Welcome to NorthShore Physician Associates Value Based Care, LLC.,
an Accountable Care Organization
NorthShore Physician Associates Value Based Care (NPA VBC) is an Accountable Care Organization (ACO) that was formed as a wholly owned subsidiary of NorthShore Physician Associates (NPA). The NPA is the population health oversight and operational vehicle for the broader NorthShore University HealthSystem (NorthShore).
NorthShore Physician Associates Value Based Care's Mission is to drive the highest level of value for the patients of our community through clinically integrated care. More specifically, the mission is to develop and deliver care delivery models for the patients we serve that result in:
- Equitable quality of care and health outcomes
- Efficient and cost-effective care
- High levels of engagement between NorthShore University HealthSystem and its physician partners
What is an ACO?
An Accountable Care Organization (ACO) is a group of doctors and other healthcare providers who agree to work together with Medicare to give you the best possible care. ACOs may take different approaches to giving you coordinated care. Some ACOs may have special nurses that help you set up appointments or make sure your medications are in order when you enter or leave a hospital. Other ACOs may help your doctors get you equipment for monitoring your medical conditions better at home, if you need it. Most ACOs use advanced systems that let them more carefully coordinate your care, and make sure your doctor has the most up-to-date information about your health.
The goal of the ACO is to support your doctor in caring for you by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions over and over. Working together, your doctors can do more to follow your health, make sure you get the best possible care, and may hire additional staff to help meet your unique care needs, depending on what works best for you.
Doctors and other healthcare providers choose to participate in an ACO because they're committed to providing you with a better care experience. They may also be financially rewarded for offering you better, more coordinated care. If your doctor chooses to participate in an ACO, you'll see a poster with information displayed in the office or hospital.
An ACO isn't a Medicare Advantage Plan or Health Maintenance Organization (HMO). You're still in Original Medicare, and your Medicare benefits, services, rights and protections won't change. And you still have the right to use any doctor or hospital that accepts Medicare at any time, the same way you do now.
ACO Name and Location
NorthShore Physician Associates Value Based Care, LLC
Previous Names: N/A
1301 Central Street
Suite 301
Evanston, Illinois 60201
ACO Primary Contact
|
Primary Contact Name
|
Tricia Eminger
|
|
Primary Contact Phone Number
|
847.982.6810
|
|
Primary Contact Email Address
|
teminger@northshore.org
|
For general questions or additional information about Accountable Care Organizations,
please visit
www.medicare.gov/acos.html or call 1-800-MEDICARE (
1.800.633.4227).
Organizational Information
ACO Participants
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
|---|
|
ABK Medical Center Ltd
|
N
|
|
Advanced Internal Medicine Associates, Inc
|
N
|
|
Advanced Primary Care SC
|
N
|
|
Argiro Zofakis, Ltd
|
N
|
|
Brikha Medical Center
|
N
|
|
Deerfield Medical Associates, SC
|
N
|
|
Dangremond & Jaharis, LLC (DBA Winnetka Family Medicine)
|
N
|
|
East West Internal Medicine Associates, P.C.
|
N
|
|
Family Medical, Ltd (DBA Dr. Elena Edwards)
|
N
|
|
First Clinic, SC
|
N
|
|
Gabriel I. Berlin, M.D. LLC
|
N
|
|
Glen Medical Associates, SC
|
N
|
|
L. Scott Kanter, MD
|
N
|
|
Medical Health Clinic Ltd
|
N
|
|
Mohammad Siddiqui, MD, Ltd
|
N
|
|
NorthShore University HealthSystem
|
N
|
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
N
|
|
North Shore Associates in Gynecology and Obstetrics, SC
|
N
|
|
Robin Wind, MD, SC (DBA Wind Medical Group)
|
N
|
|
Smriti Goel, MD, SC
|
N
|
|
Stephen J. Clark, MD, PC
|
N
|
|
Swedish Covenant Management Services, Inc.
|
N
|
|
Vadim Edelstein MD Ltd
|
N
|
|
Winnetka Avenue Physicians SC
|
N
|
ACO Governing Body
| Member | Member's Voting Power | Membership Type | ACO Participant TIN Legal Business Name/DBA, if Applicable |
|---|
| Last Name | First Name | Title/Position |
|---|
|
Hensing
|
Thomas
|
NPA VBC Medical Director
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Murtos
|
Kristen
|
ACO Executive; Chief Administrative and Strategy Officer
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem
|
|
Fisk
|
Benjamin
|
NPA VBC Executive Director
|
1
|
Other
|
|
|
Halasyamani
|
Mahalakshmi
|
Chief Medical Officer
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Boyle
|
Christopher
|
Utilization Management Physician Lead
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Chon
|
Chris
|
Affiliate Physician
|
1
|
ACO Participant Representative
|
First Clinic, SC
|
|
Denham
|
Ervin
|
Employed Physician
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Kaul
|
Karen
|
Clinical Chairman
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Revis
|
John
|
Employed Physician
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Wallman
|
Gregory
|
Affiliate Physician
|
1
|
ACO Participant Representative
|
Covenant Medical Group, LLC
|
|
MacGregor
|
Scott
|
Employed Physician
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Kirkorsky
|
Deborah
|
VP, Medical Group
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Mermel
|
Donna
|
|
1
|
Medicare Beneficiary Representative
|
|
|
Bauer
|
Tyler
|
VP, Medical Group
|
0
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Rahija
|
David
|
President, Skokie Hospital
|
0
|
ACO Participant Representative
|
NorthShore University HealthSystem
|
|
Braund
|
Victoria
|
Employed Physician
|
0
|
ACO Participant Representative
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
|
Smith
|
Steven
|
NPA VBC Information Technology Executive
|
0
|
Other
|
|
|
Jones
|
Harry
|
NPA VBC Compliance Officer
|
0
|
Other
|
|
|
Eminger
|
Tricia
|
NBA VBC Operations Executive
|
0
|
Other
|
|
Key ACO Clinical and Administrative Leadership
|
ACO Executive
|
Kristen Murtos
|
|
Medical Director
|
Thomas Hensing, M.D.
|
|
Compliance Officer
|
Harry Jones
|
|
Quality Assurance/Improvement Officer
|
Mahalakshmi Halasyamani, MD
|
Associated Committees and Committee Leadership
| Committee Name | Committee Leader Name and Position |
|---|
|
Quality Committee
|
Mahalakshmi K. Halasyamani, M.D., Chief Medical Officer
|
|
Ambulatory Care Quality Council
|
Thomas A. Hensing, M.D., Associate Chief Quality Officer for Ambulatory Care
|
|
Hospitals Quality Council
|
Gregory A. Wallman, DO, NPA VBC Participant & Board Member
Mahalakshmi K. Halasyamani, M.D., Chief Medical Officer
John Tressa, Chief Nursing Officer
|
|
Operations Committee
|
Benjamin Fisk, NPA VBC Executive Director
|
|
Finance Committee
|
Ervin Woody Denham, M.D., ACO Participant
|
|
Compliance Committee
|
Harry Jones, NPA VBC Compliance Officer
|
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
- Fourth Agreement Period
- Performance Year 2021, $5,246,081
- Third Agreement Period
- Performance Year 2020, $13,089,596.15
- Second Agreement Period
- Performance Year 2019, $0
- First Agreement Period
- Performance Year 2018, $0
Shared Savings Distribution
- Fourth Agreement Period
- Performance Year 2021
- Proportion invested in infrastructure: 7%
- Proportion invested in redesigned care processes/resources: 34%
- Proportion of distribution to ACO participants: 59%
- Third Agreement Period
- Performance Year 2020
- Proportion invested in infrastructure: 12%
- Proportion invested in redesigned care processes/resources: 58%
- Proportion of distribution to ACO participants: 30%
- Second Agreement Period
- Performance Year 2019
- 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 2018
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
Quality Performance Results
2021 Quality Performance Results:
Quality performance results are based on CMS Web Interface.
| Measure# | Measure Name | Rate | ACO Mean |
|---|
|
ACO-001
|
Diabetes: Hemoglobin A1c (HbA1c) Poor Control
|
9.43
|
12.46
|
|
ACO-134
|
Preventative Care and Screening: Screening for Depression and Follow-up Plan
|
72.21
|
74.38
|
|
ACO-236
|
Controlling High Blood Pressure
|
74.61
|
74.87
|
|
ACO-318
|
Falls: Screening for Future Fall Risk
|
91.20
|
87.03
|
|
ACO-110
|
Preventative Care and Screening: Influenza Immunization
|
90.65
|
80.52
|
|
ACO-226
|
Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention
|
90.00
|
80.97
|
|
ACO-113
|
Colorectal Cancer Screening
|
81.66
|
73.63
|
|
ACO-112
|
Breast Cancer Screening
|
81.40
|
75.11
|
|
ACO-438
|
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
|
79.62
|
84.24
|
|
ACO-370
|
Depression Remission at Twelve Months
|
6.25
|
15.50
|
|
ACO-479
|
Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups
|
0.1597
|
0.1540
|
|
ACO-MCC1
|
All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)
|
37.64
|
33.99
|
|
CAHPS-1
|
Getting Timely Care, Appointments, and Information
|
89.16
|
84.67
|
|
CAHPS-2
|
How Well Providers Communicate
|
93.70
|
93.56
|
|
CAHPS-3
|
Patient’s Rating of Provider
|
93.21
|
92.19
|
|
CAHPS-4
|
Access to Specialists
|
74.57
|
78.80
|
|
CAHPS-5
|
Health Promotion and Education
|
62.23
|
61.61
|
|
CAHPS-6
|
Shared Decision Making
|
59.54
|
60.89
|
|
CAHPS-7
|
Health Status and Functional Status
|
73.12
|
71.78
|
|
CAHPS-8
|
Care Coordination
|
86.27
|
85.66
|
|
CAHPS-9
|
Courteous and Helpful Office Staff
|
90.67
|
91.88
|
|
CAHPS-11
|
Stewardship of Patient Resources
|
27.69
|
24.71
|
For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.
Payment Rule Waivers
ACO Participation Waiver Protection Arrangements
NorthShore University HealthSystem (NS), an ACO participant, has entered into agreements with certain primary care physician practices participating in the NorthShore Physician Associates Value Based Care ACO (NPA VBC) commencing on or after August 1, 2018, pursuant to which NS furnishes certain electronic medical record (EMR) and practice management software and support to primary care physicians in an effort to achieve a more consolidated EMR platform amongst the ACO participants. NPA VBC’s governing body made a bona fide determination that the furnishing of such EMR and practice management software and support will allow all ACO participating primary care physicians and the ACO to utilize an interconnected EMR, which are reasonably related to, and will continue to further, the purposes of the Medicare Shared Savings Program by:
- Promoting accountability for the quality, cost, and overall care for Medicare beneficiaries;
- Allowing for the managing and coordinating of care for Medicare fee-for service beneficiaries through the ACO; and
- Encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare beneficiaries.