ACO Name and Location
AdvantagePoint Health Alliance - Blue Ridge, LLC
330 Seven Springs Way
Brentwood, TN 37027
ACO Primary Contact
| Primary Contact Name |
Monica Crews |
| Primary Contact Phone Number |
(434) 425-1357 |
| Primary Contact Email Address |
mcrews@gatewayhealth.com |
Organizational Information
| ACO Participants |
ACO Participant in Joint Venture (Y or N)
|
| Chatham Family Medical Center PC |
N |
| Clinch Valley Medical Center, INC |
N |
| Clinch Valley Physician Associates LLC |
N |
| Complexions Dermatology, PC |
N |
| Danville Gastroenterology Center PC |
N |
| Danville Patient Care Inc |
N |
| Danville Physician Practices LLC |
N |
| Danville Regional Medical Center LLC |
N |
| Danville Womens Care PC |
N |
| DLP Twin County Physician Practices, LLC |
N |
| DLP Twin County Regional Healthcare LLC |
N |
| Family Healthcare of Wytheville, PC |
N |
| Fauquier Family Practice PLC |
N |
| Fauquier Medical Center LLC |
N |
| Fauquier Physician Practices LLC |
N |
| Martinsville Neurological Assoc Inc |
N |
| Martinsville Physician Practices LLC |
N |
| Peachtree Inpatient Consulting, LLC |
N |
| Piedmont Access to Health Services Inc |
N |
| Piedmont Health & Wellness, PC |
N |
| Two Rivers Physician Practices LLC |
N |
| Wythe County Community Hospital LLC |
N |
| Wythe County Physician Practices LLC |
N |
ACO Governing Body
| Member First Name |
Member Last Name |
Title/Position |
Members' Voting Power |
Membership Type |
ACO Participant Legal Business Name |
| Mike |
Caplan |
Member/Chair |
11.1111% |
ACO Participant Representative |
Danville Physician Practices LLC |
| Nona |
Crouse |
Member |
11.1111% |
ACO Participant Representative |
Clinch Valley Physician Associates LLC |
| Stephanie |
Crumpton |
Member |
11.1111% |
ACO Participant Representative |
Sovah Physician Practices LLC |
| Steve |
Heatherly |
Member |
11.1111% |
ACO Participant Representative |
Sovah Physician Practices LLC |
| Peter |
Howard |
Member |
11.1111% |
Medicare Beneficiary Representative |
N/A |
| James |
Milam |
Member |
11.1111% |
ACO Participant Representative |
Piedmont Access To Health Services Inc |
| Kristen |
Phillips |
Member |
11.1111% |
Community Stakeholder Representative |
N/A |
| Suthanthira |
Ratnasamy |
Member |
11.1111% |
ACO Participant Representative |
Twin County Regional Healthcare, LLC |
| Kareem |
Zaki |
Member |
11.1111% |
ACO Participant Representative |
DLP Twin County Physician Practices LLC |
Due to rounding, ‘Member’s Voting Power’ may not equal 100 percent.
Key ACO Clinical and Administrative Leadership
| Interim ACO Executive |
Monica Crews |
| Medical Director |
Mike Caplan, MD |
| Compliance Officer |
Ashlie Heald |
| Quality Assurance/Improvement Officer |
Carol Ann Hudson |
ACO Committees and Committee Leadership
| Committee Name |
Committee Leader Name and Position |
| Contracting and Finance |
Steve Heatherly, CEO |
| Quality and Performance Improvement |
Monica Crews, MSN, RN, CMCN |
Types of ACO Participants, or combinations or participants, that formed the ACO:
-
- Federally Qualified Health Center (FQHC)
- ACO Professionals in a group practice arrangement
- Hospital Employing ACO Professionals
- Network of individual practices of ACO professionals
- Rural Health Center (RHC)
Shared Savings and Losses
Amount of Shared Savings & Losses
-
- First Performance Period
- Performance Year 2023, 1,720,360
- Performance Year 2022, 1,329,182
- Performance Year 2021, $0
- Performance Year 2020, $1,928,248
- Performance Year 2019A, $0
Shared Savings Distribution
-
- First Performance Period
- 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: 50%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2021
- Performance Year 2020
- Proportion invested in infrastructure: 25%
- Proportion invested in redesigned care processes/resources: 5%
- Proportion of distribution to ACO participants: 75%
- Performance Year 2019A
Quality Performance Results
2023 Quality Performance Results:
| Measure # |
Measure Name |
Collection Type |
ACO Performance |
ACO Mean |
| 001 |
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [1] |
MIPS CQM |
42.20 |
35.18 |
| 134 |
Preventive Care and Screening: Screening for Depression and Follow-up Plan |
eCQM |
42.61 |
48.99 |
| 236 |
Controlling High Blood Pressure |
MIPS CQM |
63.17 |
72.35 |
| 479 |
Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [1] |
Administrative Claims |
0.1479 |
0.1553 |
| CAHPS-1 |
Getting Timely Care, Appointments, and Information |
CAHPS for MIPS Survey |
87.29 |
83.68 |
| CAHPS-2 |
How Well Providers Communicate |
CAHPS for MIPS Survey |
92.89 |
93.69 |
| CAHPS-3 |
Patient’s Rating of Provider |
CAHPS for MIPS Survey |
90.46 |
92.14 |
| CAHPS-4 |
Access to Specialists |
CAHPS for MIPS Survey |
77.05 |
75.97 |
| CAHPS-5 |
Health Promotion and Education |
CAHPS for MIPS Survey |
62.92 |
63.93 |
| CAHPS-6 |
Shared Decision Making |
CAHPS for MIPS Survey |
61.03 |
61.6 |
| CAHPS-7 |
Health Status and Functional Status |
CAHPS for MIPS Survey |
75.62 |
74.12 |
| CAHPS-8 |
Care Coordination |
CAHPS for MIPS Survey |
85.05 |
85.77 |
| CAHPS-9 |
Courteous and Helpful Office Staff |
CAHPS for MIPS Survey |
91.6 |
92.31 |
| CAHPS-11 |
Stewardship of Patient Resources |
CAHPS for MIPS Survey |
29.8 |
26.69 |
[1] A lower performance rate corresponds to higher quality.
For Previous Years' Financial and Quality Performance Results: please visit data.cms.com.
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
