ACO Name and Location

Dakota Healthcare Partners, LLC dba AccoCare
910 E 20th Street
Sioux Falls, South Dakota 57105

 

ACO Primary Contact

Primary Contact NameAnn Roemen
Primary Contact Phone Number(605) 444-8672
Primary Contact Email Addressann.roemen@accocare.org

 

Organizational Information

ACO participants:

ACO ParticipantsACO Participant in Joint Venture (Enter Y or N)
Gerald M. Rieber, MD, PCY
Michael J. Vener, MD, PCY
Sioux Falls Cardiovascular, PCY
Dr. Casey D. Johnston, MD, PCY
Physicians Laboratory of Northwest Iowa, LTD.Y
Ophthalmology, LTD.Y
Physicians Laboratory, LTD.Y
Horizon Health Care, Inc.Y
Sioux Falls Specialty Hospital, LLPY
Plastic Surgery Associates of South Dakota, LTD.Y
Brown Clinic, P.L.L.P.Y
Storm Clinic Prof, LLCY

ACO Governing Body:

MemberMember's Voting PowerMembership TypeACO Participant TIN Legal Business Name/DBA, if Applicable
Last NameFirst NameTitle/Position
Thaemert, MDBradleyChair OneACO Participant RepresentativeSioux Falls Specialty Hospital, LLC
Curd, MDR. BlakeVice-Chair OneACO Participant RepresentativeSioux Falls Specialty Hospital, LLC
Scott, MDKennethMember OneACO Participant RepresentativeSioux Falls Specialty Hospital, LLC
McKenzie, MDMatthewMember OneACO Participant RepresentativeSioux Falls Specialty Hospital, LLC
BensonGailMember OneMedicare Beneficiary RepresentativeN/A
EricksonWadeMemberOneACO Participant RepresentativeHorizon Health Care, Inc
HorrarRobMemberOneACO Participant RepresentativeSioux Falls Specialty Hospital, LLC
Lenssen, MDStacieMemberOneACO Participant RepresentativeBrown Clinic, PLLP
Thum, MDJosephMemberOneCommunity Stakeholder RepresentativeN/A

 

Key ACO clinical and administrative leadership:

Bradley Thaemert, MDACO Executive
Ann Roemen, MBAACO Executive
Jeremy Storm, DOMedical Director
JoAnn Hirsch, RNCompliance Officer
TBDQuality Assurance/Improvement Officer

Associated committees and committee leadership:

Committee NameCommittee Leader Name and Position
Quality CommitteeTBD
Finance CommitteeMarty Appelhof, Chair
Nominations CommitteeR. Blake Curd, MD, Chair

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

  • Networks of individual practices of ACO professionals
  • Partnerships or joint venture arrangements between hospitals and ACO professionals
  • Hospital employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year, 2020 $0
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2019, $0
  • First Agreement Period
    • Performance Year 2019, $0
    • Performance Year 2018, $0
    • Performance Year 2017, $0
    • Performance Year 2016, $0

Note: our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Shared Savings Distribution

  • Second Agreement Period
  • Performance Year 2019
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A
  • First Agreement Period
  • Performance Year 2019
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A
  • Performance Year 2018
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A
  • Performance Year 2017
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A
  • Performance Year 2016
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A

Note: our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Quality Performance Results

2020 Quality Performance Results:

ACO-43Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))1.640.95
ACO-13Falls: Screening for Future Fall Risk90.6684.97
ACO-14Preventive Care and Screening: Influenza Immunization80.6376.03
ACO-17Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention90.6381.67
ACO-18Preventive Care and Screening: Screening for Depression and Follow-up Plan80.5371.46
ACO-19Colorectal Cancer Screening70.5472.59
ACO-20Breast Cancer Screening75.7974.05
ACO-42Statin Therapy for the Prevention and Treatment of Cardiovascular Disease70.0883.37
ACO-27Diabetes Mellitus: Hemoglobin A1c Poor Control9.4914.70
ACO-28Hypertension (HTN): Controlling High Blood Pressure74.9072.87

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the imipact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov

Fraud and Abuse Waivers

  • ACO Pre-Participation Waiver:
    The following information describes each arrangement for which our ACO seeks protection under the ACO Pre-Participation Waiver, including any material amendment or modification to a disclosed arrangement.

Orthopedic Initiative:

Dakota Health Partners, LLC d/b/a AccoCare (the “ACO”), Sioux Falls Specialty Hospital (“SFSH”), an ACO participant, and Great Plains Surgical, LLC (“Great Plains”) are parties to an arrangement for which protection is sought under the “Final Waivers in Connection with the Shared Savings Program,” as described at 76 Fed. Reg. 67992 (Nov. 2, 2011), and continued at 80 Fed. Reg. 66726 (Oct. 29, 2015) (the “Waiver Rule”), pursuant to which Great Plains and its affiliated physicians have been engaged to manage the orthopedic service line at SFSH (the “Orthopedic Initiative”).  The ACO’s Board of Managers has determined that the Orthopedic Initiative is reasonably related to the one or more of the MSSP purposes described in the Waiver Rule, including (i) promoting accountability for the quality, cost, and overall care for a Medicare patient population as described in the MSSP, (ii) managing and coordinating care for original Medicare fee-for-service beneficiaries, and (iii) encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare fee-for-service beneficiaries. The Orthopedic Initiative commenced on February 1, 2015 and is reviewed annually and updated periodically.

  • ACO Participation Waiver
    The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement.

Care Coordination Initiative:

Dakota Health Partners, LLC d/b/a AccoCare (the “ACO”) and participating providers are parties to an arrangement for which protection is sought under the “Final Waivers in Connection with the Shared Savings Program,” as described at 76 Fed. Reg. 67992 (Nov. 2, 2011), and continued at 80 Fed. Reg. 66726 (Oct. 29, 2015) (the “Waiver Rule”), pursuant to which the ACO has engaged the providers/suppliers to participate in the development and implementation of protocols for the timely and efficient transition of care in a rural setting to and from other participants in the ACO’s network  (the “Care Coordination Initiative”).  The ACO’s Board of Managers has determined that the Care Coordination Initiative is reasonably related to one or more of the MSSP purposes described in the Waiver Rule, including (i) promoting accountability for the quality, cost, and overall care for a Medicare patient population as described in the MSSP, (ii) managing and coordinating care for original Medicare fee-for-service beneficiaries, and (iii) encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare fee-for-service beneficiaries. The Care Coordination Initiative commenced on May 11, 2016.

Transitional Care Management Initiative:

Dakota Health Partners, LLC d/b/a AccoCare (the “ACO”) and participating providers are parties to an arrangement for which protection is sought under the “Final Waivers in Connection with the Shared Savings Program,” as described at 76 Fed. Reg. 67992 (Nov. 2, 2011), and continued at 80 Fed. Reg. 66726 (Oct. 29, 2015) (the “Waiver Rule”), pursuant to which the ACO has engaged the providers to participate in the development and implementation of a transitional care initiative is to reduce readmission rates by increasing effective communication with the patient and the patient’s care giver during the discharge process (“Transitional Care Initiative”).  The focus of the Initiative is to ensure providers communicate with patients or patient’s family within a certain time after discharge to address matters that could increase readmission rates. The ACO’s Board of Managers has determined that the Transitional Care Initiative is reasonably related to one or more of the MSSP purposes described in the Waiver Rule, including (i) promoting accountability for the quality, cost, and overall care for a Medicare patient population as described in the MSSP, (ii) managing and coordinating care for original Medicare fee-for-service beneficiaries, and (iii) encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare fee-for-service beneficiaries. The Transitional Care Management Initiative commenced on May 19, 2016.

Wellness Initiative:

Dakota Health Partners, LLC d/b/a AccoCare (the “ACO”) and participating providers are parties to an arrangement for which protection is sought under the “Final Waivers in Connection with the Shared Savings Program,” as described at 76 Fed. Reg. 67992 (Nov. 2, 2011), and continued at 80 Fed. Reg. 66726 (Oct. 29, 2015) (the “Waiver Rule”), pursuant to which the ACO has engaged the providers/suppliers to participate in the development and implementation of a wellness initiative to ensure that patients see their primary care physician at least once annually (“Wellness Initiative”).  The purpose of this care visit is make sure that the patient remains connected to the resources of the health care system and that patient’s care is coordinated in order to focus on preventative medicine and other patient care improvement modifiers.   The ACO’s Board of Managers has determined that the Wellness Initiative is reasonably related to one or more of the MSSP purposes described in the Waiver Rule, including (i) promoting accountability for the quality, cost, and overall care for a Medicare patient population as described in the MSSP, (ii) managing and coordinating care for original Medicare fee-for-service beneficiaries, and (iii) encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare fee-for-service beneficiaries. The Wellness Initiative commenced on May 11, 2016.

Chronic Care Management Initiative:

Dakota Health Partners, LLC d/b/a AccoCare (the “ACO”) and participating providers are parties to an arrangement for which protection is sought under the “Final Waivers in Connection with the Shared Savings Program,” as described at 76 Fed. Reg. 67992 (Nov. 2, 2011), and continued at 80 Fed. Reg. 66726 (Oct. 29, 2015) (the “Waiver Rule”) pursuant to which the ACO has engaged the providers to participate in the development and implementation of a Chronic Care Management Initiative. The focus of the Initiative is to ensure providers and case managers communicate with patients on a regular basis to better manage the chronic health needs of Medicare beneficiaries and reduce unnecessary hospitalizations. The Chronic Care Management Initiative provides incentives including but not limited to education and data analytics to assist providers in identifying patients who qualify for Chronic Care Management. The ACO’s Board of Managers has determined that the Chronic Care Management Initiative is reasonably related to one or more of the MSSP purposes described in the Waiver Rule, including (i) promoting accountability for the quality, cost, and overall care for a Medicare patient population as described in the MSSP, (ii) managing and coordinating care for original Medicare fee-for-service beneficiaries, and (iii) encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare fee-for-service beneficiaries. The Chronic Care Management Initiative commenced on January 1, 2020.