ACO Name and Location

PQN – Georgia, LLC
3715 Northside Pkwy NW
Atlanta, GA 30327

ACO Primary Contact

JIM SAMS, MD
Phone: 571-366-8850
Email: jsams@priviahealth.com

Organizational Information

ACO Participants:

ACO Participants ACO Participant in Joint Venture
Aim Medical Associates, PC Y
Anu Ravikanth MD LLC Y
Bainbridge Medical Associates PC Y
Bcg Medical Group LLC Y
Bohler Family Practice PC Y
Capstone Medical Clinic LLC Y
Dr. Jay Veliyath, INC Y
Family Medicine Specialist, PC Y
Family Practice Associates LLC Y
Heartland Healthcare PC Y
High Mountain Healthcare, LLC Y
Hillandale Internal Medicine P.C Y
Howard S Ellison MD PC Y
John A Keller MD PC Y
Jorge Amador MD LLC Y
Lawrence A. Adjei, APMC Y
Lifetime Medical Center PC Y
Linda L Casteel MD PC Y
Mcintosh Clinic, PC Y
Mcintosh Trail Family Practice Y
Peachtree Medical Center Y
Perisseia Physicians, LLC Y
Perry Family Practice LLC Y
Prime Care Medical Services PC 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
Suzanne L. Nunn, MD PC Y
Tate Medical Associates, LLC Y
The Veranda, PC Y
Thomasville Family Medicine Center Y
Yonah Mountain Family Practice Y

ACO Governing Body:

Member First Name Member Last Name Member Title/Position Member’s Voting Power –Expressed as a percentage or number Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable
Jim Sams Executive 8.34% ACO Executive Privia Health
Amy Cheslock Executive 8.33% ACO Executive Privia Health
Michael Gee Physician 8.34% ACO Participant Representative Privia Medical Group – Georgia
Charles Kemp Physician 8.33% ACO Participant Representative Privia Medical Group – Georgia
Frank Cole Physician 8.33% ACO Participant Representative Privia Medical Group – Georgia
Joseph Stubbs Physician 8.34% ACO Participant Representative Privia Medical Group – Georgia
Robert Weeks Physician 8.33% ACO Participant Representative Privia Medical Group – Georgia
Garrett White Physician 8.33% ACO Participant Representative Privia Medical Group – Georgia
W Scott Bohlke Physician 8.33% ACO Participant Representative Privia Medical Group – Georgia
William Cooper Physician 8.33% ACO Participant Representative Privia Medical Group – Georgia
Monica Manocha Physician 8.34% ACO Participant Representative Privia Medical Group – Georgia
James Thomas, Jr 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 Committe 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 2022: $17,369,116
    • Performance Year 2021: $13,117,176
    • 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 2022
        • Proportion invested in infrastructure: 30%
        • Proportion invested in redesigned care processes/resources: 10%
        • Proportion of distribution to ACO participants: 60%
      • Performance Year 2021 
        • Proportion invested in infrastructure: 30%
        • Proportion invested in redesigned care processes/resources: 10%
        • Proportion of distribution to ACO participants: 60%
      • Performance Year 2020
        • Proportion invested in infrastructure: 30%
        • Proportion invested in redesigned care processes/resources: 10%
        • Proportion of 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

2022 Quality Performance Results:

Quality Performance Results are based on CMS Web Interface Measure Set

Measure # Measure Name Collection Type Rate ACO
Mean
Measure # 001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control CMS Web Interface 6.45 10.71
Measure # 134 Preventative Care and Screening: Screening for Depression and Follow-up Plan CMS Web Interface 94.35 76.97
Measure # 236 Controlling High Blood Pressure CMS Web Interface 88.57 76.16
Measure # 318 Falls: Screening for Future Fall Risk CMS Web Interface 95.38 87.83
Measure # 110 Preventative Care and Screening: Influenza Immunization CMS Web Interface 85.68 77.34
Measure # 226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface 84.09 79.27
Measure # 113 Colorectal Cancer Screening CMS Web Interface 82.90 75.32
Measure # 112 Breast Cancer Screening CMS Web Interface 87.63 78.07
Measure # 438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface 87.44 86.37
Measure # 370 Depression Remission at Twelve Months CMS Web Interface 32.20 16.03
Measure # 479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups Administrative Claims 0.1527 0.1510
Measure # 484 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions Administrative Claims 31.59 30.97
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS Survey 85.86 83.96
CAHPS-2 How Well Providers Communicate CAHPS for MIPS Survey 94.55 93.47
CAHPS-3 Patient’s Rating of Provider CAHPS for MIPS Survey 93.68 92.06
CAHPS-4 Access to Specialists CAHPS for MIPS Survey 78.78 77
CAHPS-5 Health Promotion and Education CAHPS for MIPS Survey 67.63 62.68
CAHPS-6 Shared Decision Making CAHPS for MIPS Survey 62.87 60.97
CAHPS-7 Health Status and Functional Status CAHPS for MIPS Survey 72.15 73.06
CAHPS-8 Care Coordination CAHPS for MIPS Survey 88.55 85.46
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS Survey 92.65 91.97
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS Survey 28.62 25.62

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.