Quality Initiatives

Care Coordination Initiative:
i. 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.

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.

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.

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 Wellness Initiative commenced on May 11, 2016.