Medicare ACO – Wellstar Clinical Partners

Medicare Accountable Care Organization

Pathways to Success

Achieving Quadruple Aim Success

Join us as we continue the journey toward the Quadruple Aim through our Medicare Accountable Care Organization (ACO) and other products. Our past success is a strong indicator of the success we can achieve with the new Centers for Medicare and Medicaid Services (CMS) Pathways to Success Program. Providing services to an average of 43,000 Medicare beneficiaries annually, Wellstar Clinical Partners Medicare ACO has generated shared savings four out the five years as participants in Medicare Shared Savings Plan (MSSP).

Program Overview

CMS Pathways to Success is a new five-year program designed to bring greater value to patients while rewarding participating providers.

Effective January 1, 2020, the CMS Pathways to Success program will replace the former MSSP program and introduce a risk acceptance glide path to further encourage the delivery of high value and quality care to Medicare beneficiaries.

The program includes a five-year participation period where the shared savings upside opportunity remains fixed at a maximum of 10% of the ACO’s annual expenditures during years one through five. There is no downside risk for the first year. Downside risk begins in year two, limited to 1% of the ACOs annual expenditures. In year three, the downside risk increases to 2% followed by 4% in years four and five. Participants can make annual decisions to continue with the program.

Public Reporting PDF

ACO Information

Name and Location

Wellstar Clinical Partners Medicare ACO, LLC
793 Sawyer Road
Marietta, GA 30062

Primary Contact

Lauren Sloan
(470) 956-9207
Lauren.Sloan@Wellstar.org

Akstein Eye Center
American Foot & Leg Specialists, PC
Apex Medical Center
Atlanta Center for Dermatologic Diseases, PC
Atlanta Clinical Research Centers, LLC
Atlanta Family Physicians
Atlanta Kidney and Hypertension Associates
Atlanta Kidney Specialists, LLC
Atlanta Lung Specialists, PC
Atlanta Psychiatry & Neurology
Atlanta South Nephrology, PC
Atlanta Urological Group, PC
Atlanta West Dermatology, PC
Babatunde Fariyike, MD, LLC
Barrack Spine and Joint Medicine, Inc.
Barrett Parkway Foot and Leg
Bernard Orewa
Blatt Eye Center, PC
Bridgemill Neurological Associates, PC
C.B. Reddy, MD, PC
Cardiology Associates of Atlanta, PC
Center for Allergy & Asthma of Georgia, PC
Center for Spine Interventions, PC
Classicare Medical Consult PC, Inc.
Cobb Hospital Inc.
Cobb Internal Medicine Associates
Cobb Nephrology Hypertension Associates, PC
Cobb Women’s Health, PA
Corey Patrick Harkins
Covenant Pulmonary Critical Care Inc.
Craniospinal Institute of Georgia
Crawford Plastic Surgery
Dhiraj A. Patel, MD
Dinesh K. Bhatia, MD, PC
Douglas Hospital Inc.
Douglas Women’s Center PC
Douglasville Eye Clinic, PC
Douglasville Nephrology & HTN Clinic
Dr. Wendy Giles
East Cobb Foot & Ankle Care, PC
Elizabeth George, MD, PC
Essential Medical Care
Family Medical Center, PC
Feng’s Medical & Neurological Clinic
Gastrointestinal Specialist of Georgia
Georgia Anesthesiologists, PC
Georgia Blue Foot and Ankle, LLC
Georgia Emergency Group, LLC
George Eye Specialists
Georgia Gynecology
Georgia Imaging Associates, PC
Georgia Kidney Associates, Inc.
Georgia Pain and Spine Solutions, PC
Georgia Podiatry, Inc.
Georgia Radiology Services, LLC
Grace Medical Clinic
Grace Medical Practice Ltd.
Guo’s Medical Clinic, LLC
Gynecology Issues
Healthwise Internal Medicine
Hyperbaric Physicians of Georgia
Irshad Syed, MD, LLC
J. Michael Petway, MD, PC
James B. Depew, MD, PC
James K. Fortson, MD, PC
Jasmine Jeffers, MD, LLC
Javaid Sayeed
Jeremy Meisel, MD, LLC
Joseph M. Still Burn Centers Inc.
Kamlesh D. Nayak, MD, PC
Kennesaw Mountain Medical Group
Kennestone Hospital Inc.
Kiritkumar J. Shah, MD, PC
LaGrange Emergency Physicians, LLC
LaGrange Internal Medicine, PC
Lotus Vision LLC
M. Ramzy Hajmurad, MD, PC
Mahaveer Vakharia, MD, PC
MAK Anesthesia Holdings, LLC
Maldonado & Moreno, PC
Marietta Eye Clinic, PA
Marietta Medical Group
Marietta OB/GYN Affiliates, PA
Marietta Podiatry Group
Marietta Rheumatology Associates, PC
Medical Care of LaGrange, LLC
Mediclinic of Georgia, PC
Metro Nephrology, Inc.
MetroDerm, PC
Michael Biddle
Michael Petrosky
Mina C. Nayak, MD
Multispecialty Services, LLC
Norman I. Kornblatt
North Atlanta Primary Care, PC
North Fulton Emergency Physicians, LLC
North Georgia Kidney Specialists, LLC
North Georgia Internal Medicine, PC
Northwest Georgia Oncology Centers, PC
Northwest Neurology, PC
Omolara B. Kuteyi MD, Inc.
Orthopaedic Solutions, PC
Orthopaedics of Atlanta, PC
Patricia Lloyd
Paulding Medical Center, Inc.
Peachland Nephrology & Hypertension, PC
Personal Concierge MD, LLC
Physician Pain Care, PC
Pinnacle Orthopaedics & Sports Medicine
Podiatry Group of Georgia, Inc.
Polaris Medical Group
Providence Rd Primary Care, LLC
Quantum Radiology, PC
Rausch Family Practice
Resurgens, PC
Richard W. King Jr.
Robert T Goetzinger, MD, PC
Sam Peng, MD, PC
Shelton Hospitalists Group, LLC
Smyrna Medical Associates, PC
South Atlanta Pulmonary and Critical Care Associates
South Atlanta Pulmonary Group
South Fulton Emergency Physicians, LLC
Southeast Podiatry
Southern Nephrology Clinic, LLC
Spilker Medical, LLC
St. Jude’s Internal Medicine, LLC
Sumner Neurology Associates, PLLC
Surgical Arts, PC
The Bortolazzo Group, LLC
The Breast Center, PC
Vascular Surgical Associates, PC
We Care MD, PC
Wellstar Atlanta Medical Center Inc.
Wellstar Community Hospice, LLC
Wellstar Home Health, LLC
Wellstar Medical Group, LLC
Wellstar North Fulton Hospital, Inc.
Wellstar Spalding Regional Hospital Inc.
Wellstar Sylvan Grove Hospital Inc.
West Atlanta OB-GYN Inc.
West Georgia Infectious Diseases
West Georgia Medical Center, Inc.
William E. Snell, DO, PC
William Tung, MD, PC

Governing Body

Arif Aziz, MD

Gastrointestinal Specialists of Georgia, LLC

Thomas Bhat, MD

Chairman

North Atlanta Primary Care

Srinivas Bramhadevi, MD

Wellstar Medical Group, LLC

Danny Branstetter, MD

Wellstar Medical Group, LLC

John Brennan, MD

George Brown, MD

Wellstar Medical Group, LLC

Brett Cannon, MD

The Bortolazzo Group, LLC

Arum Chevru, MD

Vascular Surgical Associates, LLC

Damon Denzin, PA

Wellstar Medical Group, LLC

Charmaine Emelife, MD

Atlanta South Nephrology

Rusty Durham

Joseph Havlik, MD

Chairman

West Georgia Infectious Diseases

Larry Hornsby, MD

Wellstar Medical Group, LLC

Barry Mangel, MD

Wellstar Medical Group, LLC

Prashant Mishra, MD

Wellstar Medical Group, LLC

Vijay Nath, MD

Georgia Kidney Associates, Inc.

Ike Nwaobi, MD

Wellstar Medical Group, LLC

Jehangir Pirzada, MD

Wellstar Medical Group, LLC

Ed Richardson

Roderick Rhyant, MD

Wellstar Medical Group, LLC

Clinical and Administrative Leadership

Barbara Corey ACO Executive
Chirag Patel, MD Medical Director
Beth Kost Compliance Officer
Stephanie Lamar Quality Assurance/Improvement Officer

Associated Committees and Committee Leadership

Quality & Operations Committee
Roderick Rhyant, MD Chair

Finance Committee
Barry Mangel, MD Chair

Network Committee
Brett Cannon, MD Chair

Governance and Strategy Committee
Vijay Nath, MD Chair

Types of ACO participants, or combinations of participants, that formed the ACO:

Partnerships or joint venture arrangements between hospitals and ACO professionals.

Shared Savings and Losses

Amount of Shared Savings/Losses

Second Agreement Period Performance Year 2021
First Agreement Period Performance Year 2020, $6,987,217

Shared Savings Distribution

Second Agreement Period Performance Year 2021
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
First Agreement Period Performance Year 2020
- Proportion invested in infrastructure: 15%
- Proportion invested in redesigned care processes/resources: 11%
- Proportion of distribution to ACO participants: 72%

Quality Performance Results

2020 Quality Performance Results

ACO Quality Measure Number	Measure Name	Rate	ACO Mean
ACO43	Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91)	1.07	0.95
ACO13	Falls: Screening for Future Fall Risk	85.45	84.97
ACO14	Preventive Care and Screening: Influenza Immunization	75.58	76.03
ACO17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	78.95	81.67
ACO18	Preventive Care and Screening: Screening for Depression and Follow-up Plan	70.04	71.46
ACO19	Colorectal Cancer Screening	70.36	72.59
ACO20	Breast Cancer Screening	73.38	74.05
ACO42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	81.67	83.37
ACO2	Diabetes Mellitus: Hemoglobin A1c Poor Control	12.72	14.70

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

Physician Led

Clinically-integrated leadership in your community

Supported

Analytics and data-driven support for the success of your practice

Valuable

Participation in other payor agreements and care strategies

Beneficial

Gain advantages from shared ACO MIPs scoring and strategic exemptions

Why consider a value-based venture?

Designed to Deliver

5-year program designed to deliver greater value to patients while rewarding participating providers for high-quality care

WCP Membership

WellStar Clinical Partners membership required for all ACO participants

Value-based Reimbursement

Offers gradual introduction to a value-based reimbursement model with risk acceptance. No downside risk in year 1. Incremental risk and reward for years 2-5.

WellStar Partnership

As a strategic partner, WellStar will assume most of the risk

Join us

Take the next step. Subscribe below to get information about attending chapter meetings or web events, and learn how you can participate in revolutionizing care delivery as part of the Wellstar ACO.

Public Reporting PDF

Name and Location

Primary Contact

Governing Body

Arif Aziz, MD

Thomas Bhat, MD

Srinivas Bramhadevi, MD

Danny Branstetter, MD

John Brennan, MD

George Brown, MD

Brett Cannon, MD

Arum Chevru, MD

Damon Denzin, PA

Charmaine Emelife, MD

Rusty Durham

Joseph Havlik, MD

Larry Hornsby, MD

Barry Mangel, MD

Prashant Mishra, MD

Vijay Nath, MD

Ike Nwaobi, MD

Jehangir Pirzada, MD

Ed Richardson

Roderick Rhyant, MD

Clinical and Administrative Leadership

Associated Committees and Committee Leadership

Types of ACO participants, or combinations of participants, that formed the ACO:

Shared Savings and Losses

Amount of Shared Savings/Losses

Shared Savings Distribution

Quality Performance Results

2020 Quality Performance Results

Physician Led

Supported

Valuable

Beneficial

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