Mary Washington Health Alliance MSSP Enhanced (2022-Current)
ACO Name and Location
Mary Washington Health Alliance, LLC.
2300 Fall Hill Ave.
Suite 308A
Fredericksburg, Virginia 22401
ACO Primary Contact
|
Primary Contact Name
|
Travis Turner
|
|
Primary Contact Phone Number
|
(540) 741-1557
|
|
Primary Contact Email Address
|
travis.turner@mwhc.com
|
Organizational Information
ACO Participants:
| ACO Participants |
ACO Participant in Joint Venture |
| MARY WASHINGTON MEDICAL GROUP HOSPITALIST SERVICES, LLC |
N |
| MARY WASHINGTON HEALTHCARE PHYSICIANS |
N |
| RADIOLOGIC ASSOCIATES OF FREDERICKSBURG |
N |
| MEDICAL IMAGING OF FREDERICKSBURG, LLC |
N |
| VIRGINIA URGENT CARE LLC |
N |
| STAFFORD HOSPITAL, LLC |
N |
|
|
| OBHG VIRGINIA LLC |
N |
| ELITE WOMENS HEALTH INC |
N |
| MARY WASHINGTON HOSPITAL INC |
N |
| ACCESS EYE CENTERS, PC |
N |
| CENTERCARE FAMILY PRACTICE LLC |
N |
| RAPPAHANNOCK WOMEN'S HEALTH CENTER PC |
N |
| Gaertner Psychiatric, PC |
|
| VIRGINIA CENTER FOR ALLERGY AND ASTHMA INC. |
N |
| FREDERICKSBURG EMERGENCY MEDICAL ALLIANCE, INC. |
N |
| GASTROENTEROLOGY ASSOCIATES OF FREDERICKSBURG, P.C. |
N |
| VIRGINIA DERMATOLOGY AND SKIN SURGERY CENTER |
N |
| Polaris Heart and Vascular, PLLC. |
N |
| CARDIOLOGY ASSOCIATES OF FREDERICKSBURG, LTD. |
N |
| UROLOGY ASSOCIATES OF FREDERICKSBURG, PC |
N |
|
|
| CENTRAL VIRGINIA ORTHOPAEDICS & SPORTS MEDICINE |
N |
| PATHOLOGY ASSOCIATES OF FREDERICKSBURG PTR |
N |
| COLONIAL INTERNAL MEDICINE ASSOCIATES PC |
N |
| CORNELL J SHELTON MD PLLC |
N |
| VIRGINIA ONCOLOGY CARE PC |
N |
| FALL HILL GASTROENTEROLOGY ASSOCIATES, LTD. |
N |
| DERMATOLOGY CENTER PC |
N |
| VIRGINIA CARDIOVASCULAR CONSULTANTS PC |
N |
| Dynamic Foot and Ankle Center LLC |
|
| CENTRAL VIRGINIA OB GYN GROUP PC |
N |
| ORACLE HEART & VASCULAR PLLC |
N |
| LEE'S HILL FAMILY PHYSICIANS, P.C. |
N |
| PULMONARY ASSOCIATES OF FREDERICKSBURG |
N |
| CENTRAL VIRGINIA ANESTHESIA LLC |
N |
| EAR NOSE AND THROAT AND FACIAL PLASTIC SURGERY CENTER OF FREDERICK |
N |
| NEW BEGINNINGS OB GYN PC |
N |
| Christopher Harrington MD PC |
|
| CENTRAL VIRGINIA INTERNAL MEDICINE PLC |
N |
| WOMENS HEALTH AND SURGERY CENTER |
N |
| OPTIMUM CARE LLC |
N |
| MEDICAL & URGENT CARE CENTER, PC |
N |
| Fredericksburg Christian Health Center |
N |
| PEDSPLUS URGENT CARE LLC |
N |
| MAP RC LLC |
N |
| FREDERICKSBURG ANESTHESIA SERVICES LLC |
N |
| METROPOLITAN HEALTH CARE PROVIDERS, INC. |
N |
| VISTA EYE SPECIALISTS PC |
N |
| NORTHERN VIRGINIA HEMATOLOGY ONCOLOGY ASSOCIATES PC |
N |
| BLUE NILE MEDICAL CENTER, P.C. |
N |
| THE CENTER FOR ORTHOPEDICS, INC. |
N |
| COMMONWEALTH INTERNAL MEDICINE PC |
N |
| SLEEP DISORDER CENTER OF FREDERICKSBURG PLC |
N |
| CENTRAL VIRGINIA SLEEP CENTER PLC |
N |
| MARY WASHINGTON EYE CARE CENTER, LLC |
N |
| METROHEALTH INTERNAL MEDICINE, PC |
N |
| FAMILY FOOT AND ANKLE CENTER |
N |
| RADIATION ONCOLOGY SPECIALISTS OF CENTRAL VIRGINIA PLC |
N |
| Vision Innovation Centers of Virginia LLC |
N |
| RAPIDAN MEDICAL CENTER |
N |
| FAMILY CARE OF FREDERICKSBURG PLC |
N |
| WILLIAM HAMILTON |
N |
| SERENITE MEDICAL & SPA INC |
N |
| INTERNAL MEDICINE OF VIRGINIA, P.C. |
N |
| FREDERICKSBURG FOOT & ANKLE CENTER |
N |
| MCMANUS & ASSOCIATES INTERNAL MEDICINE PC |
N |
| DIABETES & THYROID ASSOCIATES |
N |
| CHANCELLOR PRIMARY CARE PLLC |
N |
| BELMONT AESTHETIC & RECONSTRUCTIVE PLASTIC SURGERY |
N |
| PSYCHIATRIC CARE INC |
N |
| DHMR CLINICS, INC |
N |
| WECARE MEDICAL ASSOCIATES |
N |
ACO Governing Body:
|
|
Member's Last Name
|
Member's First Name
|
Member's Title/Position
|
Member's Voting Power (Expressed as a percentage) |
Membership Type |
ACO Participant TIN Legal Business Name/DBA, if Applicable |
|
McManus
|
Patrick
|
MD,
Chairman/Voting Member
|
10%
|
ACO Participant Representative
|
McManus & Associates Internal Medicine, PC
|
|
McDermott
|
Michael
|
MD, Vice Chair/Voting Member
|
10%
|
ACO Participant Representative
|
Mary Washington Hospital, Inc.
|
|
Newman
|
Christopher
|
MD,
Secretary/Voting Member
|
5%
|
ACO Participant Representative
|
Mary Washington Hospital, Inc.
|
|
Frazier
|
Jeffrey
|
MD,
Treasurer/Voting Member
|
5%
|
ACO Participant Representative
|
Radiologic Associates of Fredericksburg, Ltd.
|
| Nakave |
Abhijeet |
MD, Voting Member
|
5%
|
ACO Participant Representative
|
Mary Washington Hospital, Inc.
|
|
Thott
|
Kurian
|
MD, Voting Member
|
5%
|
ACO Participant Representative
|
Womens Health and Surgery Center
|
|
Szlyk
|
Gregory
|
MD, Voting Member
|
5%
|
ACO Participant Representative
|
Urology Associates of Fredericksburg, PC
|
|
Amory
|
Charles
|
MD
|
0
|
Other – Community Physician
|
Chancellor Pediatrics
|
|
DeTrane
|
Frank
|
MD
|
5%
|
ACO Participant Representative
|
Gastroenterology Associates of Fredericksburg
|
|
Vacant
|
|
MD, Voting Member
|
0
|
ACO Participant Representative
|
TBD
|
|
Sims
|
Adam
|
MD, Voting Member
|
5%
|
ACO Participant Representative
|
Fredericksburg Emergency Medical Alliance, Inc.
|
|
Woodford
|
Dan
|
MD,
Voting Member
|
5%
|
ACO Participant Representative
|
Mary Washington Hospital, Inc.
|
|
McDowell
|
Kenneth
|
MD,
Voting Member
|
5%
|
ACO Participant Representative
|
Colonial Internal Medicine Associates PC
|
| Gamache |
Donna |
MD, Voting Member
|
5%
|
ACO Participant Representative
|
Lee's Hill Family Physicians, PC
|
|
Brown
|
Dana
|
MD, Voting Member
|
5%
|
ACO Participant Representative
|
Mary Washington Hospital, Inc.
|
|
Sherwood
|
Timothy
|
MD, Voting Member
|
5%
|
ACO Participant Representative
|
Mary Washington Hospital, Inc.
|
|
Aiken
|
Matthew
|
DO, Voting Member
|
5%
|
ACO Participant Representative
|
Mary Washington Hospital, Inc.
|
|
Branscome
|
Ronald
|
Voting Member
|
5%
|
Medicare Beneficiary Representative
|
N/A
|
|
Davis
|
Bruce |
Voting Member
|
5%
|
Community Stakeholder Representative
|
N/A
|
|
Barden
|
Sean
|
Voting Member
|
5%
|
ACO Participant Representative
|
Mary Washington Hospital, Inc.
|
Key ACO Clinical and Administrative Leadership:
ACO Executive: Travis Turner
Medical Director: Richard Lewis, MD
Compliance Officer: Lauren Blalock
Quality Assurance/Improvement Officer: Dan Woodford, MD
Associated Committees and Committee Leadership:
-
Patrick McManus, MD;
MWMD Board Chair
-
Dan Woodford, MD;
Chair, Clinical Quality Committee
-
Kurian Thott, MD;
Chair, Communications and Education Committee
-
Jeffrey Frazier, MD;
Chair, Finance and Contracting Committee
-
Gregory Szlyk, MD;
Chair, Information Technology Committee
-
Kenneth McDowell, DO;
Chair, Nominating and Membership/Operations Committees
Types of ACO Participants, or Combinations of Participants, That Formed the ACO:
- 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:
-
First Agreement Period
- Performance Year 2021, N/A
Shared Savings Distribution:
-
First Agreement Period
-
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
Quality Performance Results
2021 Quality Performance Results:
Our ACO did not participate in the Shared Savings Program in the 2021 performance
year, therefore this section is not applicable at this time.
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 Pre-Participation Waiver:
Our ACO is not using any Pre-Participation Waivers
ACO Participation Waiver:
The Secretary of the Department of Health and Human Services (HHS) has
made available a participation waiver of federal fraud and abuse laws
in connection with the operation of accountable care organizations (ACOs)
that have entered into a participation agreement under the Medicare Shared
Savings Program (MSSP) with the Centers for Medicare & Medicaid Services (CMS).
The Mary Washington Health Alliance (ACO) Governing Body has duly authorized
the arrangements below and made a bona fide determination that each arrangement
is reasonably related to the purposes of the MSSP because the arrangements
will promote accountability for the quality, cost and overall care for
Medicare beneficiaries assigned to ACO. The descriptions of relevant arrangements
are set forth below for the purpose of ACO availing itself of the protections
afforded under the MSSP Waivers:
- ACO has implemented a care coordination arrangement beginning January 1,
2016, pursuant to which the ACO identifies certain Medicare beneficiaries
as being at high risk or rising risk and actively engages such beneficiaries
under a navigation program constituting an evidenced-based approach to
improving patient engagement and improving the overall efficiency of care.
- ACO has entered into a Hospital Quality and Efficiency Program with Mary
Washington Hospital, of the ACO’s providers/suppliers as of January
1, 2016, for purposes of the implementation by the ACO of quality initiatives
that will support the efficiency and efficacy of various transitions of
care processes in a manner that is transparent to patients, has detailed
quality controls and implements safeguards to ensure compliance with applicable
laws. Specifically, the ACO Governing Body has made a bona fide determination
that the program promotes accountability for the quality and cost of overall
care for Medicare beneficiaries assigned to the ACO.
- The ACO has approved the Surgical Advanced Practitioner Arrangement (the
“Arrangement”) which will begin on or about September 1, 2016.
Under the Arrangement, the ACO will employ a full-time qualified, experienced,
and appropriately licensed allied health professional (e.g., a nurse practitioner
or physician assistant) (“Allied Health Professional”) who
will be located at Mary Washington Hospital (“MWH”) or Stafford
Hospital (“SH”) for the purpose of assisting physician-participants
of the ACO with respect to surgical procedures performed in MWH and SH.
Such duties shall be assigned by the ACO, and may evolve from time to
time, but shall include clinical and administrative activities designed
to optimize the coordination among and engagement of health care team
members and the patient in promotion of the ACO’s quality and cost
objectives.
The Arrangement is designed to promote MWHA’s population health management
capabilities, improve management and coordination of patient care for
Medicare beneficiaries to encompass the hospital setting, and represents
a key investment in MWHA’s infrastructure and redesigned care processes
to achieve high quality and efficient service delivery for patients, including
Medicare beneficiaries. This Arrangement will be located at MWH and SH
for the purpose of assisting physician-participants of MWHA with respect
to surgical procedures performed in MWH and SH. Specifically, the ACO
Governing Body has made a bona fide determination that the program promotes
accountability for the quality and cost of overall care for Medicare beneficiaries
assigned to the ACO.
Types of ACO Participants or Combinations of Participants that Formed the ACO:
- Networks of individual practices of ACO professionals
- Partnerships or joint venture arrangements between hospitals and ACO professionals