ACO

 

ACO Name and Location

Summa Accountable Care Organization
Previous Names: N/A
1077 Gorge Blvd.
Akron, Ohio 44310

ACO Primary Contact

Organizational Information

ACO Participants:

ACO Governing Body:

Due to rounding, ‘Member’s Voting Power’ may not equal 100 percent.

Key ACO Clinical and Administrative Leadership:

Associated Committees and Committee Leadership:

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:

Third Agreement Period

• Performance Year 2023, $2,067,045
• Performance Year 2022, $1,182,124
• Performance Year 2021, $3,754,223
• Performance Year 2020, $5,652,023

Second Agreement Period

• Performance Year 2019, $3,936,201
• Performance Year 2018, $4,531,433
• Performance Year 2017, $0
• Performance Year 2016, $0

First Agreement Period

• Performance Year 2015, $3,060,189
• Performance Year 2014, $4,456,811
• Performance Year 2013, $5,780,129

Note: Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019

Shared Savings Distribution

Third Agreement Period - Update

• Performance year 2023
  • Proportion invested in infrastructure: 25%
  • Proportion invested in redesigned care processes/resources: 25%
  • Proportion of distribution to ACO participants: 50%

• Performance year 2022
  • Proportion invested in infrastructure: 25%
  • Proportion invested in redesigned care processes/resources: 25%
  • Proportion of distribution to ACO participants: 50%

• Performance year 2021
  • Proportion invested in infrastructure: 20%
  • Proportion invested in redesigned care processes/resources: 20%
  • Proportion of distribution to ACO participants: 60%

• Performance year 2020
  • Proportion invested in infrastructure: 20%
  • Proportion invested in redesigned care processes/resources: 20%
  • Proportion of distribution to ACO participants: 60%

Second Agreement Period

• Performance year 2019
  • Proportion invested in infrastructure: 12.5%
  • Proportion invested in redesigned care processes/resources: 12.5%
  • Proportion of distribution to ACO participants: 75%
• Performance Year 2018
  • Proportion invested in infrastructure: 23.5%
  • Proportion invested in redesigned care processes / resources: 23.5%
  • Proportion of distribution to ACO participants: 53%
• Performance Year 2017
  • Proportion invested in infrastructure: N/A
  • Proportion invested in redesigned care processes/resources: N/A
  • Proportion of distribution to ACO participants: N/A
• Performance Year 2016
  
  • 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 2015
  
  • Proportion invested in infrastructure: 18.5%
  • Proportion invested in redesigned care processes/resources: 18.5%
  • Proportion of distribution to ACO participants: 63%
• Performance Year 2014
  
  • Proportion invested in infrastructure: 17.5%
  • Proportion invested in redesigned care processes/resources: 17.5%
  • Proportion of distribution to ACO participants: 65%
• Performance Year 2013
  
  • Proportion invested in infrastructure: 16%
  • Proportion invested in redesigned care processes/resources: 16%
  • Proportion of distribution to ACO participants: 68%

Note: Our ACO participated in multiple performance years during Calendar Year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Quality Performance Results

2023 Quality Performance Results:

Measure #	Measure Name	Collection Type	Reported Performance Rate	Current Year Mean Performance Rate (SSP ACOs)
Quality ID# 001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1]	CMS Web Interface	8.95 *	9.84
Quality ID# 134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	CMS Web Interface	80.97	80.97
Quality ID# 236	Controlling High Blood Pressure	CMS Web Interface	80.20	77.80
Quality ID# 318	Falls: Screening for Future Fall Risk	CMS Web Interface	94.20	89.42
Quality ID# 110	Preventative Care and Screening: Influenza Immunization	CMS Web Interface	66.54	70.76
Quality ID# 226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	CMS Web Interface	68.97	79.29
Quality ID# 113	Colorectal Cancer Screening	CMS Web Interface	73.90	77.14
Quality ID# 112	Breast Cancer Screening	CMS Web Interface	80.49	80.36
Quality ID# 438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	CMS Web Interface	86.76	87.05
Quality ID# 370	Depression Remission at Twelve Months	CMS Web Interface	2.63	16.58
Quality ID# 321	CAHPS for MIPS	CAHPS for MIPS Survey	N/A	N/A
Measure# 479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1]	Administrative Claims	0.16 *	0.16
Measure# 484	Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1]	Administrative Claims	37.03	30.97
CAHPS-1	Getting Timely Care, Appointments, and Information	CAHPS for MIPS Survey	83.93	83.41
CAHPS-2	How Well Providers Communicate	CAHPS for MIPS Survey	95.61	94.08
CAHPS-3	Patient’s Rating of Provider	CAHPS for MIPS Survey	92.81	92.49
CAHPS-4	Access to Specialists	CAHPS for MIPS Survey	74.22	75.33
CAHPS-5	Health Promotion and Education	CAHPS for MIPS Survey	70.29	64.11
CAHPS-6	Shared Decision Making	CAHPS for MIPS Survey	65.95	61.77
CAHPS-7	Health Status and Functional Status	CAHPS for MIPS Survey	94.37	92.62
CAHPS-8	Care Coordination	CAHPS for MIPS Survey	86.04	86.19
CAHPS-9	Courteous and Helpful Office Staff	CAHPS for MIPS Survey	31.68	26.24
CAHPS-11	Stewardship of Patient Resources	CAHPS for MIPS Survey	77.13	74.49

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov

Payment Rule Waivers

• Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
  • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612
• Waiver for Payment for Telehealth Services:
  • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612 (f) and 42 CFR § 425.613
    
     

Fraud and Abuse Waivers

• ACO Pre-Participation Waiver: 

   N/A – ACO does not utilize the Pre-Participation Waiver

• ACO Participation Waiver: 

The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement.  

Parties: ACO, ACO participants and other ACO providers/suppliers affiliated with ACO
Date: As of July 1, 2019, as amended February 25, 2021
Description: 
Care Provision Arrangements: 

Under the Care Provision Arrangements, ACO employs and oversees the use of physicians, specialists, process improvement staff, a tightly aligned post-acute care network, and health care personnel with expertise in integrated care management and care transformation processes to assist ACO participants and other ACO providers/suppliers affiliated with ACO, with:

• coordinating and providing primary and specialty care for high-risk, vulnerable MSSP beneficiary populations;

• managing medication adherence and reconciliation

• appropriately managing care transitions; and

• transforming primary care processes.

Parties: ACO, ACO participants, ACO providers/suppliers, or other providers and suppliers affiliated with ACO
Date: As of July 1, 2019, as amended November 21, 2019
Description: 
Health IT Arrangements:

Under the Health IT Arrangements, ACO (or, Summa Health or its subsidiary, Summa Health Network, on ACO’s behalf) purchases or contracts for the provision of multiple health Information technology resources, including electronic health record (“EHR”), population health management technology, data analytics systems and data extraction and aggregation tools to facilitate the following benefits for ACO participants, ACO providers/suppliers, or other providers and suppliers affiliated with ACO: 

• Access to electronic medical records by and among providers in different care settings; 

• Analytics to support referral management among MSSP beneficiaries’ health care providers;

• Provision of gap reporting, patient summaries, risk stratification, and enhanced registry services; and 

• Support for the coordination of care and population health management of MSSP beneficiaries.


Parties: ACO participants and/or ACO providers’/suppliers 
Date: As of July 1, 2019
Description: 
Infrastructure & Care Redesign Arrangement:

Under the Infrastructure & Care Redesign Arrangement, ACO assesses an annual “administrative fee” against the ACO participants’ and/or ACO providers’/suppliers’ SummaCare Medicare Advantage and Medicare fee-for-service reimbursement in order to support ACO operations and infrastructure needs. 


Parties: ACO, ACO participants and other ACO providers/suppliers affiliated with ACO
Date: As of July 1, 2019
Description: 
Care Relationship Arrangements: 

Under the Care Relationship Arrangements, ACO engages in activities that will serve to coordinate care for its beneficiaries with ACO participants and with other providers and suppliers, including but not limited to: the distribution of informational brochures, emails, or other materials about ACO participants and ACO providers/suppliers to patients transitioning from acute to post-acute care facilities, to patients seeking information about available treating providers and suppliers, or to other providers and suppliers that may refer patients to ACO participants.