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HHC ACO Inc., an Accountable Care Organization

Medicare Shared Savings Program

The HHC ACO is participating in the Medicare Shared Savings Program (MSSP) to encourage investment in infrastructure and redesigned care processes for high quality and efficient service delivery. The HHC ACO works to meet and exceed the quality of care performance standard defined by CMS and determined using nationally recognized measures in four key areas:

  • Patient/caregiver experience
  • Care coordination/patient safety
  • Preventive health
  • At-risk population (diabetes, depression, hypertension, ischemic vascular disease, heart failure and coronary artery disease)

Amount of Shared Savings / Losses

  • Performance Year 1: $3,639,766
  • Performance Year 2: $2,644,605
  • Performance Year 3: $6,052,364

How Shared Savings Are Distributed

i. Up to 100% retained by HHC ACO as an offset to costs incurred in developing and maintaining the ACO’s infrastructure and operations.
ii. If MSSP shared savings payments exceed the amounts described in (i), the remainder is divided 50% to NYC Health + Hospitals and 50% to other participants for reinvestment in meeting the goals of HHC ACO and incentivizing population health management.

Quality Performance Results

2015 Reporting Period
Measure NumberMeasure NameACO Performance RateMean performance rate (SSP-ACOs)
ACO #1
CAHPS: Getting Timely Care, Appointments, and Information
ACO #2CAHPS: How Well Your Providers Communicate86.5392.65
ACO #3CAHPS: Patients’ Rating of Provider86.9491.94
ACO #4CAHPS: Access to Specialists69.3883.61
ACO #5CAHPS: Health Promotion and Education57.4559.06
ACO #6CAHPS: Shared Decision Making74.0075.17
ACO #7CAHPS: Health Status/Functional Status72.7572.30
ACO #34CAHPS: Stewardship of Patient Resources22.1426.87
ACO #8Risk Standardized, All Condition Readmission15.8314.86
ACO #35Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)18.7418.07
ACO #36All-Cause Unplanned Admissions for Patients with Diabetes58.3354.60
ACO #37All-Cause Unplanned Admissions for Patients with Heart Failure107.1276.96
ACO #38All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions81.3162.92
ACO #9Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)1.881.11
ACO #10Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)1.591.04
ACO #11Percent of PCPs who Successfully Meet Meaningful Use Requirements100.00%80.14%
ACO #39Documentation of Current Medications in the Medical Record65.11%84.07%
ACO #13Falls: Screening for Future Fall Risk50.36%56.46%
ACO #14Preventative Care and Screening Influenza Immunization72.93%62.03%
ACO #15Pneumonia Vaccination Status for Older Adults85.09%63.73%
ACO #16Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up64.34%71.15%
ACO #17Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention93.09%90.16%
ACO #18Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan91.15%45.25%
ACO #19Colorectal Cancer Screening65.33%60.06%
ACO #20Breast Cancer Screening81.85%65.67%
ACO #21Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented74.06%70.04%
ACO #40Depression Remission at Twelve Months9.43%6.11%
ACO #27Diabetes Mellitus: Hemoglobin A1c Poor Control18.77%20.38%
ACO #41Diabetes: Eye Exam*59.39%41.05%
ACO #28Hypertension: Controlling High Blood Pressure62.36%69.62%
ACO #30Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic91.25%83.82%
ACO #31Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)98.86%87.22%
ACO #33Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)91.47%77.73%

Note: 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

2012 Reporting Period2013 Reporting Period2014 Reporting Period
Measure numberPerformance measureACO performance RateMean performance rate for all ACOsACO performance RateMean performance rate for all ACOsACO performance RateMean performance rate for all ACOs
ACO #1Getting Timely Care, Appointments, and InformationNot in Operations70.1981.4863.4680.13
ACO #2How Well Your Doctors CommunicateNot in Operations89.1692.9689.2292.39
ACO #3Patients’ Rating of DoctorNot in Operations89.1892.0690.1691.58
ACO #4Access to SpecialistsNot in Operations75.9285.1276.7383.97
ACO #5Health Promotion and EducationNot in Operations63.2458.3864.8258.29
ACO #6Shared Decision MakingNot in Operations70.6274.5370.9274.60
ACO #7Health Status / Functional StatusNot in Operations70.3571.1271.1371.10
ACO #8Risk Standardized, All Condition ReadmissionsNot in Operations16.3214.9015.6415.15
ACO #9ASC Admissions: COPD or Asthma in Older AdultsNot in Operations3.101.172.411.08
ACO #10ASC Admission: Heart FailureNot in Operations2.061.201.861.19
ACO #11Percent of PCPs who Qualified for EHR Incentive PaymentNot in Operations2.8666.2116.4276.71
ACO #12Medication ReconciliationNot in Operations93.0773.5695.7382.61
ACO #13Falls: Screening for Fall RiskNot in Operations49.5639.5745.9645.60
ACO #14Influenza ImmunizationNot in Operations75.2956.9376.8757.51
ACO #15Pneumococcal VaccinationNot in Operations79.5254.7679.8455.03
ACO #16Adult Weight Screening and Follow-upNot in Operations59.3461.6164.2266.75
ACO #17Tobacco Use Assessment and Cessation InterventionNot in Operations88.4084.0187.3286.79
ACO #18Depression ScreeningNot in Operations86.5731.1988.8739.27
ACO #19Colorectal Cancer ScreeningNot in Operations75.5759.3070.9656.14
ACO #20Mammography ScreeningNot in Operations76.4162.0578.4661.41
ACO #21Proportion of Adults who had blood pressure screened in past 2 yearsNot in Operations67.0474.2578.4660.24
ACO #22Hemoglobin A1c Control (HbA1c) (<8 percent)Not in Operations72.81N/A69.21N/A
ACO #23Low Density Lipoprotein (LDL) (<100 mg/DL)Not in Operations63.12N/AN/AN/A
ACO #24Blood Pressure (BP) <140/90Not in Operations67.87N/A69.87N/A
ACO #25Tobacco Non UseNot in Operations58.37N/A80.79N/A
ACO #26Aspirin UseNot in Operations87.13N/A90.28N/A
ACO #27Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent)Not in Operations14.2622.1116.3920.35
ACO #28Percent of beneficiaries with hypertension whose BP <140/90Not in Operations68.3467.7963.7168.02
ACO #29Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dlNot in Operations68.7755.44N/AN/A
ACO #30Percent of beneficiaries with IVD who use Aspirin or other antithromboticNot in Operations87.3876.3593.4680.79
ACO #31Beta-Blocker Therapy for LVSDNot in Operations93.7579.8289.6282.71
ACO #32Drug Therapy for Lowering LDL CholesterolNot in Operations92.86N/AN/AN/A
ACO #33ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSDNot in Operations88.59N/A91.62N/A

Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease, PCP = primary care physician, 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.

For more information on how to interpret scores on the above quality performance measures, see http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/MSSP-QM-Benchmarks.pdf.

For general questions or additional information regarding Accountable Care Organizations, please visit: www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227 (TTY users should call 1-877-486-2048)).