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Deaconess Care Integration (ACO)

A Next Generation Accountable Care Organization (ACO) is an ACO Model implemented by the Centers for Medicare and Medicaid Services (CMS). ACOs are groups of doctors, hospitals, and other health care providers that come together to provide coordinated, high quality care to their Medicare Fee-for-Service patients. Coordinated care helps ensure patients, especially the chronically ill or those who are hospitalized, get the right care at the right time, and avoid unneeded duplication of services such as lab tests and x-rays. The Next Generation ACO Model offers different methodologies and financial arrangements with higher levels of risk and reward than current Medicare ACO initiatives.

Please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227) (TTY users should call 1-877-486-2048) for questions or additional information about Next Generation Accountable Care Organizations.  

General & Organizational information

General and organizational information is covered in a FAQ document

 

Name and Location of the Accountable Care Organization (ACO) 

Deaconess Care Integration, LLC
7100 Eagle Crest Blvd.
Evansville, IN 47715
Open Monday - Friday 8 AM - 5 PM
 

Deaconess Care Integration Primary Contact:

Roy Evan McConnell
Director Accountable Care/Payor Risk Strategies
7100 Eagle Crest Blvd.
Evansville, IN 47715
Open Monday - Friday 8 AM - 5 PM
812-426-6642
Roy.McConnell@deaconess.com

Executive Director for the ACO
Roy Evan McConnell
 
Medical Director for the ACO
Dr. Fredrick Wallisch

Composition of Deaconess Care Integration

Deaconess Care Integration currently consists of hospital and physician membership.
Open Monday - Friday 8 AM - 5 PM

Deaconess Care Integration  

View the current Next Generation ACO participants and preferred providers below

2019 Deaconess Care Integration Participants

2019 Deaconess Care Integration Preferred Providers

Joint ventures between or among the Next Generation Participants and Preferred Providers

Neurosurgery:  Mainspring Managers, LLC 
In an effort to improve coordination of care and create programs that will result in achieving the “Three Part Aim” of providing improved care for the Medicare Fee-For-Service beneficiaries we serve, better health for the populations we care for, and doing so in a financially sustainable manner, Deaconess Hospital, Inc. (Deaconess Hospital),Neurosurgical Consultants, LLP and its participating neurosurgeons, working in collaboration with DCI, formed the joint venture Mainspring Managers, LLC.

Orthopedics:  Ortho Align, LLC
In an effort to improve coordination of care and create programs that will result in achieving the “Three Part Aim” of providing improved care for the Medicare Fee-For-Service beneficiaries we serve, better health for the populations we care for, and doing so in a financially sustainable manner, Deaconess Hospital, Orthopaedic Associates, Inc. and its participating physicians, working in collaboration with DCI, formed the joint venture OrthoAlign, LLC. 

Vascular Surgery:  Vascmed, LLC
In an effort to improve coordination of care and create programs that will result in achieving the “Three Part Aim” of providing improved care for the Medicare Fee-For-Service beneficiaries we serve, better health for the populations we care for, and doing so in a financially sustainable manner, Deaconess Hospital,Evansville Surgical Associates, LLC and its participating physicians, working in collaboration with DCI, formed the joint venture Vascmed, LLC.  

Deaconess Care Integration Clinical Integration Program:  Swing Bed Liaison
In an effort to improve coordination of care and create programs that result in achieving the “Three Part Aim” of providing improved care of patients, including without limitation, Medicare Fee-For-Service beneficiaries we serve; better health for the populations we care for; and doing so in a financially sustainable manner, Deaconess Illinois (a wholly owned company of Deaconess Health System), participating Critical Access Hospitals (CAH), in collaboration with DCI, in 2018, developed a program to enhance the quality and efficiency of health care services, participate in programs and initiatives designed to manage, coordinate, and promote accountability for quality, patient safety, cost and overall care of patients.

Digital Care Integration Program
In connection with the Digital Care Integration Program, Deaconess will include participating ACO Network Providers in its website to allow for open access, transactional scheduling through the Epic electronic health record system. 

Deaconess Care Integration, LLC – ACO Programs and Initiatives
In connection with the Next Generation ACO Model, CMS published the Notice of Amended Waivers of Certain Fraud and Abuse Laws in Connection with the Next Generation ACO Model dated December 29, 2016 which provides a waiver of the application of the Physician Self-Referral Law (the Stark Law) and the Federal Anti-Kickback Statute for certain arrangements involving ACOs that participate in the Next Generation ACO Model (Next Generation ACO Participation Waiver).

In an effort to carry out its duties and obligations under the Next Generation ACO Model and to achieve the goals of the Next Generation ACO Model (including improving health outcomes and reducing expenditures for Medicare fee-for-service beneficiaries), DCI’s Board of Managers have reviewed and approved the following arrangements which are designed to manage, coordinate, and promote accountability for the quality, patient safety, cost, and overall care of patients and for which waiver protection is sought under the Next Generation ACO Participation Waiver:

Deaconess Care Integration Governing Body

  • Dr. Rick Crawford, Voting Member and Board Chairman | Affiliate Programs, Self Employed
  • Dr. Maqbool Ahmed, Voting Member | Deaconess Clinic
  • E. Kyle Bennett, Voting Member | Memorial Hospital and Health Care Center
  • Dr. Brad Scheu, Voting Member | Deaconess Clinic
  • Adam Thacker, Voting Member | Good Samaritan Hospital
  • Roy Evan McConnell, Voting Member | Deaconess Hospital
  • Dr. Lori Seiboldt, Voting Member | Deaconess Hospital
  • Dr. Chandra Kumbar, Voting Member | Affiliate Programs, The Heart Group
  • Nick Dus, MHA, Voting Member | Evolent Health
  • Dr. James Porter, Voting Member | Deaconess Hospital
  • Dr. Fredrick Wallisch, Voting Member | Evolent Health
  • Cheryl Wathen, Voting Member | Deaconess Hospital
Medicare Beneficiary
  • Jean G. Dremstedt, Voting Member
Consumer Advocate 
  • Sherry Schroeder, RN, Voting Member | Deaconess Clinic

DCI Committees and Key Leadership Personnel

  • Executive Director: Roy Evan McConnell | Deaconess Hospital
  • General Manager: Nicholas Dus, MHA I Evolent Health
  • Quality & Utilization Management Committee: Dr. Fredrick Wallisch | Evolent Health
  • Care & Network Coordination Committee: Kelly Banning | Evolent Health
  • Finance Committee: Richard Perry | Deaconess Health System
  • Medical Director: Dr. Fredrick Wallisch | Evolent Health
  • Compliance Committee: Roy Evan McConnell | Deaconess Hospital

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

  • Deaconess Care Integration, LLC was formed by Deaconess Health System.

Shared Savings & Losses

  • The amount of any Shared Savings or Shared Losses for any Performance Year

    • Medicare Shared Savings Program Performance Year 3:  $0
    • Next Generation ACO Year 1: $5,719,530 payable to Deaconess for 2016 Performance Year
    • Next Generation ACO Year 2: $16,101,886.00 payable to Deaconess for 2017 Performance Year
    • Next Generation ACO Year 3: TBD
  • The proportion of Shared Savings invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries
    • The proportion of shared savings to be invested in infrastructure depends on the amount of shared savings received. Currently, the distribution policy covers operating expenses for the ACO including participant incentives for engagement and coordination of care.
  • The proportion of Shared Savings distributed to Next Generation Participants and Preferred Providers

    • The current Next Generation ACO Participants receive incentives for completing work designed to achieve improvement in patient experience, quality performance, and total cost of care reduction. These incentives are paid regardless of the shared savings results.

Payment Rule Waiver 
Yes, Our ACO utilizes the 3-Day SNF Rule Waiver Benefit Enhancement

  1. Amber Manor Care Center- Trilogy, Petersburgh, IN
  2. Bethel Manor Nursing & Rehab, Evansville, IN
  3. BridgePointe Health Campus, Vincennes, IN
  4. Brookside Village, Jasper, IN
  5. Evansville Protestant Home, Evansville, IN
  6. Gibson General Hospital, Princeton, IN
  7. Heritage Center, Evansville, IN
  8. Northwood Retirement Community- Good Samaritan Society, Jasper, IN
  9. Pine Haven Health & Rehabilitation Center, Evansville, IN
  10. Redbanks, Henderson, KY
  11. Scenic Hills Care Center- Trilogy, Evansville, IN
  12. Skilled Care Center (SCC) of Memorial Hospital, Jasper, IN
  13. Solabron Nursing & Rehab-Cardon & Associates, Inc., Evansville, IN
  14. St. Charles Health Campus, Jasper, IN
  15. Villages of Oak Ridge, Washington, IN
  16. Wabash Christian Village, Carmi, IL
  17. West River Health Campus, Evansville, IN
  18. Woodlands Convalescent Center, Evansville, IN


Disclaimer: The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this.
 

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