Georgia MSSP Information
ACO Name and Location
PQN – Georgia, LLC
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 |
---|---|
CAPSTONE MEDICAL GROUP | Y |
LIFETIME MEDICAL CENTER PC | Y |
HILLANDALE INTERNAL MEDICINE P.C. | Y |
TATE MEDICAL ASSOCIATES, LLC | Y |
PRIVIA MEDICAL GROUP OF GEORGIA, LLC | Y |
BLACKSHEAR FAMILY PRACTICE | 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 |
HEARTLAND HEALTHCARE PC | Y |
SOUTHCOAST MEDICAL GROUP LLC | Y |
YONAH MOUNTAIN FAMILY PRACTICE | Y |
ACO Governing Body:
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 | |
White | Garrett | Physician | 18.75% | ACO Participant Representative | Privia Medical Group – Georgia | |
Weeks | Robert | 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:
ACO Executive | James Sams |
Medical Director | James Sams | 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
- First Agreement Period
- Performance Year 2019, $5,618,143
- Performance Year 2018, $6,112,852
- Performance Year 2017, $4,954,482
Shared Savings Distribution
- 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%
- Performance Year 2019
Quality Performance Results
2019 Quality Performance Results:
ACO# | Measure Name | Rate | ACO Mean |
---|---|---|---|
ACO 1 | CAHPS: Getting Timely Care, Appointments, and Information | 86.70 | 85.86 |
ACO 2 | CAHPS: How Well Your Providers Communicate | 93.74 | 94.11 |
ACO 3 | CAHPS: Patients’ Rating of Provider | 92.61 | 92.69 |
ACO 4 | CAHPS: Access to Specialists | 84.17 | 81.54 |
ACO 5 | CAHPS: Health Promotion and Education | 59.92 | 60.44 |
ACO 6 | CAHPS: Shared Decision Making | 60.39 | 62.78 |
ACO 7 | CAHPS: Health Status/Functional Status | 72.66 | 73.79 |
ACO 34 | CAHPS: Stewardship of Patient Resources | 24.63 | 26.17 |
ACO 8 | Risk Standardized, All Condition Readmission | 15.08 | 14.86 |
ACO 38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 53.15 | 58.15 |
ACO 43 | Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) | 1.78 | 1.87 |
ACO 13 | Falls: Screening for Future Fall Risk | 99.21 | 84.04 |
ACO 14 | Preventive Care and Screening: Influenza Immunization | 90.15 | 74.77 |
ACO 17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 86.36 | 78.04 |
ACO 18 | Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan | 85.94 | 70.40 |
ACO 19 | Colorectal Cancer Screening | 80.18 | 70.76 |
ACO 20 | Breast Cancer Screening | 84.87 | 73.84 |
ACO 42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 84.9 | 82.17 |
ACO 27 | Diabetes: Hemoglobin A1c Poor Control | 9.18 | 13.88 |
ACO 28 | Controlling High Blood Pressure | 80.29 | 75.04 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
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.
Beneficiary Incentive Program
Our ACO does not use the Beneficiary Incentive Program (BIP) established under 42 CFR §425.304(c).