ACO Name and Location

Caravan Health ACO 13 LLC
dba Berkshire ACO
7509 NW Tiffany Springs Parkway
Ste. 310
Kansas City, Missouri 64153

 

ACO Primary Contact

Primary Contact Name Greg Paris
Primary Contact Phone Number 916-542-4582
Primary Contact Email Address gparis@caravanhealth.com

Organizational Information

ACO participants
ACO Participants ACO Participant in Joint Venture (Enter Y or N)
Green Mountain Neurology, Inc N
The Brien Center for Mental Health and Substance Abuse Services Inc N
FAMILY PRACTICE ASSOCIATES R TAYLOR E HEYMAN & R LEE PTRS N
Fairview Hospital Y
Berkshire Medical Center Inc Y
Berkshire Faculty Services Inc Y
Berkshire Orthopaedic Associates, Inc. N
Western Massachusetts Pathology Services, PC N
Contemporary Rheumatology Specialists, PC. N
SUBURBAN INTERNAL MEDICINE, INC. N
DALTON MEDICAL ASSOCIATES, LLP N
ANDREW DANYLUK N
Advanced Berkshire Medical Imaging, PC N
Berkshire Hand to Shoulder Center LLC N
Berkshire Radiation Oncology PC 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
Rodowicz Darlene Treasurer 1 ACO Participant Representative Berkshire Medical Center Inc
Phelps David Board Member 1 ACO Participant Representative Berkshire Medical Center Inc
Hornstein Dr. Edmund Chairman 1 ACO Participant Representative Berkshire Medical Center Inc
McInerney Dr. Michael Vice-Chairman 1 ACO Participant Representative Berkshire Medical Center Inc
Siegel Carol Board Member 1 Medicare Beneficiary
Representative
N/A
Doyle  Dr. Dan ACO Medical Director  ACO Participant Representative  Berkshire Health Systems 
McLean  Ashley  Non-Voting Member 0 ACO Participant Representative Berkshire Health Systems 
Rogers John ACO Board Member 1 ACO Participant Representative Berkshire Health Systems
McDonald Ann Secretary 1 ACO Participant Representative Berkshire Health Systems
           
 
Key ACO clinical and administrative leadership:
Greg Paris ACO Executive
Dan Doyle, 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 William Young, Chairman
Care Coordination & Patient Engagement Committee Ann McDonald, Chairman
Evidence-Based Medicine Committee Edmund Hornstein, Chairman
Finance Committee Deborah Delaney, Chairman
Quality & Performance Improvement Committee William DeMarco, Chairman
 
Typ

Types of ACO participants, or combinations of participants, that formed the ACO:

  • Critical Access Hospital (CAH) billing under Method II
  • ACO professionals in a group practice arrangement
  • Hospital employing 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 2018, $0
 

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2018
      • 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

2018 Quality Performance Results:
ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 85.88 86.14
ACO-2 CAHPS: How Well Your Providers Communicate 94.72 93.93
ACO-3 CAHPS: Patients’ Rating of Provider 92.98 92.45
ACO-4 CAHPS: Access to Specialists 81.28 81.50
ACO-5 CAHPS: Health Promotion and Education 67.23 59.26
ACO-6 CAHPS: Shared Decision Making 68.83 61.94
ACO-7 CAHPS: Health Status/Functional Status 74.79 73.35
ACO-34 CAHPS: Stewardship of Patient Resources 18.97 26.26
ACO-8 Risk Standardized, All Condition Readmission 15.32 14.98
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 18.14 18.59
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 41.78 37.01
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 86.78 76.75
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 66.30 59.00
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91) 1.63 1.98
ACO-11 Use of Certified EHR Technology 100.00 98.20
ACO-12 Medication Reconciliation Post-Discharge 54.42 85.91
ACO-13 Falls: Screening for Future Fall Risk 86.40 79.73
ACO-44 Use of Imaging Studies for Low Back Pain 68.75 64.36
ACO-14 Preventive Care and Screening: Influenza Immunization 75.00 72.71
ACO-15 Pneumonia Vaccination Status for Older Adults 80.95 75.97
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 64.34 76.83
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 88.37 72.81
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 57.55 66.74
ACO-19 Colorectal Cancer Screening 70.43 68.27
ACO-20 Breast Cancer Screening 86.45 71.96
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 85.06 81.47
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 13.49 15.51
ACO-41 Diabetes: Eye Exam 56.75 52.42
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 73.80 73.10
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet 96.40 88.92
 
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.  
Note: In the Quality Performance Results file(s) above, search for “Caravan Health ACO 13 LLC” or “Berkshire ACO” to view the quality performance results. This ACO can also be found by using the ACO ID A3576 in the public use files on data.cms.gov.

Payment Rule Waivers

  • No, our ACO does not use the SNF 3-Day Rule Waiver.
Arrangements Disclosed
 
The ACO Board of Managers for Caravan Health ACO 13 LLC (“Board”) has formally determined the following arrangements are reasonably related to the purposes of the Medicare Shared Savings Program (“MSSP”), as required for use of the MSSP ACO Participation Waiver:
 
Participant Support Arrangements
 
Under the applicable Participant Agreements between the ACO and the Participants listed above, certain Participants are designated as Principal Participants and others are Non-Principal Participants.  Under the Service Agreements between each Participant and Caravan Health, Inc., the Principal Participants have agreed to pay for certain ACO-related expenses of the Non-Principal Participants in their respective regions, including management fees owed by each Non-Principal Participant.  In each case, the fees and other expenses paid by the Principal Participants on behalf of the Non-Principal Participants will be set in advance, will not vary based on the volume or value of any referrals between the Principal Participants and Non-Principal Participants (except to the extent such referrals indirectly contribute to the earning of shared savings or shared losses as applicable).
 
Through a formal resolution dated March 20, 2018, the Board determined that these arrangements are reasonably related to the purposes of the Medicare Shared Savings Program because they facilitate the participation of the Non-Principal Participants in the Medicare Shared Savings Program, which: i) promotes the accountability of Non-Principal Participants for the quality, cost, and overall care for a Medicare patient population as described in the Shared Savings Program; ii) promotes the management and coordination of care for Medicare fee-for-service beneficiaries attributed to Non-Principal Participants through an ACO; and iii) encourages investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare beneficiaries, served by Non-Principal Participants.

BERKSHIRE ACO
MEDICARE SHARED SAVINGS PROGRAM
ACO PARTICIPATION WAIVER DISCLOSURE

 
 
Caravan Health ACO 13 LLC, d/b/a Berkshire ACO (“Berkshire ACO”), is currently participating in the Medicare Shared Savings Program (the “MSSP”) pursuant to a Participation Agreement with the Centers for Medicare and Medicaid Services (“CMS”).  The Secretary of the U.S. Department of Health and Human Services has issued waivers of certain federal fraud and abuse laws that may otherwise limit innovation by accountable care organizations participating in the MSSP (see “Medicare Program; Final Waivers in Connection With the Shared Savings Program”, 80 Fed. Reg. 66,726 (Oct. 29, 2015)) (the “Final Rule”).  Pursuant to the Final Rule, Berkshire ACO seeks waiver protection for the arrangement described below.
 
On January 30, 2020, the Berkshire ACO Board of Managers exercised its authority under Social Security Act § 1899(f) to waive the application  of certain federal fraud and abuse laws, including the Stark Law and Anti-Kickback Statute, as they relate to an arrangement (the “Target Arrangement”). Under the Target Arrangement, certain participants of Berkshire ACO that are hospitals agreed to provide other ACO participants with software licenses and financial support for implementation and training associated with an electronic health record and practice management system (and certain related ancillary software).
 
The Board of Managers determined the Target Arrangement is reasonably related to the purposes of the Medicare Shared Savings Program because it will assist Berkshire ACO and its participants to manage and coordinate care for Medicare fee-for-service beneficiaries through an ACO, and encourage investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare beneficiaries. Specifically, the Target Arrangement will improve the accuracy of patient health information; facilitate the exchange of patient health information between and among Berkshire ACO participants and their ACO providers/suppliers who have a role in coordinating and managing care for Medicare beneficiaries aligned with Berkshire ACO; reduce the provision of duplicative testing; contribute to meeting the quality performance standards of the MSSP; enhance patient safety by maintaining complete and accurate medical records; and  allow Berkshire ACO Medicare beneficiaries to better able to communicate with their health care providers through use of a BHS patient portal.
 
 
 
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