Mary Washington Health Alliance Accountable Care Organization (ACO)

Medicare ACO's are comprised of groups of doctors, hospitals, and other health care providers and suppliers who come together voluntarily to provide coordinated, high-quality care at lower costs to their participating Medicare patients. The Next Generation ACO Model is an initiative for ACO's that are experienced in coordinating care for populations of patients.

Mary Washington Health Alliance will build on Mary Washington Healthcare's (MWHC) rich 100-year history through partnerships with key stakeholders who share a common mission of improving the health of the population they serve. After completing three consecutive years in the Medicare Shared Savings Program and having shown savings and improved quality of care, the Alliance is ready to take on the road ahead within the Next Generation ACO.

As one of only 58 participants in the Next Generation ACO Model across the country, the Alliance will be able to build on the current level of coordinated care and will provide an enhanced quality of care at lower costs to Medicare patients. The Alliance chose to participate in the Next Generation ACO Model because we believe that this model allows the best opportunity to shift patient care away from a clinical model built for the fee-for-service payment environment and towards a whole-person population health-focused clinical model. By partnering with their patients in care decisions, NGACO Participants will achieve the goals of better health and better care for Medicare beneficiaries.

ACO Name and Location:

Mary Washington Health Alliance, LLC.
2300 Fall Hill Ave.
Suite 308A
Fredericksburg, Virginia 22401
Phone: 540.741.1557

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:

Access Eye
Advanced Digestive Care, LLC
Allergy Partners of Fredericksburg
American Anesthesia Associates
Aquia Family Medical Center
Belmont Aesthetic and Reconstructive Plastic Surgery
BetterMed Urgent Care
Blue Nile Medical Center
Brett Chicko DPM Family Foot and Ankle Center
Cardiology Associates of Fredericksburg

Carriage Hill Health and Rehab
Centercare Family Practice, LLC
Centercare Urgent Care
Central Virginia Anesthesia Anesthesia Concepts
Central Virginia Internal Medicine
Central Virginia OBGYN Group
Central Virginia Orthopedics & Sport Medicine
Central Virginia Podiatry
Central Virginia Sleep Center
Chancellor Internal Medicine
Colonial Internal Medicine Associates PC
Commonwealth Internal Medicine
Cornell J Shelton MD PLLC
DHMR Clinics
Diabetes and Thyroid Associates
Elite Womens Health Inc
ENT & Facial Plastic Surgery of Fredericksburg
Fairfax Medical Clinic LLC
Fall Hill Gastroenterology Associates
Family Care of Fredericksburg
Fredericksburg Anesthesia Services
Fredericksburg Christian Health Center
Fredericksburg Emergency Medical Alliance
Fredericksburg Foot & Ankle Center
Fredericksburg Nephrology Associates
Fredericksburg Women's Health Associates
Gaertner Psychiatric PC
GAF Sedation
Gastroenterology Associates of Fredericksburg
Internal Medicine of Virginia PC
Lee's Hill Family Physicians PC
Mary Washington Cardiology
Mary Washington Dermatology
Mary Washington Endocrinology
Mary Washington Eye Care Center
Mary Washington Family and Internal Medicine
Mary Washington Family Medicine
Mary Washington Family Medicine and Pediatrics
Mary Washington Family Medicine Orange
Mary Washington General Surgery & Trauma
Mary Washington General Surgery Lee’s Hill
Mary Washington Hospitalist Services
Mary Washington Neurology
Mary Washington Neurosurgery
Mary Washington Observation Unit
Mary Washington Obstetrics and Gynecology
Mary Washington Orthopedics
Mary Washington Primary Care
Mary Washington Radiation Oncology
Mary Washington Rheumatology
Mary Washington Sleep Medicine
Mary Washington Spine and Rehabilitation Clinic
Mary Washington Surgical Oncology
Mary Washington Urgent Care
Mary Washington Urology
Mary Washington Virginia Cardiovascular and Thoracic Surgery
Mary Washington Weight Loss Center
McManus & Associates Internal Medicine
Medical Imaging of Fredericksburg
MediDoctors LLC dba Mary Washington Home Health & Hospice
Meridian Independent Physician Group
MetroHealth Internal Medicine PC
Metropolitian Health Care Providers Inc
New Beginnings ObGyn
North Stafford Family Medical Center
Northern Virginia Hematology & Oncology Associates
NOVA Cardiovascular Care, LLC
OBHG Hospitalist
Optimum Care LLC
Oracle Heart & Vascular LLC
Orthopedic Specialty Clinic Ltd
PACS at Ruther Glen
Pathology Associates of Fredericksburg
Plastic Surgery Services
Polaris Heart and Vascular PLLC
Prime Regenerative and Pain Management
Psychiatric Care Inc
Pulmonary Associates of Fredericksburg
Radiation Oncology Specialists of Central Virginia
Radiologic Associates of Fredericksburg
Rapidan Medical Center Inc
Rappahannock Family Healthcare Inc
Rappahannock Women's Health Center Inc
Serenite Medical & Spa
Sieht
Sleep Disorder Center of Fredericksburg
Stafford Internal Medical Services
Stafford Neurology
The Center for Orthopedics
The Dermatology Center
Urology Associates of Fredericksburg
Virginia Cardiovascular Consultants
Virginia Center for Allergy & Asthma
Virginia Dermatology and Skin Surgery Center
Virginia Interventional and Vascular Associates
Virginia Oncology Care, PC
Virginia Urgent Care LLC dba NextCare Urgent Care
Vista Eye
WeCare Medical Associates
William A Hamilton MD
Womens Health and Surgery Center INC

Providers participating with Alliance ACO

There are no joint ventures between the Alliance ACO and any of its Next Generation Participants or Preferred Providers.


Key ACO Clinical and Administrative Leadership

ACO Governing Body

Travis Turner

ACO Executive

Patrick McManus, MD

Medical Director

Lauren Blalock

Compliance Officer

Daniel Woodford, MD

Quality Assurance/Improvement Officer

Key ACO clinical and administrative leadership

Member

Member's Voting Power

Membership Type

ACO Participant TIN Legal Business Name/DBA, if Applicable

Last Name

First Name

Title/Position

McManus

Patrick

MD,

Chairman/Voting Member

1

ACO Participant Representative

McManus & Associates Internal Medicine, PC

McDermott

Michael

MD, Vice Chair/Voting Member

1

ACO Participant Representative

Washington Hospital, Inc., Mary

Christopher

Newman

MD,

Secretary/Voting Member

1

ACO Participant Representative

Washington Hospital, Inc., Mary

Frazier

Jeffrey

MD,

Treasurer/Voting Member

1

ACO Participant Representative

Radiologic Associates of Fredericksburg, Ltd.

Vranian

Robert

MD, Voting Member

1

ACO Participant Representative

Virginia Cardiovascular Consultants, PC

Thott

Kurian

MD, Voting Member

1

ACO Participant Representative

Women’s Health and Surgery Center, Inc.

Szlyk

Gregory

MD, Voting Member

1

ACO Participant Representative

Urology Associates of Fredericksburg, PC

Amory

Charles

MD

0

Other – Community Physician

Chancellor Pediatrics

DeTrane

Frank

MD

1

ACO Participant Representative

Gastroenterology

Associates of Fredericksburg

Vacant

MD, Voting Member

1

ACO Participant Representative

TBD

Sims

Adam

MD, Voting Member

1

ACO Participant Representative

Fredericksburg Emergency Medical Alliance, Inc.

Clemo

F. Lynne

MD, Voting

Member

1

ACO Participant

Representative

Chancellor Internal

Medicine

Woodford

Daniel

MD, Voting Member

1

ACO Participant Representative

Mary Washington Family and Internal Medicine

McDowell

Kenneth

DO, Voting Member

1

ACO Participant Representative

Colonial Internal Medicine

Branscome

Ronald

Voting Member

1

Medicare Beneficiary Representative

N/A

Wilder

Martin

Voting Member

 1

Community Stakeholder Representative

N/A

Barden

Sean

Voting Member

1

ACO Participant Representative

Washington Hospital, Inc., Mary

Aiken

Matthew

DO, Voting Member

1

ACO Participant Representative

Mary Washington Hospitalist Services

ACO Structure and 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

  • Performance Year 2019, Lost $1.3 million
  • Performance Year 2018, Saved $5.161 million
  • Performance Year 2017, Saved $11.997 million shared savings $5.12 million
  • Performance Year 2016, Saved $3.75 million shared savings $0
  • Performance Year 2015, Saved $3.5 million shared savings $0

Shared Savings Distribution

  • Performance Year 2019
    • Proportion Invested in infrastructure TBD
    • Proportion invested in redesigned care processes/resources TBD
    • Proportion of distribution to ACO participants TBD
  • Performance Year 2018
    • Proportion Invested in infrastructure TBD
    • Proportion invested in redesigned care processes/resources TBD
    • Proportion of distribution to ACO participants TBD
  • Performance Year 2017
    • Proportion invested in infrastructure TBD
    • Proportion invested in redesigned care processes/resources TBD
    • Proportion of distribution to ACO participants TBD
  • 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

2019 Quality Performance Results Table

Table 1. Summary Information
Domain Points Earned without Quality Improvement Points Domain Improvement Score [1]
(%) 		Quality Improvement Reward Points [2] Points Earned with Quality Improvement Reward Points [3] Domain Score
(%) 		Quality Performance Standard Status: Completely Reported Quality Performance Standard Status [4]: Minimum Attainment Met
(% measures in domain)
Patient/Caregiver Experience 17.90 0.00 0.00 17.90 89.50 Yes 100.00
Care Coordination/Patient Safety 6.00 -50.00 0.00 6.00 75.00 Yes 75.00
Preventive Health 12.00 33.33 1.36 12.00 100.00 Yes 100.00
At-Risk Population 5.55 66.67 2.68 6.00 100.00 Yes 100.00
Table 2. Patient/Caregiver Experience [1]
Measure Number Measure Name P4P or P4R --- Number of Surveys Completed Your ACO Performance Rate Completely Reported? Quality Improvement Reward Information [2,3] Points Earned [4] Total Possible Points Prior Year Performance Rate Current Year Mean Performance Rate (NextGen ACOs) Current Year Mean Performance Rate (All ACOs) 30th Percentile Benchmark 90th Percentile Benchmark
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information P --- 280 85.22 Yes No Significant Change 1.85 2.00 83.64 86.03 85.88 30.00 90.00
ACO-2 CAHPS: How Well Your Providers Communicate P --- 310 94.48 Yes No Significant Change 2.00 2.00 93.93 94.11 94.11 30.00 90.00
ACO-3 CAHPS: Patients’ Rating of Provider P --- 301 93.34 Yes No Significant Change 2.00 2.00 91.47 92.75 92.70 30.00 90.00
ACO-4 CAHPS: Access to Specialists P --- 210 81.41 Yes No Significant Change 1.85 2.00 80.41 80.97 81.48 30.00 90.00
ACO-5 CAHPS: Health Promotion and Education P --- 328 54.84 Yes No Significant Change 1.10 2.00 52.69 60.46 60.44 54.18 63.44
ACO-6 CAHPS: Shared Decision Making P --- 298 63.69 Yes No Significant Change 2.00 2.00 59.54 61.38 62.63 54.75 62.76
ACO-7 CAHPS: Health Status/Functional Status R --- 333 76.63 Yes No Significant Change 2.00 2.00 74.23 74.49 73.86 N/A N/A
ACO-34 CAHPS: Stewardship of Patient Resources P --- 321 24.86 Yes No Significant Change 1.10 2.00 19.38 24.40 25.98 24.25 33.43
ACO-45 CAHPS: Courteous and Helpful Office Staff R --- 304 94.59 Yes Not Applicable 2.00 2.00 --- 93.05 92.86 N/A N/A
ACO-46 CAHPS: Care Coordination R --- 333 88.72 Yes Not Applicable 2.00 2.00 --- 87.26 86.93 N/A N/A
Table 3. Care Coordination/Patient Safety
Measure Number Measure Name P4P or P4R Numerator Denominator Your ACO Performance Rate Completely Reported? Quality Improvement Reward Information [2,3] Points Earned [4] Total Possible Points Prior Year Performance Rate Current Year Mean Performance Rate (NextGen ACOs) Current Year Mean Performance Rate (All ACOs) 30th Percentile Benchmark 90th Percentile Benchmark
ACO-8 Risk-Standardized, All Condition Readmission R --- --- 16.27 Yes Significant Decline 2.00 2.00 15.41 14.98 14.86 15.18 14.27
ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions R --- --- 73.71 Yes Significant Decline 2.00 2.00 69.74 56.34 58.02 65.99 41.39
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator [PQI] #91) (version with additional Risk Adjustment) P --- --- 2.77 Yes Significant Decline 0.00 2.00 2.73 1.72 1.86 1.95 1.51
ACO-13 Falls: Screening for Future Falls Risk P 407 442 92.08 Yes Significant Improvement 2.00 2.00 88.85 88.97 84.39 43.42 90.73
Table 4. Preventive Health
Measure Number Measure Name P4P or P4R Numerator Denominator Your ACO Performance Rate Completely Reported? Quality Improvement Reward Information [2,3] Points Earned [4] Total Possible Points Prior Year Performance Rate [5] Current Year Mean Performance Rate (NextGen ACOs) Current Year Mean Performance Rate (All ACOs) 30th Percentile Benchmark 90th Percentile Benchmark
ACO-14 Preventive Care and Screening: Influenza Immunization R 242 387 62.53 Yes Not Applicable 2.00 2.00 61.24 76.98 74.93 N/A N/A
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention R 19 23 82.61 Yes Not Applicable 2.00 2.00 43.24 79.60 78.15 N/A N/A
ACO-18 Preventive Care and Screening: Screening for Depression and Follow-up Plan R 274 435 62.99 Yes Not Applicable 2.00 2.00 46.35 73.00 70.59 N/A N/A
ACO-19 Colorectal Cancer Screening R 247 325 76.00 Yes No Significant Change 2.00 2.00 72.76 77.12 71.22 30.00 90.00
ACO-20 Breast Cancer Screening R 290 378 76.72 Yes No Significant Change 2.00 2.00 73.79 79.31 74.23 30.00 90.00
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease R 254 282 90.07 Yes Significant Improvement 2.00 2.00 84.49 82.43 82.19 N/A N/A
Table 5. At-Risk Population
Measure Number Measure Name P4P or P4R Numerator Denominator Your ACO Performance Rate Completely Reported? Quality Improvement Reward Information [2,3] Points Earned [4] Total Possible Points Prior Year Performance Rate Current Year Mean Performance Rate (NextGen ACOs) Current Year Mean Performance Rate (All ACOs) 30th Percentile Benchmark 90th Percentile Benchmark
ACO-40 Depression Remission at Twelve Months R 0 26 0.00 Yes No Significant Change 2.00 2.00 0.00 11.82 13.45 N/A N/A
ACO-27 [6] Diabetes Mellitus: Hemoglobin A1c (HbA1c) Poor Control (>9%) P 52 449 11.58 Yes Significant Improvement 1.85 2.00 18.84 11.43 13.71 70.00 10.00
ACO-28 Hypertension: Controlling High Blood Pressure P 324 456 71.05 Yes Significant Improvement 1.70 2.00 66.12 78.62 75.30 30.00 90.00

2018 Quality Performance Results Table

Table 2. Patient/Caregiver Experience
Measure Number Measure Name P4P or P4R* Your ACO Performance Rate*
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information P 83.64
ACO-2 CAHPS: How Well Your Providers Communicate P 93.93
ACO-3 CAHPS: Patients’ Rating of Provider P 91.47
ACO-4 CAHPS: Access to Specialists P 80.41
ACO-5 CAHPS: Health Promotion and Education P 52.69
ACO-6 CAHPS: Shared Decision Making P 59.54
ACO-7 CAHPS: Health Status/Functional Status R 74.23
ACO-34 CAHPS: Stewardship of Patient Resources R 19.38
Table 3. Care Coordination/Patient Safety
Measure Number Measure Name P4P or P4R* Your ACO Performance Rate*
ACO-8 Risk Standardized, All Condition Readmission P 15.41
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) R 19.67
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes R 42.58
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure R 86.91
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions R 69.74
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) R 2.35
ACO-12 Medication Reconciliation R 32.77%
ACO-13 Falls: Screening for Future Fall Risk P 88.85%
ACO-44 Imaging Studies for Low Back Pain R 88.89%
Table 4. Preventive Health
Measure Number Measure Name P4P or P4R* Your ACO Performance Rate*
ACO-14 Preventive Care and Screening: Influenza Immunization P 61.24%
ACO-15 Pneumonia Vaccination Status for Older Adults P 81.09%
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up P 59.68%
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention P 43.24%
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan P 46.35%
ACO-19 Colorectal Cancer Screening P 72.76%
ACO-20 Breast Cancer Screening P 73.79%
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease R 84.49%
Table 5. At-Risk Population
Measure Number Measure Name P4P or P4R* Your ACO Performance Rate*
ACO-40 Depression Remission at Twelve Months R 0.00%
Diabetes Composite Diabetes Composite (All or Nothing Scoring) R 40.22%
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control R 18.84%
ACO-41 Diabetes: Eye Exam R 46.74%
ACO-28 Hypertension (HTN): Controlling High Blood Pressure P 66.12%
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic P 91.08%
ACO-43 Ambulatory Sensitive Condition Acute Composite 2.73%

2017 Quality Performance Results Table

2016 Quality Performance Results Table

ACO#

Measure Number

Rate

ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 92.62 92.63
ACO-2 CAHPS: How Well Your Providers Communicate 92.15 91.93
ACO-3 CAHPS: Patients' Rating of Provider 82.7 83.52
ACO-4 CAHPS: Access to Specialists 57.43 60
ACO-5 CAHPS: Health Promotion and Education 74.36 75.28
ACO-6 CAHPS: Shared Decision Making 74.36 75.28
ACO-7 CAHPS: Health Status/Functional Status 72.39 71.82
ACO-34 CAHPS: Stewardship of Patient Resources 26.6 27.52
ACO-8 Risk-Standardized, All Condition Readmission 14.74 14.7
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 18.58 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 53.25 53.2
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 73.97 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 59.54 59.81
ACO-9 Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 16.55 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 ) 17.4 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 85.71 82.72
ACO-39 Documentation of Current Medications in the Medical Record 92.36 87.54
ACO-13 Falls: Screening for Future Fall Risk 59.04 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization 56.05 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults 78.71 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 82.14 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 95 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 30.68 53.63
ACO-19 Colorectal Cancer Screening 68.8 61.52
ACO-20 Breast Cancer Screening 45.01 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented 76.53 76.84
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 81.12 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 15.41 18.24
ACO-41 Diabetes: Eye Exam 57.52 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 77.42 70.52
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 90.91 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 98.79 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%) 74.23 79.67
2016 Quality Performance Results Table

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 “Mary Washington Health Alliance, LLC.” to view the quality performance results. This ACO can also be found by using the ACO ID A07732 in the public use files on data.cms.gov.

For more information: