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

Last Name First Name Title/Position Member’s Voting Power Membership Type Legal Business Name/DBA if applicable
Fitzpatrick John MD, Chair 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Campbell Joe MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Crosby Samuel MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Douglas Christopher MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Hrom Bo MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Hudson Jeffrey MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
King Thomas “Clay” MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Reynolds Judd DO 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Robbins Brett MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Royals Katherine MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Stogner Steven MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Whitehead Raymond MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Younis Walid MD 6.25% ACO participant representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Riley Pat Not Applicable 6.25% Medicare beneficiary representative Hattiesburg Clinic, PA
Hattiesburg Clinic, ACO
Woodard Andy CEO, FGH 6.25% ACO participant representative Forrest County General Hospital
Hattiesburg Clinic, ACO
Cook Jeff VP, FGH 6.25% ACO participant representative Forrest County General Hospital
Hattiesburg Clinic, ACO


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

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Second Agreement Period
    • 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.

How Shared Savings are Distributed:

  • Second Agreement Period
    • 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

2022 Quality Performance Results

Quality performance results are based on CMS web interface.

  1. A lower performance rate corresponds to higher quality.
  2. For PY 2022, the CMS Web Interface measures Quality ID #438 and Quality ID #370 do not have benchmarks, and therefore, were not scored.
  3. CAHPS for MIPS is a composite measure, so numerator, denominator, and performance rate values are not applicable (N/A). The CAHPS for MIPS composite score is calculated as the average number of points across scored Summary Survey Measures (SSMs) (86 FR 65256). Refer to Table 5 for details on CAHPS for MIPS performance.

2022 Quality Performance Results Continued


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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