Accountable Care Organization (ACO) Public Reporting (Pioneer)

This list satisfies our public reporting obligations.ACO Participants in Joint Ventures between ACO Professionals and Hospitals:
No participants are involved in a joint venture between ACO professionals and hospitalsACO Governing Body:

1. Dr. Richard Brown, Voting Member & Chair, ACO Participant,Park Family Health Care PC
2. Dr. Safwan Badr, Voting Member & ACO Participant, Wayne State University Physician Group
3. Dr. Reginald J. Eadie, Voting Member & Physician, President, DMC Detroit Receiving & Harper Hospitals
4. Dr. Mahir Elder, Voting Member & ACO Participant, Heart and Vascular Institute PLLC
5. Dr. Alka Jain, Voting Member & ACO Participant, Commerce Primary Care
6. Dr. Jeet Pillay, Voting Member & ACO Participant, Pillay Internal Medicine Associates PLLC
7. Dr. Suzanne White, Voting Member & Physician, Chief Medical Officer, Detroit Medical Center
8. Ms. Paula Autry, Voting Member, ACO Supplier & President, DMC Sinai-Grace Hospital
9. Ms. Vern Davis-Anthony, Voting Member & Medicare Beneficiary Representative

Key Clinical and Administrative Leadership:
Roger Wiseman, ACO President
Dr. Gregory Berger, Executive Medical Director
Michelle Castro, ACO Compliance Officer
Kelly Bida, Manager, Quality Assurance/Improvement Officer
Dr. Safwan Badr, Associate Medical Director
Chris Allen, Director of Health Plan Operations and Finance
Mara Duvall, Director of ACO Operations
Justin Williams, Manager, Care Management

Associated Committees and Committee Leadership:
MiPACO Performance Committee, Committee Co-Chair – Dr. Greg Naman
MiPACO Performance Committee, Committee Co-Chair – Dr. Safwan Badr
Compliance Committee, Committee Chair – Michelle Castro

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

• ACO professionally in a group practice arrangement;
• Networks of individual practices of ACO professionals;
• Partnerships or joint venture arrangements between hospitals and ACO professionals; and
• A hospital employing ACO professionals

Shared Savings and Losses:

• Amount of Shared Savings/Losses:
  • Agreement period beginning 2012, Performance Year 1, 2012: $4,022,379
  • Agreement period beginning 2012, Performance Year 2, 2013: $5,827,210
  • Agreement period beginning 2012, Performance Year 3, 2014: $9,821,272
  • Agreement period beginning 2012, Performance Year 4, 2015: $ *
    

How Shared Savings Are Distributed:

Those ACO Participating Physicians who hold Class B units received approximately 1% of the shared savings pursuant to their agreement with the ACO.
The remaining shared savings were used to reimburse Tenet Healthcare Corporation (Tenet), whose corporate affiliate is the largest Class A unit holder, for amounts advanced to the ACO through Tenet's corporate affiliate and used by the ACO to pay expenses incurred during the performance year and to reinvest in the ACO's operations--i.e., shared savings were expended to support the purposes of the Pioneer ACO program.

• Agreement period beginning 2012, Performance Year 1
  • Proportion invested in infrastructure: 10.43%
  • Proportion invested in redesigned care processes/resources: 29.56%
  • Proportion of distribution to ACO participants: 21.36%
• Agreement period beginning 2012, Performance Year 2013
  • Proportion invested in infrastructure: 10.22%
  • Proportion invested in redesigned care processes/resources: 44.49%
  • Proportion of distribution to ACO participants: 29.21%
• Agreement period beginning 2012, Performance Year 2014
  • Proportion invested in infrastructure: 6.10%
  • Proportion invested in redesigned care processes/resources: 28.83%
  • Proportion of distribution to ACO participants: 24.65%
• Agreement period beginning 2012, Performance Year 2015
  • Proportion invested in infrastructure: * %
  • Proportion invested in redesigned care processes/resources: * %
  • Proportion of distribution to ACO participants: * %

Payment Waiver Rules:

• Yes, our ACO utilizes the SNF 3-Day Rule Waiver

1. Ambassador Nursing Center
2. Hartford Nursing & Rehab Center
3. Oakpointe Senior Care & Rehab Center
4. Medilodge of Milford
5. Notting Hill of West Bloomfield

2012 - 2014 Quality Performance Results Table
Measure number	Performance measure	2012 reporting period		2013 reporting period		2014 reporting period
		ACO perfor- mance rate	Pioneer Mean	ACO perfor- mance rate	Pioneer Mean	ACO perfor- mance rate	Pioneer Mean
ACO-1	Getting Timely Care, Appointments, and Information	80.43	80.96	76.89	81.64	73.9	81.95
ACO-2	How Well Your Doctors Communicate	92.55	92.64	92.68	92.95	91.1	92.99
ACO-3	Patients’ Rating of Doctor	91.3	91.67	91.48	92.50	90.23	92.41
ACO-4	Access to Specialists	85.24	84.66	88.91	84.93	85.8	83.93
ACO-5	Health Promotion and Education	58.5	57.07	61.92	59.58	60.78	60.15
ACO-6	Shared Decision Making	72.25	74.36	69.75	73.99	69.07	74.63
ACO-7	Health Status/Functional Status	65.01	70.34	66.77	71.55	66.48	72.32
ACO-8	Risk Standardized, All Condition Readmissions	16.88	15.48	16.4	14.96	16.61	15.30
ACO-9	ASC Admissions: COPD or Asthma in Older Adults	1.61	1.07	1.48	1.11	1.45	1.06
ACO-10	ASC Admission: Heart Failure	0.96	1.03	1.23	1.16	1.1	1.11
ACO-11	Percent of PCPs who Qualified for EHR Incentive Payment	32.38	63.61	49.11	77.04	73.45	86.13
ACO-12	Medication Reconciliation	24.25	70.55	78.31	70.35	90.35	83.56
ACO-13	Falls: Screening for Fall Risk	37.93	35.64	72.62	59.52	88.83	64.61
ACO-14	Influenza Immunization	49.39	53.37	55.72	69.03	75.97	70.56
ACO-15	Pneumococcal Vaccination	37.52	57.26	61.02	72.06	75.49	77.00
ACO-16	Adult Weight Screening and Follow-up	45.1	53.12	52.23	65.07	82.37	67.90
ACO-17	Tobacco Use Assessment and Cessation Intervention	68.51	77.82	85.92	90.07	97.18	93.70
ACO-18	Depression Screening	32.16	23.62	43.02	49.80	74.03	59.67
ACO-19	Colorectal Cancer Screening	50.62	58.10	57.57	71.97	78.3	74.46
ACO-20	Mammography Screening	68.98	64.77	55.38	71.69	69.42	76.02
ACO-21	Proportion of Adults who had blood pressure screened in past 2 years	83.66	63.19	49.76	61.80	75.73	56.23
ACO-22	Hemoglobin A1c Control (HbA1c) (<8 percent)	40.28	64.73	60.72	75.42	72.33	75.23
ACO-23	Low Density Lipoprotein (LDL) (<100 mg/dL)	37.67	55.12	48.98	63.76	61.41	67.22
ACO-24	Blood Pressure (BP) <140/90	46.35	67.08	62.3	77.20	70.87	78.58
ACO-25	Tobacco Non Use	49.48	66.61	68.4	75.39	84.71	82.30
ACO-26	Aspirin Use	62.82	78.52	54.3	83.86	82.19	88.22
ACO-27	Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent)	52.6	27.08	29.8	16.10	16.02	14.11
ACO-28	Percent of beneficiaries with hypertension whose BP <140/90	44.93	63.94	60	74.23	74.21	74.98
ACO-29	Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dl	35.8	54.01	55.61	62.51	62.54	65.40
ACO-30	Percent of beneficiaries with IVD who use Aspirin or other antithrombotic	43.58	76.07	79	84.28	93.73	87.68
ACO-31	Beta-Blocker Therapy for LVSD	56.21	82.05	78.49	85.11	94.12	88.82
ACO-32	Drug Therapy for Cholesterol Lowering LDL	37.16	69.43	73.15	76.49	81.18	78.74
ACO-33	ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD	47.67	71.12	78.69	74.94	95.96	81.01

Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease, EHR = electronic health record, IVD = ischemic vascular disease, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

2015 Quality Performance Results Table
Measure number	scope="col" Measure Name	2015 reporting period
		ACO performance rate	Pioneer Mean
ACO-1	CAHPS: Getting Timely Care, Appointments, and Information	78.76	81.61
ACO-2	CAHPS: How Well Your Providers Communicate	93.14	93.15
ACO-3	CAHPS: Patients’ Rating of Provider	90.84	92.35
ACO-4	CAHPS: Access to Specialists	84.4	83.87
ACO-5	CAHPS: Health Promotion and Education	59.39	61.74
ACO-6	CAHPS: Shared Decision Making	74.07	75.09
ACO-7	CAHPS: Health Status/Functional Status	70.26	72.34
ACO-34	CAHPS: Stewardship of Patient Resources*	25.99	25.53
ACO-8	Risk Standardized, All Condition Readmission	16.63	15.41
ACO-35	Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)* Readmission	22.52	18.94
ACO-36	All-Cause Unplanned Admissions for Patients with Diabetes*	69.99	57.14
ACO-37	All-Cause Unplanned Admissions for Patients with Heart Failure*	102.53	82.55
ACO-38	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions	82.23	66.32
ACO-9	Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)	1.73	1.15
ACO-10	Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)	1.08	1.05
ACO-11	Percent of Primary Care Physicians who Successfully Meet Meaningful Use Requirements	45.78	81.78
ACO-39	Documentation of Current Medications in the Medical Record*	70.68	72.33
ACO-13	Falls: Screening for Future Fall Risk	77.66	62.71
ACO-14	Preventive Care and Screening: Influenza Immunization	72.8	76.93
ACO-15	Pneumonia Vaccination Status for Older Adults	75.34	79.87
ACO-16	Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up	80.72	65.45
ACO-17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	96.83	92.04
ACO-18	Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan	52.61	56.82
ACO-19	Colorectal Cancer Screening	72.83	75.24
ACO-20	Breast Cancer Screening	71.4	78.92
ACO-21	Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented	90.84	72.03
ACO-40	Depression Remission at Twelve Months*	N/A	4.09
ACO-27	Diabetes Mellitus: Hemoglobin A1c Poor Control	22.61	17.36
ACO-41	Diabetes: Eye Exam*	43.11	50.45
ACO-28	Hypertension: Controlling High Blood Pressure	74.25	74.94
ACO-30	Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic	90.49	87.41
ACO-31	Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)	91.07	89.18
ACO-33	Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)	94.59	82.78
CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease. *= Measure required beginning Reporting Year 2015. N/A= Reporting on the depression remission measure is not required for 2015, as indicated by N/A