ACO Name and Location

National Rural ACO 4 LLC
dba Prairie Hills Care Organization
7509 NW Tiffany Springs Parkway
Suite 310
Kansas City, MO 64153

ACO Primary Contact

Primary Contact Name Desiree Brewer
Primary Contact Phone Number 916-542-4582
Primary Contact Email Address dbrewer@caravanhealth.com

Organizational Information

ACO participants:
ACO Participants ACO Participant in Joint Venture (Enter Y or N)
Avera St Lukes Y
Avera Queen of Peace Y
St Benedict Health Center Y
Avera St Marys Y
Landmann Jungman Memorial Hospital Corporation Y
Marshall County Memorial Hospital Y
Rural Health Care, Inc Y
 
ACO governing body:
Member Member’s Voting Power Membership Type ACO Participant TIN
Legal Business Name/DBA, if Applicable
Last Name First Name Title/Position
Flicek David  co-Executive Director 1 ACO Participant Representative Avera St Lukes
Lenker Stacey Treasurer 1 ACO Participant Representative Avera Queen of Peace
Jacobs Tad Chairman 1 ACO Participant Representative Avera Queen of Peace
Clark Tom Board Member 1 ACO Participant Representative Avera Queen of Peace
Walker Gale Secretary 1 ACO Participant Representative St Benedict Health Center
Sanger Larissa Board Member 1 ACO Participant Representative St Benedict Health Center
Forkel Todd  Board Member 1 ACO Participant Representative Avera St Lukes
Sutton Bob Board Member 1 ACO Participant Representative Avera St Marys
Hardwick Jim Vice-Chairman 1 ACO Participant Representative Rural Health Care, Inc
Clark Patrick Board Member 1 Medicare Beneficiary Representative  
 
Key ACO clinical and administrative leadership:
Teri Bergeleen ACO Executive
David Basel Medical Director
LeeAnn Hastings Compliance Officer
Rayna Caplan Quality Assurance/Improvement Officer
 
Associated committees and committee leadership:
Committee Name Committee Leader Name and Position
Information Technology Committee Jim Veline, Chair
Care Coordination & Patient Engagement Committee Sandy Crisp, Chair
Evidence-Based Medicine Committee Dr. Jeff Bock, Chair
Finance Committee Jim Breckenridge, Chair
Quality & Performance Improvement Committee Brett Kollars, Chair
 
Types of ACO participants, or combinations of participants, that formed the ACO:
  • Partnerships or joint venture arrangements between hospitals and ACO professionals
  • Hospital employing ACO professionals
  • Critical Access Hospital (CAH) billing under Method II
  • Federally Qualified Health Center (FQHC)
  • Rural Health Clinic (RHC)

Shared Savings and Losses

  • First Agreement Period
    • Performance Year 2017, $2,740,252
    • Performance Year 2016, $2,165,699
 
Shared Savings Distribution
  • First Agreement Period
    • Performance Year 2017
      • Proportion invested in infrastructure: 10%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 90%
    • Performance Year 2016
      • Proportion invested in infrastructure: 10%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 90%

Quality Performance Results

2017 Quality Performance Results:
 
ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 81.87 80.60
ACO-2 CAHPS: How Well Your Providers Communicate 92.31 93.13
ACO-3 CAHPS: Patients’ Rating of Provider 92.09 92.31
ACO-4 CAHPS: Access to Specialists 85.68 83.32
ACO-5 CAHPS: Health Promotion and Education 60.62 62.30
ACO-6 CAHPS: Shared Decision Making 74.80 75.85
ACO-7 CAHPS: Health Status/Functional Status 73.57 73.05
ACO-34 CAHPS: Stewardship of Patient Resources 25.21 25.68
ACO-8 Risk Standardized, All Condition Readmission 14.53 15.01
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 17.74 18.46
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 44.74 53.95
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 69.47 79.16
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 56.15 61.74
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.59 1.93
ACO-11 Use of Certified EHR Technology 100.00 98.48
ACO-12 Medication Reconciliation 51.76 75.32
ACO-13 Falls: Screening for Future Fall Risk 99.03 74.38
ACO-44 Imaging Studies for Low Back Pain 65.38 67.32
ACO-14 Preventive Care and Screening: Influenza Immunization 74.75 72.52
ACO-15 Pneumonia Vaccination Status for Older Adults 83.33 72.92
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 73.90 70.69
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 95.97 90.48
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 80.82 61.98
ACO-19 Colorectal Cancer Screening 83.03 64.58
ACO-20 Breast Cancer Screening 83.77 70.05
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 79.32 79.89
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 12.35 16.74
ACO-41 Diabetes: Eye Exam 42.63 50.37
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 70.32 71.47
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 97.76 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 “National Rural ACO 4 LLC” or “Prairie Hills Care Organization” to view the quality performance results. This
ACO can also be found by using the ACO ID A59816 in the public use files on data.cms.gov.

Payment Rule Waivers

  • No, our ACO does not use the SNF 3-Day Rule Waiver.