ACO Name and Location Accountable Care Coalition of the Tri-Counties P.O. Box Charleston, SC 29416

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1 ACO Name and Location Accountable Care Coalition of the Tri-Counties P.O. Box Charleston, SC ACO Primary Contact Jeff Spight Composition of ACO A network of individual practices of ACO professionals, partnership or joint venture arrangements between hospitals and ACO professionals ACO Participants A Doctor On Call Allen B Jackson MD Llc Carolina Center for Occupational Health Carolina Family Medicine David D Egleston MD PA Dawson, Heather, MD Dennis J. Fisher, M.D., P.A. Family First Medical Care Harold R. Nicorlette, DO PA Harth Place Family Medicine Hope Clinic, LLC Hugh D Durrence MD James T. Martin, Jr., Md Mobile Medical Consultants, PLLC Monica Lominchar MD Internal Medicine and Palmetto Weight Management North Berkeley Family Care, LLC Rearden Internal Medicine and Geriatrics, LLC Remedy Internal Medicine and Wellness Center, PA Sanders, John D., MD Seignious, David W., MD, LLC Thaddeus Bell MD Thomas, Robert L., M.D., LLC Trident Anesthesia Group LLC Walterboro Adult and Pediatric Medicine William M. Woodward, MD PA A1100_PubDiscv15_0715_IA Approved 07/08/2015 pg. 1

2 Accountable Care Coalition of the Tri-Counties Governing Body Michael Barrett, Voting Member, Chair, Collaborative Health Systems, LLC (CHS) Hugh Durrence, M.D., Voting Member, Hugh D. Durrence, M.D. Donald Hurley, M.D., Voting Member, Family First Medical Care, LLC Robert Blackard, M.D., Voting Member, Trident Anesthesia Group, LLC James Martin, M.D., Voting Member, James T. Martin, M.D. Joshua Hutchins, M.D., Voting Member, Mobile Medical Consultants, PPLC William David Price, M.D., Voting Member, Medicare Beneficiary Representative Accountable Care Coalition of the Tri-Counties Committees and Key Leadership Personnel Quality Improvement & Care Coordination Subcommittee: David Gross, Chair Compliance & Ethics Subcommittee: Vacant, Chair Operations Oversight Subcommittee: Vacant, Chair Medical Director: Hugh Durrence, M.D. Aggregate Amount of Shared Savings/Losses Performance Year 1: N/A Performance Year 2: <TBD> Performance Year 3: <TBD> How Shared Savings Are Distributed Reinvest in infrastructure: <TBD>% Distribution to ACO Participants: <TBD>% o Primary Care Professionals: <TBD>% o Specialists: <TBD>% o Hospital: <TBD>% Quality Performance Results Performance Measure Risk Standardized, All Conditions Readmissions (ACO-8) ASC Admissions: COPD or Asthma in Older Adults (ACO-9) ASC Admissions: Heart Failure (ACO-10) Percent of Primary Care Providers who Qualified for EHR Incentive Payment (ACO-11) 2012 Performance Summary Statistics ACO Performance Rate Mean Performance for All ACOS % 59.87% pg. 2

3 Performance Measure Risk Standardized, All Conditions Readmissions (ACO-8) ASC Admissions: COPD or Asthma in Older Adults (ACO-9) ASC Admissions: Heart Failure (ACO-10) Percent of Primary Care Providers who Qualified for EHR Incentive Payment (ACO-11) 2013 Performance Summary Statistics ACO Performance Rate Mean Performance for All ACOS % 66.21% pg. 3

4 Accountable Care Coalition of the Tri-Counties, LLC ACO Participation Waiver Documentation Annual Wellness Visit Challenge For Practice Managers Parties Involved: Start Date: June 2015 Accountable Care Coalition of the Tri-Counties, LLC ( ACO ) Collaborative Health Systems ( CHS ) Description/Purpose of the Arrangement: Practice Manager Annual Wellness Visit Challenge ( AWV Challenge ), titled I m Well Done, designed to stimulate awareness of the Medicare Annual Wellness Visit ( AWV ) available to Medicare beneficiaries and to support practice managers efforts to outreach to ACO beneficiaries in their practices and have their clinicians complete AWVs. The AWV Challenge invites practice managers of ACO participants to submit a short application that describes the effectiveness of their efforts relating to AWVs. The application will consist of four (4) questions that are designed to assess both qualitative and quantitative outcomes. Applications are graded on a scale of 0% 100%, with each answer worth 25% of the total grade. The questions are: Explain what your practice does to outreach to ACO beneficiaries and encourage such beneficiaries to have their AWV. What break out idea has your practice had that enables your practice to get more beneficiaries to come in to have an AWV? How do you know your efforts are working? Include metrics. For example, out of all the ACO beneficiaries in your practice, what percentage are well done (meaning, patients have completed their AWV)? Provide a brief story about your patients experience with the AWV, and why AWVs are beneficial, such as describing a positive outcome, or a before and after situation. Applications will be evaluated by the Management Committee of the ACO with input from the ACO Executive Director and staff from CHS. The application with the highest grade, out of the pool of all applications received for the ACO, will be awarded a grand prize trip for two (2) to a warm-weather resort (e.g., Florida or California) provided, (a) pg. 4

5 there must be at least three (3) unique applications from different ACO participants; and (b) the applicant s application score must be sixty-five percent (65%) or greater. The AWV Challenge criteria may, in the ACO s sole discretion, be modified, with or without notice, at any time. The AWV Challenge application process will run from June November During this period, the Executive Director will meet with practices during lunch n learns to encourage participation in the AWV Challenge, monitor AWV progress, and provide education about AWVs and other topics pertaining to the ACO, such as quality measures and O2 (Outstanding Opportunity) initiatives. The grand prize winner of the AWV challenge will be announced in November. Timing: AWV Challenge waiver approved by ACO Management Committee June 15 Monthly Lunch n Learns June 15 September 15 Launch AWV Challenge June 15 First Lunch n Learn June 15 July 14 Second Lunch n Learn July 13 August 16 Third Lunch n Learn August 17 Sept 15 Call for Entries September 1 Entries Closed September 30 Evaluation of AWV Challenge Entries October 15 November 10 Winners announced November 20 Promote Winners November/December Team prize distributed January 2016 Items, Services and/or goods included: CHS will administer the AWV Challenge on behalf of the ACO. Prizes and promotional items in support of the challenge consist of: Grand prize - trip for two including airfare, hotel, dining and entertainment to a location to be determined in January What s included: pg. 5

6 two round trip coach plane tickets from winner s home city; baggage fees transfer from airport to hotel and hotel to airport; 3 night hotel stay at a luxury hotel; Cash in form of gift card for spa treatment, golf or other entertainment, maximum total value of $200 per person. Gift card to provide 9 meals (Day 1, lunch, dinner, Day 2, breakfast, lunch, dinner, Day 3, breakfast, lunch, dinner, Day 4 breakfast). Maximum total value of $200 per person. Gift card(s) may be used for food or other goods/services. CHS will handle bookings directly with grand prize winner. Grand prize is non transferable. Must be 18 years of age or over to participate. Promotional items to support and build excitement among practice managers for the AWV challenge. These items will be branded with the title of the AWV Challenge - I m Well Done - and will include items such as pens, post-it note paper cubes, and a limited number of higher value items, such as a meat thermometer and cooler, that continue with the barbeque theme. The Executive Director will distribute promotional items to Lunch N Learn attendees by random selection. Financial/Economic Terms: Grand Prize for Practice Manager and a guest approximate value of $3,000 Promotional items up to $200 Relation to Purposes of the Medicare Shared Savings Program: In order for this program to move forward, this Governing Body must make and duly authorize a bona fide determination, consistent with each member s duty under 42 CFR (b)(3), that the arrangement is reasonably related to one of the stated purposes of the Shared Savings Program. Please select at least one of the following and then describe how this program is reasonably related to that purpose: Promoting accountability for the quality, cost and overall care for a Medicare patient population as described in the Shared Savings Program, Managing and Coordinating care for Medicare Fee-For-Service beneficiaries through an ACO, or Encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare beneficiaries. The AWV Challenge supports the stated purpose by promoting Annual Wellness Visits which can: pg. 6

7 - help the ACO s efforts to complement and improve care processes for the ACO s Fee-For-Service population; - bolster the patient/provider relationship, improve patient engagement and provide a personalized prevention plan at no cost to the beneficiary; - provide an avenue to ensure ACOs are monitoring and retaining healthy beneficiaries in the ACO s assigned beneficiary population from year to year; - helps provide a baseline measurement for care coordination and to identify changes in medical condition of the beneficiaries over time. Authorization by Governing Body Method of Authorization (select one): Date: _6/1/2015 X_ Unanimous Written Consent Governing Body Vote documented accordingly in the meeting minutes pg. 7