Georgia MSSP Information

ACO Name and Location

PQN – Georgia, LLC
Previous Names: N/A
602 Dogwood Trail
Suite F
Tyrone, GA 30290

ACO Primary Contact

Primary Contact Name Jim Sams, MD
Primary Contact Phone Number (470) 588-9480
Primary Contact Email Address jsams@priviahealth.com

Organizational Information

ACO participants:

ACO Participants ACO Participant in Joint Venture (Enter Y or N)
Valdosta Medical Clinic Y
Capstone Medical Group Y
Lifetime Medical Center PC Y
Doc in the Box, Inc. Y
Hillandale Internal Medicine P.C. Y
Tate Medical Associates, LLC Y
Privia Medical Group Of Georgia Llc Y
Georgia Physicians South PC Y
Thomasville Family Medicine Center Y
Howard S Ellison MD PC Y
Robert G. Carter Y
McIntosh Clinic, PC Y
McIntosh Trail Family Practice Y
Family Medicine Specialist, PC Y
Perisseia Physicians, LLC Y
AIM Medical Associates, PC Y
Dr. Jay Veliyath, Inc Y
Peachtree Medical Center Y
Family Practice Assoicates LLC Y
Randy B Cronic, M.D. PC Y
Privia Medical Group South Georgia, LLC Y

ACO Governing Body:

Member
 Member’s Voting Power –
Expressed as a percentage or number
Last Name First Name Title/Position Membership Type ACO Participant Legal Business Name/DBA, if Applicable
Sams Jim Executive 8.34% ACO Executive Privia Health
Cheslock Amy Executive 8.33% ACO Executive Privia Health
Gee Michael Physician 18.75% ACO Participant Representative Privia Medical Group – Georgia
Kemp Charles Physician 18.75% ACO Participant Representative Privia Medical Group – Georgia
Hobby  Thomas Physician 18.75% ACO Participant Representative Privia Medical Group – Georgia
Watkins Clyde Physician 18.75% ACO Participant Representative Privia Medical Group – Georgia
Chastain Frank Patient 8.33% Medicare Beneficiary Representative N/A

Key ACO Clinical and Administrative Leadership:

James Sams ACO Executive
James Sams Medical Director
Gwen Wyles Compliance Officer
Dana Fields Compliance Officer
Gwen Wyles Quality Assurance/Improvement Officer

Associated Committees and Committee Leadership:

 Committee Name  Committee Leader Name & Position
PQN – Georgia, LLC Board James Sams, MD, Chair
Membership Committee Frank Cole, MD, Chair
Steering Committee Thomas Hobby, MD, Chair
Clinical Performance Committee Frank Cole, MD, Chair
Finance Committee Amy Cheslock, Chair
Compliance Committee James Sams, MD, Chair

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

  • ACO professionals in a group practice arrangement

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2018, $6,112,852
    • Performance Year 2017, $4,954,482

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2018
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 10%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2017
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 10%
      • Proportion of distribution to ACO participants: 60%

Quality Performance Results

2018 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 87.31 86.14
ACO-2 CAHPS: How Well Your Providers Communicate 91.71 93.93
ACO-3 CAHPS: Patients’ Rating of Provider 92.40 92.45
ACO-4 CAHPS: Access to Specialists 81.63 81.50
ACO-5 CAHPS: Health Promotion and Education 57.40 59.26
ACO-6 CAHPS: Shared Decision Making 57.15 61.94
ACO-7 CAHPS: Health Status/Functional Status 73.96 73.35
ACO-34 CAHPS: Stewardship of Patient Resources 29.57 26.06
ACO-8 Risk Standardized, All Condition Readmission 14.44 14.98
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 18.67 18.59
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 31.66 37.01
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 63.65 76.75
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 53.31 59.00
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 2.03 1.98
ACO-11 Use of Certified EHR Technology 99.10 98.20
ACO-12 Medication Reconciliation 99.68 85.91
ACO-13 Falls: Screening for Future Fall Risk 80.33 79.73
ACO-44 Imaging Studies for Low Back Pain 54.29 64.36
ACO-14 Preventive Care and Screening: Influenza Immunization 70.06 72.71
ACO-15 Pneumonia Vaccination Status for Older Adults 82.38 75.97
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 70.98 76.83
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 66.67 72.81
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 74.23 66.74
ACO-19 Colorectal Cancer Screening 52.03 68.27
ACO-20 Breast Cancer Screening 54.58 71.96
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 76.00 81.47
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 8.49 15.51
ACO-41 Diabetes: Eye Exam 50.97 52.42
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 72.63 73.10
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 87.21 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.

Note: In the Quality Performance Results file(s) above, search for “PQN – Georgia, LLC” or “Privia Quality Network of Georgia” to view the quality performance results. This ACO can also be found by using the ACO ID A3236 in the public use files on data.cms.gov.

Payment Rule Waivers

Skilled Nursing Facility (SNF) 3-day Rule Waiver:

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

Waiver for Payment for Telehealth Services:

  • No, our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.