ACO Name and Location

Caravan Health ACO 12 LLC
dba Wilderness Health ACO
7509 NW Tiffany Springs Parkway
Ste. 310
Kansas City, Missouri 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)
St. Luke’s Hospital of Duluth Y
International Falls Memorial Hospital Association Y
Community Memorial Hospital Association Y
Lake View Memorial Hospital, Inc. Y
MOOSE LAKE COMMUNITY HOSPITAL DISTRICT N
ORTHOPEDIC ASSOCIATES OF DULUTH, P.A. N
LABORATORY MEDICINE SPECIALISTS OF DULUTH N
Northland Gastroenterology, P. A. N
Range Foot & Ankle PLC N
 
 
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
Terhaar Kim Secretary 1 ACO Participant Representative St. Luke’s Hospital of Duluth
Lohn Eric Board Member 1 ACO Participant Representative St. Luke’s Hospital of Duluth
Delfs Mike Board Member 0 ACO Participant Representative Mercy Hospital
Herstad Suzanne Board Member 0 ACO Participant Representative Orthopedic Associates of Duluth
Strange John Vice-Chairman 1 ACO Participant Representative St. Luke’s Hospital of Duluth
Ruberg Greg Chairman 1 ACO Participant Representative Lake View Memorial Hospital, Inc.
Breurer Rick Treasurer 1 ACO Participant Representative Community Memorial Hospital Association
Erickson Bonnie Secretary 1 ACO Participant Representative International Falls Memorial Hospital Association
Hall Ed Board Member 1 Medicare Beneficiary
Representative
 
 
Key ACO clinical and administrative leadership:
Greg Paris ACO Executive
Gary Peterson, MD 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 Mike Kongsjord, Chairman
Care Coordination & Patient Engagement Committee Ben Bengtson, Chairman
Evidence-Based Medicine Committee Gary Peterson, Chairman
Finance Committee Eric Lohn, Chairman
Quality & Performance Improvement Committee Kathy Johnson, Chairman
 
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
 

Shared Savings and Losses

Amount of Shared Savings/Losses
  • N/A
Shared Savings Distribution
  • N/A
 

Quality Performance Results

Our ACO did not participate in the Shared Savings Program in the previous performance year, therefore this section is not applicable at this time.

Payment Rule Waivers

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