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St. Luke’s Medicare ACO

ACO Name and Location     

St. Luke’s Shared Savings Plan, LLC
dba St. Luke’s Medicare ACO
801 Ostrum Street
Bethlehem, PA 18015

 

ACO Primary Contact

Linda Gately
484-658-6840
Linda.Gately@sluhn.org

Organizational Information

ACO Participants:

ACO Participants

ACO Participant in Joint Venture

Gastroenterology Associates, LTD

N

GSLPG, Inc

N

Otorhinolaryngology Associates, P.C.

N

Penn Foundation, INC

N

Progressive Physicians Associates, INC

N

Specialty Physicians Associates, LLC

N

St. Luke’s Physician Group, INC

N

St. Luke’s Warren Physician Group, PC

N

Whitehall Medical Associates, LLC

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

John

Brinker

Member

8%

ACO Participant

St. Luke’s Physician Group, Inc

Aldo

Carmona

Chair

8%

ACO Participant

St. Luke’s Physician Group, Inc

Dean

Evans

Member

8%

Medicare Beneficiary

N/A

Joel

Fagerstrom

Member

8%

Stakeholder Representative

N/A

Robert

Fournier

Member

8%

ACO Participant

Progressive Physician Associates, Inc

Robert

Gayner

Member

8%

ACO Participant

St. Luke’s Physician Group, Inc

Jarrod

Keeler

Member

8%

ACO Participant

Specialty Physician Associates, LLC

Dennis

McGorry

Member

8%

ACO Participant

St. Luke’s Physician Group, LLC

Joseph

Minahan

Member

8%

ACO Participant

St. Luke’s Physician Group, LLC

Lisa

Perry

Member

8%

ACO Partcipant

St. Luke’s Physician Group, LLC

Justin

Psaila

Member

8%

ACO Participant

St. Luke’s Physician Group, LLC

Donna

Sabol

Member

8%

Stakeholder Representative

N/A

Due to rounding, ‘Member’s Voting Power’ may not equal 100%.

 

Key ACO Clinical and Administrative Leadership:

ACO Executive: Scott Wolfe

Medical Director: Robert Gayner, MD

Compliance Officer: Linda Gately

Quality Assurance/Improvement Officer: Donna Sabol

Associated Committees and Committee Leadership:

Committee Name

Committee Leader Name and Position

Value Based Committee

Donna Sabol, Chair

 

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

  • Network of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Second Agreement Period
    • Performance Year 2023, $15,636,199
    • Performance Year 2022, $15,029,934
  • First Agreement Period
    • Performance Year 2021, $7,454,113
    • Performance Year 2020, $9,087,692
    • Performance Year 2019, $0
    • Performance Year 2018, $0

 

Shared Savings Distribution:

  • Second Agreement Period
    • Performance Year 2023
      • Proportion invested in infrastructure: 19%
      • Proportion invested in redesigned care processes/resources: 45%
      • Proportion of distribution to ACO participants: 36%
    • Performance Year 2022
      • Proportion invested in infrastructure: 17%
      • Proportion invested in redesigned care processes/resources: 47%
      • Proportion of distribution to ACO participants: 36%
  • First Agreement Period
    • Performance Year 2021
      • Proportion invested in infrastructure: 12%
      • Proportion invested in redesigned care processes/resources: 34%
      • Proportion of distribution to ACO participants: 54%
    • Performance Year 2020
      • Proportion invested in infrastructure: 23%
      • Proportion invested in redesigned care processes/resources: 10%
      • Proportion of distribution to ACO participants: 58%
  • Performance Year 2019
    • N/A
  • Performance Year 2018
    • N/A

 

Quality Performance Results

2023 Quality Performance Results:

Quality performance results are based on the CMS Interface collection type.

Measure #

Measure Name

Collection Type

Reported Performance Rate

Current Year Mean Performance Rate (SSP ACOs)

Measure #1

Diabetes: Hemoglobin A1CPoor Control (>9%)

CMS Web Interface

7.90

9.84

Measure #134

Preventive Care and Screening: Screening for Depression and Follow-up Plan

CMS Web Interface

93.97

80.97

Measure #236

Controlling High Blood Pressure

CMS Web Interface

78.97

77.80

Measure #318

Falls: Screening for Future Fall Risk

CMS Web Interface

97.26

89.42

Measure #110

Preventive Care and Screening: Influenza Immunization

CMS Web Interface

74.64

70.76

Measure #226

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

CMS Web Interface

95.24

79.29

Measure #113

Colorectal Cancer Screening

CMS Web Interface

87.80

77.14

Measure #112

Breast Cancer Screening

CMS Web Interface

88.41

80.36

Measure #438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

CMS Web Interface

89.45

87.05

Measure #370

Depression Remission at Twelve Months

CMS Web Interface

27.03

16.58

Measure # 321

CAHPS for MIPS

CAHPS for MIPS Survey

7.61

6.25

CAHPS-1

Getting Timely Care, Appointments, and Infrormation

CAHPS for MIPS Survey

87.23

83.68

CAHPS-2

How Well Providers Communicate

CAHPS for MIPS Survey

94.52

93.69

CAHPS-3

Patient’s Rating of Provider

CAHPS for MIPS Survey

92.53

92.14

CAHPS-4

Access to Specialists

CAHPS for MIPS Survey

71.91

75.97

CAHPS-5

Health Promotion and Education

CAHPS for MIPS Survey

67.58

63.93

CAHPS-6

Shared Decision Making

CAHPS for MIPS Survey

66.56

61.60

CAHPS-7

Health Status and Functional Status

CAHPS for MIPS Survey

74.02

74.12

CAHPS-8

Care Coordination

CAHPS for MIPS Survey

87.23

85.77

CAHPS-9

Courteous and Helpful Office Staff

CAHPS for MIPS Survey

93.61

92.31

CAHPS-11

Stewardship of Patient Resources

CAHPS for MIPS Survey

24.20

26.69

Measure #479

Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups

CMS Web Interface

0.1719

0.1553

Measure #484

Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions

CMS Web Interface

45.59

35.39

For previous years’ Financial and Quality Performance Results, please visit: Data.cms.gov

 

Fraud and Abuse Waivers

  • ACO Participation Waiver:
    The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement. 

 

  • Parties to the arrangement: St. Luke’s Shared Savings, LLC and the following ACO participants:
    Gastroenterology Associates, LTD 10/22/2019
    Otorhinolaryngology Associates, PC 03/20/2019
    Specialty Physicians Associates, LLC 02/20/2019
    Whitehall Medical Associates 08/12/2019
  • Date of arrangement: 02/20/2018 – current
  • Items, services, goods, or facility provided: Electronic Health Record
  • Date and nature of any amendments to the arrangement, if applicable: 01/01/2022 amended with new agreement years