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
EMERGENCY PHYSICIANS IMMEDIATE CARE CENTER 2 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 N
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
MEDIDOCTORS LLC 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
ORTHOPEDIC SPECIALTY CLINIC LTD N
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
Chancellor Internal Medicine N
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
LEF, PC 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

Key ACO Clinical and Administrative Leadership:

ACO Governing Body:


ACO Executive: Travis Turner

Medical Director: Richard Lewis, MD

Compliance Officer: Lauren Blalock

Quality Assurance/Improvement Officer: Daniel Woodford, MD

Member's Last Name

Member's First Name

Member's Title/Position

Member's Voting Power Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable

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

Mary Washington Hospital, Inc.

Newman

Christopher

MD,

Secretary/Voting Member

1

ACO Participant Representative

Mary Washington Hospital, Inc.

Frazier

Jeffrey

MD,

Treasurer/Voting Member

1

ACO Participant Representative

Radiologic Associates of Fredericksburg, Ltd.

Nakave Abhijeet

MD, Voting Member

1

ACO Participant Representative

Mary Washington Hospital, Inc.

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.

Woodford

Daniel

MD,

Voting Member

1

ACO Participant Representative

Mary Washington Hospital, Inc.

McDowell

Kenneth

MD,

Voting Member

1

ACO Participant Representative

Colonial Internal Medicine Associates PC

Gamache Donna

MD, Voting Member

1

ACO Participant Representative

Lee's Hill Family Physicians, PC

Brown

Dana

MD, Voting Member

1

ACO Participant Representative

Mary Washington Hospital, Inc.

Sherwood

Timothy

MD, Voting Member

1

ACO Participant Representative

Mary Washington Hospital, Inc.

Aiken

Matthew

DO, Voting Member

1

ACO Participant Representative

Mary Washington Hospital, Inc.

Branscome

Ronald

MD, Voting Member

1

Medicare Beneficiary Representative

N/A

Wilder

Martin

MD, Voting Member

1

Community Stakeholder Representative

N/A

Barden

Sean

MD, Voting Member

1

ACO Participant Representative

Mary Washington Hospital, Inc.

Associated Committees and Committee Leadership:

  • Patrick McManus, MD; MWMD Board Chair
  • Daniel 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 2022, N/A

Shared Savings Distribution:

  • First 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

Quality Performance Results

2022 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‚Äč

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:

  1. 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.
  2. 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.
  3. 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

For more information: