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NorthShore Physician Associates Value Based Care, LLC.

Accountable Care

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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
1301 Central Street
Suite 301
Evanston, Illinois 60201

ACO Primary Contact

Primary Contact Name	Diane Montanez
Primary Contact Phone Number	847-982-4103
Primary Contact Email Address	DMontanez@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
Anshu Gupta MD PC	N
Anuj Lal, MD, Ltd	N
Argiro Zofakis, Ltd	N
Brikha Medical Center	N
C.J. Ireland, DO, SC	N
Covenant Medical Group, LLC	N
Deerfield Medical Associates, SC	N
Denenberg Medical, SC	N
Dangremond & Jaharis, LLC (DBA Winnetka Family Medicine)	N
Kathy Fisher, MD	N
East West Internal Medicine Associates, P.C.	N
Family Doctors of Round Lake, PC	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
Gregory Kaczmarek, MD, LLC	N
Joseph P. Wyse, MD, Ltd	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 Sheridan Family Medicine (DBA Julia Gorelik, MD)	N
North Shore Associates in Gynecology and Obstetrics, SC	N
Robin Wind, MD, SC (DBA Wind Medical Group)	N
Sheilendr Khipple, MD	N
Smriti Goel, MD, SC	N
Stephen J. Clark, MD, PC	N
Stephen Kashian, MD	N
Vadim Edelstein MD Ltd	N
Vandana Jain, MD, SC	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	Member's Voting Power	Membership Type
Gutmann	Norman	NPA VBC Medical Director	1	ACO Participant Representative	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 Quality and Care Transformation Officer	1	ACO Participant Representative	NorthShore Medical Group
Boyle	Christopher	Utilization Management Physician Lead	1	ACO Participant Representative	NorthShore Medical Group
Chon	Chris	Affiliate Physician	1	ACO Participant Representative	First Clinic, SC
Denham	Ervin	Employed Physician	1	ACO Participant Representative	NorthShore Medical Group
Kaul	Karen	Clinical Chairman	1	ACO Participant Representative	NorthShore Medical Group
Revis	John	Employed Physician	1	ACO Participant Representative	NorthShore Medical Group
Wallman	Gregory	Affiliate Physician	1	ACO Participant Representative	Covenant Medical Group, LLC
MacGregor	Scott	Employed Physician	1	ACO Participant Representative	NorthShore Medical Group
Kirkorsky	Deborah	VP, Medical Group	1	ACO Participant Representative	NorthShore Medical Group
Grabowy	James		1	Medicare Beneficiary Representative
Hensing	Thomas	Associate Chief Quality Officer for Ambulatory Care	0	ACO Participant Representative	NorthShore Medical Group
Oshman	Lauren	Employed Physician	0	ACO Participant Representative	NorthShore Medical Group
Bauer	Tyler	VP, Medical Group	0	ACO Participant Representative	NorthShore Medical Group
Rahija	David	President, Skokie Hospital	0	ACO Participant Representative	NorthShore University HealthSystem
Braund	Victoria	Employed Physician	0	ACO Participant Representative	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

Kristen Murtos	ACO Executive
Norman Gutmann, MD	Medical Director
Harry Jones	Compliance Officer
Mahalakshmi Halasyamani, MD	Quality Assurance/Improvement Officer

Associated Committees and Committee Leadership

Committee Name	Committee Leader Name and Position
Quality Committee	Mahalakshmi K. Halasyamani, MD, Chief Quality and Transformation Officer
Ambulatory Care Quality Council	Thomas A. Hensing, MD, Associate Chief Quality Officer for Ambulatory Care Norman Gutmann, MD, NPA VBC Medical Director
Hospitals Quality Council	Gregory A. Wallman, DO, NPA VBC Participant & Board Member Mahalakshmi K. Halasyamani, MD, Chief Quality and Transformation Officer Mary Keegan, Chief Nursing Officer
Operations Committee	Benjamin Fisk, NPA VBC Executive Director
Finance Committee	Ervin Woody Denham, MD, 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

First Agreement Period
- Performance Year 2018, $0

Shared Savings Distribution

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

2018 Quality Performance Results:

ACO#	Measure Name	Rate	ACO Mean
ACO-1	CAHPS: Getting Timely Care, Appointments, and Information	84.95	86.14
ACO-2	CAHPS: How Well Your Providers Communicate	95.29	93.93
ACO-3	CAHPS: Patients’ Rating of Provider	93.58	92.45
ACO-4	CAHPS: Access to Specialists	78.00	81.50
ACO-5	CAHPS: Health Promotion and Education	60.41	59.26
ACO-6	CAHPS: Shared Decision Making	59.89	61.94
ACO-7	CAHPS: Health Status/Functional Status	75.39	73.35
ACO-34	CAHPS: Stewardship of Patient Resources	29.65	26.26
ACO-8	Risk Standardized, All Condition Readmission	15.01	14.98
ACO-35	Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)	19.38	18.59
ACO-36	All-Cause Unplanned Admissions for Patients with Diabetes	39.43	37.01
ACO-37	All-Cause Unplanned Admissions for Patients with Heart Failure	86.63	76.75
ACO-38	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions	64.73	59.00
ACO-43	Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91)	1.93	1.98
ACO-11	Use of Certified EHR Technology	99.95	98.20
ACO-12	Medication Reconciliation Post-Discharge	99.36	85.91
ACO-13	Falls: Screening for Future Fall Risk	88.97	79.73
ACO-44	Use of Imaging Studies for Low Back Pain	66.67	64.36
ACO-14	Preventive Care and Screening: Influenza Immunization	62.47	72.71
ACO-15	Pneumonia Vaccination Status for Older Adults	86.23	75.97
ACO-16	Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up	91.28	76.83
ACO-17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	33.33	72.81
ACO-18	Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan	59.41	66.74
ACO-19	Colorectal Cancer Screening	79.67	68.27
ACO-20	Breast Cancer Screening	75.55	71.96
ACO-42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	73.88	81.47
ACO-27	Diabetes Mellitus: Hemoglobin A1c Poor Control	8.63	15.51
ACO-41	Diabetes: Eye Exam	60.39	52.42
ACO-28	Hypertension (HTN): Controlling High Blood Pressure	75.95	73.10
ACO-30	Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet	88.96	88.92

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

For 2018 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2018-Shared-Savings-Program-SSP-Accountable-Care-O/v47u-yq84/data

Note: In the Quality Performance Results file(s) above, search for “NorthShore Physician Associates Value Based Care, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A3702 in the public use files on data.cms.gov.

Payment Rule Waivers

No, our ACO does not use the SNF 3-Day Rule Waiver

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.

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