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Hattiesburg Clinic ACO

Public Reporting

ACO Name and Location:

National Rural ACO 19 LLC DBA Hattiesburg Clinic ACO
415 S. 28th Ave. Hattiesburg, MS 39401

ACO Primary Contact:

Michael J. Kincade, JD
Email: michael.kincade@hattiesburgclinic.com
Phone: 601-579-8210

Organizational Information

ACO Participants ACO Participant in Joint Venture
Hattiesburg Clinic, PA N
Forrest County General Hospital N
Walthall General Hospital N

ACO Governing Body:

Board of Managers / Board of Members

Key ACO Clinical and Administrative Leadership:

  • ACO Executive: Bryan Batson, MD
  • Medical Director: Daniel McCall, MD
  • Compliance Officer: Michael J. Kincade, JD, Chair
  • Quality Assurance/Improvement Officer: Carla Smith

Associated Committees and Committee Leadership:

  • ACO Quality Assurance and Improvement Committee: Daniel McCall, MD, Chair
  • ACO Compliance Committee: Michael J. Kincade, JD, Chair
  • ACO Executive Committee: John M. Fitzpatrick, MD, Chair
  • ACO Evidence-Based Medicine Committee: Daniel McCall, MD, Chair
  • ACO Clinical Committee: Daniel McCall, MD, Chair
  • ACO Administrative Committee: Michael J. Kincade, JD, Chair
  • ACO Finance Committee: Alex Agnew, Chair
  • ACO Information Technology Committee: Daniel McCall, MD, Chair
  • ACO Care Coordination and Patient Engagement Committee: Daniel McCall, MD, Chair

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

  • ACO Professionals in a Group Practice Arrangement
  • Rural Health Clinics (RHCs)
  • Hospital Employing ACO Professionals
Member First Name Member Last Name Title/Position Member’s Voting Power Membership Type ACO Participant Legal Business Name/DBA if applicable
John Fitzpatrick MD, Chair 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Christopher Douglas MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Bo Hrom MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Jeffrey Hudson MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Thomas “Clay” King MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Judd Reynolds DO 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Brett Robbins MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Katherine Royals MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Steven Stogner MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Jessica Tullos DO 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Raymond Whitehead MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Walid Younis MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Jeri Eron Not Applicable 6.25% Medicare beneficiary representative N/A
Jeff Cook CEO, FGH 6.25% ACO participant representative Forrest County General Hospital
Hattiesburg Clinic, ACO
Ben Hester CFO, FGH 6.25% ACO participant representative Forrest County General Hospital
Hattiesburg Clinic, ACO

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Second Agreement Period
    • Performance Year 2023, $7,982,021.87
    • Performance Year 2022, $8,288,268.31
    • Performance Year 2021, $4,876,947.03
    • Performance Year 2020, $4,853,335.00
    • Performance Year 2019, $4,591,313.90
  • First Agreement Period
    • Performance Year 2019, $4,591,313.90
    • Performance Year 2018, $4,076,848
    • Performance Year 2017, $0
    • Performance Year 2016, $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.

Shared Savings Distribution:

  • Second Agreement Period
    • Performance Year 2023
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2022
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2021
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2020
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2019
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
  • First Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2018
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2017
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2016
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A

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.

Quality Performance Results

2023 Quality Performance Results

Measure # Measure Name Collection Type Reported Performance Rate Current Year Mean Performance Rate (SSP ACOs)
Quality ID#: 001 Diabetes: Hemoglobin Ale (HbAlc) Poor Control (>9%) [1] CMS Web Interface 5.37 9.84
Quality ID#: 134 Preventive Care and Screening: Screening for Depression and Follow-up Plan CMS Web Interface 97.78 80.97
Quality ID#: 236 Controlling High Blood Pressure CMS Web Interface 73.24 77.80
Quality ID#: 318 Falls: Screening for Future Fall Risk CMS Web Interface 97.97 89.42
Quality ID#: 110 Preventive Care and Screening: Influenza Immunization CMS Web Interface 85.68 70.76
Quality ID#: 226 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface 85.71 79.29
Quality ID#: 113 Colorectal Cancer Screening CMS Web Interface 84.06 77.14
Quality ID#: 112 Breast Cancer Screening CMS Web Interface 86.07 80.36
Quality ID#: 438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface 87.99 87.05
Quality ID#: 370 Depression Remission at Twelve Months CMS Web Interface 32.56 16.58
Quality ID#: 321 CAHPS for MIPS [2] CMS Web Interface 8.94 6.25
Measure # 479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [1] Administrative Claims 0.1581 0.1553
Measure # 484 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] Administrative Claims — 35.39
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS 88.17 83.68
CAHPS-2 How Well Providers Communicate CAHPS for MIPS 95.80 93.69
CAHPS-3 Patient’s Rating of Provider CAHPS for MIPS 92.94 92.14
CAHPS-4 Access to Specialists CAHPS for MIPS 82.46 75.97
CAHPS-5 Health Promotion and Education CAHPS for MIPS 67.80 63.93
CAHPS-6 Shared Decision Making CAHPS for MIPS 58.08 61.60
CAHPS-7 Health Status and Functional Status CAHPS for MIPS 71.32 74.12
CAHPS-8 Care Coordination CAHPS for MIPS 91.30 85.77
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS 96.07 92.31
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS 31.67 26.69

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov.

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
    • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.

Fraud and Abuse Waivers

ACO Pre-Participation Waiver:

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

Application and Operational Services:

  • Parties to the arrangement: ACO, ACO participants, ACO providers/suppliers, and vendors providing services to the ACO, ACO participants and/or ACO providers/suppliers.
  • Date of arrangement: As of January 1, 2015.
  • Items, services, goods or facility provided: The ACO entered into an arrangement pursuant to which Hattiesburg Clinic, PA (an ACO participant) provided all funding for the administrative services, management services, and information technology necessary to apply for, and successfully participate in, the MSSP and the ACO Investment Model (“AIM”). Under this arrangement the ACO participants agreed to participate in the ACO and MSSP, provide in-kind services to and for the ACO and other ACO participants, and assign their interest in the AIM funding to the ACO and Hattiesburg Clinic, PA. This arrangement included the formation and capitalization of the ACO, and the development of the ACO operating agreement and participation agreements.
  • Date and nature of any amendments to the arrangement, if applicable: None.

 

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.

Operational Services:

  • Parties to the arrangement: ACO, ACO participants, ACO providers/suppliers, and vendors providing services to the ACO, ACO participants and/or ACO providers/suppliers.
  • Date of arrangement: January 1, 2016.
  • Items, services, goods or facility provided: The ACO entered into an arrangement pursuant to which Hattiesburg Clinic, PA (an ACO participant) provides funding for the administrative services, management services, and information technology necessary to successfully participate in the MSSP and AIM. Under this arrangement the ACO participants participate in the ACO and MSSP, provide in-kind services to and for the ACO and other ACO participants, and assign their interest in the AIM funding to the ACO and Hattiesburg Clinic, PA. This arrangement includes the respective obligations of the ACO, ACO participants, and ACO providers/suppliers under the terms of the ACO’s participation agreement with the ACO participants. This arrangement also includes the respective obligations of the ACO and Hattiesburg Clinic, PA under the terms of the ACO’s operating agreement.
  • Date and nature of any amendments to the arrangement, if applicable: As of January 1, 2019, neither AIM nor AIM funding are available to the ACO or the ACO participants.

Provision of Medical Equipment:

  • Parties to the arrangement: ACO, ACO participants, ACO providers/suppliers, and Medicare beneficiaries attributed to the ACO by CMS.
  • Date of arrangement: February 18, 2016.
  • Items, services, goods or facility provided: Under this arrangement the ACO, ACO participants, or ACO provider/suppliers may provide to Medicare beneficiaries attributed to the ACO, for free or below fair market value, medical equipment that the ACO, ACO participant, or ACO provider/supplier has determined is necessary or useful for the patient to fully engage in preventive care, or to adhere to his/her treatment, drug or follow-up care regime or to manage his/her chronic disease or condition.
  • Date and nature of any amendments to the arrangement, if applicable: None.

Provision of Delivery Services and Medications:

  • Parties to the arrangement: ACO, ACO participants, ACO providers/suppliers, and Medicare beneficiaries attributed to the ACO by CMS.
  • Date of arrangement: February 18, 2016.
  • Items, services, goods or facility provided: Under this arrangement the ACO, ACO participants, or ACO provider/suppliers may provide to Medicare beneficiaries attributed to the ACO: (i) free or discounted (below fair market value) delivery of medications, or (ii) free medications to such beneficiaries with demonstrated financial need. Such items and services may be provided when the ACO, ACO participant, or ACO provider/supplier has determined that such service or medication is necessary or useful for the patient to fully engage in preventive care, or to adhere to his/her treatment, drug or follow-up care regime, or to manage his/her chronic disease or condition.
  • Date and nature of any amendments to the arrangement, if applicable: None.

Transportation Services:

  • Parties to the arrangement: ACO, ACO participants, ACO providers/suppliers, and Medicare beneficiaries attributed to the ACO by CMS.
  • Date of arrangement: February 18, 2016.
  • Items, services, goods or facility provided: Under this arrangement, the ACO, ACO participants, or ACO provider/suppliers may provide affordable transportation options to Medicare beneficiaries attributed to the ACO. Such transportation services include the provision of shuttle services, or a coupon or voucher that such beneficiaries can use to purchase transportation services from a transportation vendor. The transportation services are provided so that the beneficiaries can keep their appointments with their primary care providers, and obtain medications and other necessary medical items and services.
  • Date and nature of any amendments to the arrangement, if applicable: None.

Care Management Services:

  • Parties to the arrangement: ACO, ACO participants, and ACO providers/suppliers.
  • Date of arrangement: January 1, 2020.
  • Items, services, goods or facility provided: Under this arrangement Hattiesburg Clinic, PA (an ACO participant) provides care management services to other ACO participants and to ACO providers/suppliers. Such care management services include the provision care management personnel (e.g.: care coordinators and care managers), and care management policies and procedures.
  • Date and nature of any amendments to the arrangement, if applicable: None.
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