Accountable Care Organization


What is an Accountable Care Organization?

Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare Fee-for-Service beneficiaries..

The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program


Jackson Purchase Medical Associates, PSC is participating in a new care coordination program with Medicare

This information is provided so that you know that our organization has been selected by Medicare to participate in a Medicare Accountable Care Organization (ACO).
We’re working to improve your care

An ACO is a group of doctors and other health care providers working together with Medicare to give you better service and care.  The goal of an ACO is for your doctors to communicate closely with your other health care providers to deliver high-quality care and meet your unique individual needs and preferences.  The ACO may be rewarded for providing you with high quality, more coordinated care.
You can still see any doctor or go to any hospital

Your Medicare benefits are not changing, and you will still receive your benefits through Original Medicare.  This isn’t a Medicare Advantage plan or an HMO plan. You still have the right to use any doctor or hospital who accepts Medicare, at any time. We may continue to recommend that you see particular doctors for your specific health needs, but it’s always your choice about what doctors you use or hospitals you visit.
You control your personal information

To help us give you the right care in the right place at the right time, on June 9, 2012, Medicare plans to start sharing certain health information with us about your care.  This information will include things like visits to the doctor or hospital, medical conditions, and prescriptions you’ve had in the past and moving forward.  Having this information will help us and your other health care providers participating in our ACO give you high-quality care, because we’ll have the most up-to-date information about your health.

Your privacy is very important to us, and you control the use of your personal health information. Like Medicare, we have important safeguards in place to make sure all your medical information is safe.
You can choose to not share your health information

If you choose, you can ask Medicare not to share your personal health information with us by doing one of these things:

  • Call 1-800 MEDICARE (1-800-633-4227). TTY users should call
    1-877-486-2048.
  • Complete, sign, and return the “Declining to Share Personal Health Information” form to our office.

If you want to ask Medicare not to share your information with us, you should take one of the three steps described above.   Even after Medicare begins to share your information with us, you may always ask Medicare to stop this information-sharing in the future.

Please note, however, that Medicare will not share any information about alcohol or drug treatment without express written permission.  If you have received such treatment, it is important that we understand all of your health needs in order to allow the health care providers that treat you to coordinate your care.

If you have received such treatment, consenting to allow Medicare to share this information about you with us will not change who you go to for alcohol or drug abuse prevention, treatment or recovery supports, but will help us provide better health care for you.  You may withdraw your consent to share this information at any time either in writing or over the phone if you want Medicare to stop sharing this information.

 

Questions

If you have questions or concerns, you can call us at 270-441-4200 or bring it up next time you’re in your doctor’s office.  You can also visit www.medicare.gov/acos.html or call 1-800-MEDICARE and tell the operator you are asking about ACOs (TTY users should call 1-877-486-2048).

 

A1047 – Jackson Purchase Medical Associates, PSC
ACO Public Reporting Information

ACO Name and Location
Jackson Purchase Medical Associates, PSC
225 Medical Center Drive, Ste 201
Paducah, KY 42001

ACO Primary Contact
Peter McNally
pmcnally@jpmpsc.com
(270) 441-4250

Composition of ACO:

• ACO professionals in a group practice arrangement

ACO Participants

• Jackson Purchase Medical Associates, PSC

Jackson Purchase Medical Associates ACO Governing Body

• James Long, M.D., President

• Jesse Wallace, M.D., Vice President

• Steve McCullough, D.O., Vice President

• Raymond de la Rosa, M.D., Treasurer

• Blake Leslie, M.D., Secretary

Jackson Purchase Medical Associates ACO Committee and Key Leadership Personnel

• Clinical Transformation Council: Richard D. Smith, M.D., Chair

• Care Management Team: Christopher Phillips, M.D., Chair

• Clinical Transition Team: Blake Leslie, M.D., Chair

• Patient Council : Peter McNally

• Medical Director: Richard D. Smith, M.D.

• Executive Director: Peter McNally

 

Aggregate Amount of Shared Savings/Losses

• Performance Years 1 : $ 2,811,506

• Performance Year 2 : TBD (Due in Spring 2015)

• Performance Year 3 : TBD (Due in Spring 2016)

 

How Shared Savings Are Distributed

•  Reinvest in Infrastructure: 84%

• Distribution to ACO Participants: 16%

– Primary Care Professionals: 74%

– Specialists: 26%

– Hospitals: N/A

Quality Performance Results
2012 Performance Summary Statistics
Performance Measure ACO Performance Rate Mean Performance Rate for All ACOs
Risk Standardized, All Condition Readmission (ACO-8)                        15.11                                           15.42
ASC Admissions: COPD or Asthma in Older Adults (ACO-9)                          1.37                                             1.13
ASC Admission: Heart Failure (ACO-10)                          1.47                                             1.09
Percent of Primary Care Providers who Qualified for EHR Incentive Payment           (ACO-11) 100.00% 25.70%
2013 Performance Summary Statistics
Performance Measure ACO Performance Rate Mean Performance Rate for All ACOs
Risk Standardized, All Condition Readmission (ACO-8)                        14.12                                           14.90
ASC Admissions: COPD or Asthma in Older Adults (ACO-9)                          0.90                                             1.17
ASC Admission: Heart Failure (ACO-10)                          1.18                                             1.20
Percent of Primary Care Providers who Qualified for EHR Incentive Payment           (ACO-11) 87.50% 66.21%
For more information on how to interpret scores on the above quality performance measures,
see http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/MSSP-QM-Benchmarks.pdf