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

ACO Tip Sheet

ACO Information

Name and Location

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

Primary Contact

Edwin Walker
(470) 588-7744
[email protected]

Akstein Eye Center
American Foot & Leg Specialists, P.C.
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 Psychiatry & Neurology
Atlanta Urological Group, P.C.
Atlanta West Dermatology, P.C.
Au Medical Associates Anesthesia Billing Services, LLC
Au Medical Associates Emergency Medicine Billing Services, LLC
Au Medical Associates Inc
Aucc Aiken Dermatology LLC
Babatunde Fariyike, M.D., LLC
Barrack Spine And Joint Medicine, Inc.
Barrett Parkway Foot and Leg
Bernard Orewa
Bridgemill Neurological Associates, PC
B. Reddy MD PC

Center For Allergy & Asthma of Georgia PC
Center For Spine Interventions, PC
Classicare Medical Consult PC, Inc
Cobb Internal Medicine Associates
Cobb Kidney Center, PC
Cobb Nephrology Hypertension Associates, PC
Cobb Women’s Health, P.A.
Corey Patrick Harkins
Cowry Medical Group LLC
Craniospinal Institute of Georgia
Crawford Plastic Surgery
Dhiraj A Patel MD
Douglasville Nephrology & Htn Clinic
Dr Mahaveer Vakharia MD PC
Dr. Wendy Giles
East Cobb Foot & Ankle Care P.C.
Elizabeth George, MD, PC
Fengs Medical & Neurological Clinic
Gastrointestinal Specialist of Georgia
Georgia Blue Foot and Ankle, LLC
Georgia Breast Care, P.C.
Georgia Emergency Group LLC
Georgia Eye Specialists
Georgia Gynecology
Georgia Integrative Cardiology LLC
Georgia Kidney Associates, Inc.
Georgia Pain And Spine Solutions, PC
Georgia Podiatry, Inc
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
James B Depew MD PC
James K. Fortson, M.D., P.C.
Jasmine Jeffers, MD, LLC
Jeremy Meisel Md LLC
Joseph M Still Burn Centers Inc
Kennesaw Mountain Medical Group
Kimberlynn R. Richards, Md, PC
Lagrange Emergency Physicians, LLC
Lagrange Internal Medicine, PC
Lotus Vision, LLC
Ramzy Hajmurad, M.D., P.C.

Mak Anesthesia Holdings, LLC
Maldonado & Moreno, PC
Marietta Eye Clinic, PA
Marietta Medical Group
Marietta Ob Gyn Affiliates, P.A.
Marietta Podiatry Group
Marietta Rheumatology Associates, P.C.
Medical Care of Lagrange, LLC
Metroderm, P.C.
Michael Biddle
Michael Petrosky
Multispecialty Services LLC
Norman I Kornblatt
North Fulton Emergency Physicians, LLC
North Georgia Internal Medicine, PC
North Georgia Kidney Specialists, LLC
Northwest Georgia Oncology Centers, PC
Omolara B Kuteyi MD, Inc
Orthopaedics Of Atlanta, PC
Peachland Nephrology & Hypertension, PC
Physician Pain Care, P.C.
Pinnacle Orthopaedics & Sports Medicine
Providence Rd Primary Care LLC
Quantum Radiology PC
Resurgens, PC
Richard W King Jr
S&S Imaging Associates LLC
Sam Peng Md PC
Shashi Madan Md PC
Shelton Hospitalists Group, LLC
Smyrna Medical Associates, PC
South Atlanta Lung and Sleep Clinic Inc.
South Atlanta Medical Associates, PC
South Atlanta Pulmonary and Critical Care Associates
South Forsyth Family Medicine and Pediatrics LLC
Southeast Podiatry
Southern Medical Clinic, LLC
Southern Nephrology Clinic LLC
Spilker Medical, LLC
St. Jude’s Internal Medicine, LLC
Sumner Neurology Associates, PLLC
Surgical Arts, P.C
The Bortolazzo Group, LLC
The Breast Center PC
Total Cardiology of Atlanta
Trever Biles
Vascular Surgical Associates, PC
We Care MD, P.C.
Wellstar Medical Group, LLC
West Atlanta Internal Medicine PC
West Atlanta Ob-Gyn Inc
West Cobb Internal Medicine PC
William E Snell DO PC
William Tung MD P.C.

Governing Body

Srinivas Bramhadevi, MD

Wellstar Medical Group, LLC

Danny Branstetter, MD

Wellstar Medical Group, LLC

George Brown, MD

Wellstar Medical Group, LLC

Brett Cannon, MD

The Bortolazzo Group, LLC

Arum Chevru, MD

Vascular Surgical Associates, LLC

Charmaine Emelife, MD

Atlanta South Nephrology

Jill Hendrix, PA

Wellstar Medical Group, LLC

Larry Hornsby, MD

Wellstar Medical Group, LLC

Mike Lipscomb, MD

Barry Mangel, MD

Wellstar Medical Group, LLC

Vijay Nath, MD

Georgia Kidney Associates, Inc.

Jehangir Pirzada, MD

Wellstar Medical Group, LLC

Roderick Rhyant, MD

Wellstar Medical Group, LLC

Ed Richardson

Clinical and Administrative Leadership

Barbara Corey ACO Executive
Alan Muster, MD Medical Director
Roshunda Drummond-Dye 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

First Agreement Period
• Performance Year 2020: $6,987,217

Second Agreement Period
• Performance Year 2021: $8,324,256

Third Agreement Period
• Performance Year 2022: $6,346,514

Shared Savings Distribution

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%

Second Agreement Period
Performance Year 2021

Proportion invested in infrastructure: 15%
Proportion invested in redesigned care processes/resources: 11%
Proportion of distribution to ACO participants: 72%

Third Agreement Period
Performance Year 2022

Proportion invested in infrastructure: 22%
Proportion invested in redesigned care processes/resources: 14%
Proportion of distribution to ACO participants: 64%

Quality Performance Results

2022 Quality Performance Results

Quality performance results are based on CMS Web Interface.

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

ACO Tip Sheet

Name and Location

Primary Contact

Governing Body

Srinivas Bramhadevi, MD

Danny Branstetter, MD

George Brown, MD

Brett Cannon, MD

Arum Chevru, MD

Charmaine Emelife, MD

Jill Hendrix, PA

Larry Hornsby, MD

Mike Lipscomb, MD

Barry Mangel, MD

Vijay Nath, MD

Jehangir Pirzada, MD

Roderick Rhyant, MD

Ed Richardson

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

2022 Quality Performance Results

Physician Led

Supported

Valuable

Beneficial

ACO Beneficiary Notification

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