ALEDADE 12 WV CHC MSSP ENHANCED
Colleen Wagner
ACO Primary Contact
202-803-7979
Location
Aledade Accountable Care 12, LLC
4550 Montgomery Ave, Ste 1050N
Bethesda, MD 20814
-
ACO Participants
ACO Participants ACO Participant in Joint Venture ALEDADE CARE SOLUTIONS OF WEST VIRGINIA INC N BELINGTON COMMUNITY MEDICAL SERVICES ASSOCIATION N CAMDEN ON GAULEY MEDICAL CENTER INC N CHANGE, INCORPORATED N CLAY-BATTELLE HEALTH SERVICES ASSOCIATION N LINCOLN COUNTY PRIMARY CARE CENTER INC N MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTER, INC. N MONROE COUNTY HEALTH CENTER BOARD OF TRUSTEES N NEW RIVER HEALTH ASSOCIATION, INC N RAINELLE MEDICAL CENTER INC N RITCHIE COUNTY PRIMARY CARE ASSOC INC N SHENANDOAH VALLEY MEDICAL SYSTEM, INC. N TUG RIVER HEALTH ASSOCIATION, INC. N VALLEY HEALTH CARE INC N VALLEY HEALTH SYSTEMS, INC N WESTERN MARYLAND HEALTH CARE CORPORATION N WIRT COUNTY HEALTH SERVICES ASSOCIATION INC N -
ACO Governing Body
Member First Name Member Last Name Member Title/Position Member's Voting Power (Expressed as a percentage) Membership Type ACO Participant Legal Business Name, if applicable RAYMOND ALVAREZ Board Member 5.56 ACO Participant Representative Monongahela Valley Association Of Health Centers, Inc.KRISTI ATHA-RADER Board Member 5.56 ACO Participant Representative Rainelle Medical Center Inc MICHELLE BALLARD Board Member 5.56 ACO Participant Representative Monroe County Health Center Board Of TrusteesANDREA CLINE-THORNTON Board Member 5.56 ACO Participant Representative Tug River Health Association, Inc.MICHELLE DIXON Board Member 5.56 ACO Participant Representative Western Maryland Health Care CorporationJORDAN GODWIN Board Member 5.56 ACO Participant Representative Valley Health Care Inc MARGARET HICKEY Board Member 5.56 ACO Participant Representative Camden On Gauley Medical Center IncRHONDA KRUGMAN Board Member 5.56 ACO Participant Representative Wirt County Health Services Association IncLISA LEACH Board Member 5.56 ACO Participant Representative Lincoln County Primary Care Center IncMICHAEL LI Board Member 5.56 ACO Participant Representative Shenandoah Valley Medical System, Inc.LISA MOWRY Board Member 5.56 ACO Participant Representative Change, Incorporated ERIC RUF Board Member 5.56 ACO Participant Representative Belington Community Medical Services Association, IncJOHN SCHULTZ Board Member 5.56 ACO Participant Representative New River Health Association, IncDAVID SCITES Board Member/Medicare Beneficiary Representative 5.56 Medicare Beneficiary Representative N/A REBECCA THOMAS Board Member 5.56 ACO Participant Representative Clay-Battelle Health Services AssociationCOLLEEN WAGNER Chair/Board Member 5.56 Other N/A MATHEW WEIMER ACO Medical Director/Board Member 5.56 ACO Participant Representative Valley Health Systems, Inc AMY YOKUM Board Member 5.56 ACO Participant Representative Ritchie County Primary Care Assoc IncDue to rounding, ‘Member’s Voting Power’ may not equal 100 percent. -
Key Clinical and Administrative Leadership
- ACO Executive: Colleen Wagner
- Medical Director: Mathew Weimer
- Compliance Officer: Margaret Martuszewski
- Quality Assurance/Improvement Officer: Joshua Israel
-
ACO Committees and Committee Leaderships
Committee Name Committee Leader Name and Position Compliance Committee Jillyan Bacallao / Compliance Committee -
Composition of ACO
- Federally Qualified Health Center (FQHC)
-
Amount of Shared Savings/Losses
Third Agreement Period
- Performance Year 2023, $6,894,761
- Performance Year 2022, $5,632,892
Second Agreement Period
- Performance Year 2021, $4,503,556
- Performance Year 2020, $6,184,525
First Agreement Period
- Performance Year 2019, $4,259,380
- Performance Year 2018, $0
- Performance Year 2017, $0
Note: Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
-
How Shared Savings are Distributed
Third Agreement Period
- Performance Year 2023:
- Proportion invested in infrastructure: 10%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2022:
- Proportion invested in infrastructure: 10%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 60%
Second Agreement Period
- Performance Year 2021:
- Proportion invested in infrastructure: 10%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2020:
- Proportion invested in infrastructure: 10%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2019-A:
- Proportion invested in infrastructure: 10%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 60%
First Agreement Period
- Performance Year 2019:
- Proportion invested in infrastructure: 10%
- Proportion invested in redesigned care processes/resources: 30%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2018:
- N/A
- Performance Year 2017:
- N/A
Note: Our ACO participated in multiple performance years during Calendar Year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
- Performance Year 2023:
2023 CMS WEB
INTERFACE
QUALITY
PERFORMANCE
RESULTS
For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov
FRAUD AND ABUSE
WAIVERS
ACO Pre-Participation Waiver: N/A
ACO Participation Waiver:
– Parties to the arrangement: Aledade Accountable Care 12, LLC : ACO Participants
– Date of arrangement: 10/24/23
– Items, services, goods, or facility provided: Staffing of value based care initiatives.
The ACO will make payments as necessary to Participants in the ACO to reimburse the staffing costs required to complete certain value based care activities, which includes:
a) Conduct outreach to patients.
b) Contact patients recently discharged from a hospital emergency department or inpatient/outpatient status to assess if needs were met and schedule a follow up visit with their primary care physician if needed.
c) Contact patients who have not been seen by their primary care physician in 6-12 months (depending on chronic conditions) and schedule annual wellness or other diagnostically appropriate appointments.
d) Contact patients who are new to the Medicare program and schedule a “Welcome to Medicare” visit.
e) Implement and routinize use of the Aledade application to provide insights into patient health, diagnosis coding opportunities, and visibility into the total cost of patient care.
f) Reviewing the “care gap worklist” in the Aledade App to apprise patients of test results, conducting outreach to patients to schedule preventive screenings, and follow up with patients concerning medication adherence concerns.
g) Support accurate and complete diagnosis documentation and coding.