Georgia MSSP Information

ACO Name and Location

PQN – Georgia, LLC
602 Dogwood Trail
Suite F
Tyrone, GA 30290

ACO Primary Contact

JIM SAMS, MD
(470) 588-9480
JSAMS@PRIVIAHEALTH.COM

Organizational Information

ACO participants:

ACO Participants ACO Participant in Joint Venture 
CAPSTONE MEDICAL GROUP N
AIM MEDICAL ASSOCIATES, PC Y
ANU RAVIKANTH MD LLC Y
BAINBRIDGE MEDICAL ASSOCIATES PC Y
BCG MEDICAL GROUP LLC Y
BLACKSHEAR FAMILY PRACTICE Y
BOHLER FAMILY PRACTICE PC Y
DR. JAY VELIYATH, INC Y
FAMILY MEDICINE SPECIALIST, PC Y
FAMILY PRACTICE ASSOICATES LLC Y
HEARTLAND HEALTHCARE PC Y
HILLANDALE INTERNAL MEDICINE P.C. Y
HOWARD S ELLISON MD PC Y
LIFETIME MEDICAL CENTER PC Y
MCINTOSH CLINIC, PC Y
MCINTOSH TRAIL FAMILY PRACTICE Y
PEACHTREE MEDICAL CENTER Y
PERISSEIA PHYSICIANS, LLC Y
PROFESSIONAL PARK MEDICAL SERVICES PC Y
PRIVIA MEDICAL GROUP OF GEORGIA, LLC Y
PRIVIA MEDICAL GROUP SOUTH GEORGIA, LLC Y
RANDY B CRONIC, M.D. PC Y
ROBERT G. CARTER Y
SOUTHCOAST MEDICAL GROUP LLC Y
TATE MEDICAL ASSOCIATES, LLC Y
THOMASVILLE FAMILY MEDICINE CENTER Y
YONAH MOUNTAIN FAMILY PRACTICE 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 8.34% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
KEMP CHARLES PHYSICIAN 8.33% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
COLE FRANK PHYSICIAN 8.33% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
STUBBS JOSEPH PHYSICIAN 8.34% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
WEEKS ROBERT PHYSICIAN 8.33% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
WHITE GARRETT PHYSICIAN 8.33% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
BOHLKE W SCOTT PHYSICIAN 8.33% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
COOPER WILLIAM PHYSICIAN 8.33% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
MANOCHA MONICA PHYSICIAN 8.34% ACO PARTICIPANT REPRESENTATIVE PRIVIA MEDICAL GROUP – GEORGIA
THOMAS, JR JAMES

PATIENT

 8.33%

MEDICARE BENEFICIARY

 N/A

Key ACO Clinical and Administrative Leadership:

ACO Executive JAMES SAMS, MD
Medical Director JAMES SAMS, MD
Compliance Officer DANA FIELDS
Quality Assurance/Improvement Officer GWEN WYLES

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 CHARLES KEMP, 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

  • Second Agreement Period
    • Performance Year 2020, $8,748,128
  • First Agreement Period
    • Performance Year 2019, $5,618,143
    • Performance Year 2018, $6,112,852
    • Performance Year 2017, $4,954,482

Shared Savings Distribution

  • Second Agreement Period
    • Performance Year 2020
      • Proportioninvested in infrastructure: 30%
      • Proportioninvested in redesigned care processes/resources: 10%
      • Proportionof distribution to ACO participants: 60%
  • First Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 10%
      • Proportion of distribution to ACO participants: 60%
    • 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

2020 Quality Performance Results:

ACO# Measure Name Rate ACO
Mean
ACO 43 Ambulatory Sensitive Condition Acute Composite (AHRQ Preventive Quality Indicator (PQI # 91)) 0.96 0.95
ACO 13 Falls: Screening for Future Fall Risk 95.16 84.97
ACO 14 Preventive Care and Screening: Influenza Immunization 80.38 76.03
ACO 17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 91.67 81.67
ACO 18 Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan 78.01 71.46
ACO-19 Colorectal Cancer Screening 71.00 72.59
ACO-20 Breast Cancer Screening 80.25 74.05
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 80.57 83.37
ACO-27 Diabetes: Hemoglobin A1c Poor Control 12.45 14.70
ACO-28 Controlling High Blood Pressure 82.53 72.87

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 does not use the SNF 3-Day Rule Waiver, pursuant to 42 CFR §425.612.

Waiver for Payment for Telehealth Services:

  • Our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR §425.612(f) and 42 CFR §425.613.