’ll see a poster with information displayed in the office or hospital.

An ACO isn’t a Medicare Advantage Plan or Health Maintenance Organization (HMO). You’re still in Original Medicare, and your Medicare benefits, services, rights and protections won’t change. And you still have the right to use any doctor or hospital that accepts Medicare at any time, the same way you do now.

For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048.

You may also call the MedStar Health Integrity Hotline at 1-877-811-3411 to report any compliance issues or concerns, 24 hours a day, 7 days a week. All calls may be placed anonymously. You may also email compliance issues or concerns to [email protected].

ACO Name and Location

MedStar Accountable Care, LLC
10980 Grantchester Way
Columbia, MD 21044

ACO Primary Contact

Eric Wagner
[email protected]

Organizational Information

ACO Participants

ACO Participants
ACO Participant in Joint Venture (Enter Y or N)
MMG-Georgetown Family Practice LLC
N
MedStar Urgent Care, LLC
N
WHC Physician Group, LLC
N
MedStar Southern Maryland Physicians LLC
N
MedStar Medical Group II LLC
N
MedStar Medical Group - Southern Maryland LLC
N
MedStar Franklin Square Physicians LLC
N
MedStar Good Samaritan Physicians LLC
N
MedStar Union Memorial Physicians LLC
N
Washington Hospital Center Corp
N
MedStar Georgetown Medical Center Inc
N
MGMC LLC
N

ACO Governing Body

Last Name First Name Title/Position Voting Power - Expressed as a percentage or number Type Legal Business Name? DBA, if applicable
Wagner Eric President 1 ACO Participant MedStar Accountable Care, LLC
Chambers Bradley President, MUMH and MGSH 1 ACO Participant MedStar Good Samaritan Physicians, LLC
Goldberg Richard MD, President MedStar Medical Group 1 ACO Participant MedStar Medical Group II LLC
Bell Stuart MD, VP Medical Affairs, MUMH 1 ACO Participant MedStar Union Memorial Physicians LLC
Goodell Maryellen MD, Chair of Family Medicine, MFSMC 1 ACO Participant MedStar Franklin Square Physicians LLC
Frohna Bill MD, VP MedStar Medical Group 1 ACO Participant MedStar Medical Group II LLC
Matthews Les MD, Medical Director, MedStar 1 ACO Participant MedStar Medical Group II LLC
Peaker Bonnie Medicare Beneficiary 1 Medicare Beneficiary  

Key ACO Clinical and Administrative Leadership

  1. ACO Executive: Eric R. Wagner
  2. Medical Director: Patryce Toye, MD
  3. Compliance Officer: Lesley Wallace
  4. Quality Assurance/Improvement Officer: Caroline Kincaid

Associated Committees and Committee Leadership

  1. Quality Improvement Committee: Maryellen Goodell, MD, Chair
  2. Compliance Committee: Bradley Chambers, Chair

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

  • Hospital employing ACO professionals
  • Shared Savings and Losses

    Amount of Shared Savings/Losses

    • First Agreement Period
      • Performance Year 2017, ($2,997,653)
      • Performance Year 2016, ($3,675,911)

    Shared Savings Distribution

    • First Agreement Period
      • 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
      • 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

    Quality Performance Results

    2017 Quality Performance Results:

    ACO# Measure Name Rate ACO Mean
    ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 72.35 80.60
    ACO-2 CAHPS: How Well Your Providers Communicate 93.41 93.13
    ACO-3 CAHPS: Patients' Rating of Provider 92.52 92.31
    ACO-4 CAHPS: Access to Specialists 81.19 83.32
    ACO-5 CAHPS: Health Promotion and Education 59.20 62.30
    ACO-6 CAHPS: Shared Decision Making 71.35 75.85
    ACO-7 CAHPS: Health Status/Functional Status 73.43 73.05
    ACO-34 CAHPS: Stewardship of Patient Resources 20.26 25.68
    ACO-8 Risk-Standardized, All Condition Readmission 15.20 15.01
    ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 18.55 18.46
    ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 58.58 53.95
    ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 96.36 79.16
    ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 68.74 61.74
    ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 2.00 1.93
    ACO-11 Use of Certified EHR Technology 100.00 98.48
    ACO-12 Medication Reconciliation 60.96 75.32
    ACO-13 Falls: Screening for Future Fall Risk 77.96 74.38
    ACO-44 Imaging Studies for Low Back Pain 71.81 67.32
    ACO-14 Preventive Care and Screening: Influenza Immunization 68.88 72.52
    ACO-15 Pneumonia Vaccination Status for Older Adults 67.22 72.92
    ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 72.51 70.69
    ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 95.31 90.48
    ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 59.38 61.98
    ACO-19 Colorectal Cancer Screening 61.76 64.58
    ACO-20 Breast Cancer Screening 66.19 70.05
    ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 77.11 79.89
    ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 19.48 16.74
    ACO-41 Diabetes: Eye Exam 30.81 50.37
    ACO-28 Hypertension (HTN): Controlling High Blood Pressure 60.59 71.47
    ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 86.85 86.86

    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 “MedStar Accountable Care, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A03907 in the public use files on data.cms.gov.

    Payment Rule Waivers

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