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
 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%

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).