Medicare Shared Savings Program

See how your Medicare Shared Savings Program is working for you

ACOs bring doctors and healthcare providers together to coordinate care, improve quality and help make healthcare more affordable. Choose the ACO that provides your care to learn more and see its performance.

Novant Health ACO MSSP

About Novant Health ACO | Novant Health ACO public reporting

Physician Quality Partners MSSP

About Physician Quality Partners (PQP) ACO | PQP ACO Public Reporting

Learn about the ACO

Novant Health Medical Group Coastal Region is participating in the Centers for Medicare and Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) to provide care that delivers true value for beneficiaries by ensuring remarkable patient experiences, improving health, and reducing the cost of care.

To participate, we have set up an ACO structure for our Coastal North Carolina market.

Find answers to common questions about Physician Quality Partners, ACOs, care coordination, and Medicare participation.

What is an ACO?

An ACO is a group of doctors and other health care providers who voluntarily work together with Medicare to give you high quality service and care at the right time, in the right setting. Novant Health is participating in Physician Quality Partners, LLC, a Medicare Shared Savings Program ACO.
An ACO is not an insurance plan, such as a Medicare Advantage HMO or PPO plan.
ACOs don't change your Medicare benefits

How will an ACO help my doctor coordinate my care?

Your doctors will have a more complete picture of your health through talking with your other doctors.
To help you get better, more coordinated care, Medicare will share certain health information with us about the care you get from your doctors and other health care providers unless you ask Medicare not to share it. Medicare may also share your health information with other ACOs in which your other doctors or health care providers participate.
Our practice may continue to recommend that you see particular doctors for your specific health needs, but it's always your choice about what doctors you see or hospitals you visit.

What do I need to do?

If you want Medicare to share information about the health care you receive with Physician Quality Partners or with other ACOs in which your other doctors or health care providers participate, there's nothing more you need to do.
If you do not want Medicare to share your health care information, you need to call 1-800 MEDICARE (1-800-633-4227) and tell the representative that your doctor is part of an ACO and you don't want Medicare to share your health information. TTY user should call 1-877-486-2048.
If you change your mind in the future, you can call 1-800-MEDICARE and tell the representative what you have decided. We can't communicate with Medicare on your behalf.
You have the option to select a primary care provider on MyMedicare.gov. Review the below information to learn how to do so.
- Voluntary alignment
Each year, the Centers for Medicare and Medicaid Services (CMS) requires that your provider inform you of his/her participation in the Physician Quality Partners. Please click the link below to read the Beneficiary Information Notice for details about how this impacts you.
- Beneficiary Information Notice

What training is required for ACO providers?

Thank you for your commitment to value-based care and delivering high-quality care to Medicare beneficiaries aligned with our ACO.

Compliance Training Requirements

Individuals providing services or functions related to Novant Health are required to complete ACO Compliance Training:

Upon hire
Annually thereafter

Questions About Compliance Training?

If you are providing functions or services related to Novant Health, you must complete ACO Compliance Training upon hire and every year. For questions about compliance training or requirements, please contact Kelly Patterson, Novant Health Senior Director Compliance.

¿Quiere más información?

Pregúntele a nuestra recepción o llámenos al 844-266-8268. También puede visitor Medicare.gov o llamar para informar una inquietud o queja relacionada con Medicare al 1-800-MEDICARE (1-800-633-4227). Los usuarios de TTY pueden llamar al 1-877-486-2048.

Novant Health PQP Public Reporting

ACO name and location:

Physician Quality Partners, LLC
P.O. Box 9000
Wilmington, NC 28402

ACO primary contact:

Bill Schiff
(919) 229-2319
BSchiff@novanthealth.org

Organizational Information

ACO Participants:

ACO Participants	ACO Participant in Joint Venture
Novant Health Medical Group Coastal Region, LLC	N

ACO Governing Body:

Member First Name	Member Last Name	Member Title/Position	Member's Voting Power (Expressed as a percentage)	Membership Type	ACO Participant Legal Business Name, if applicable	ACO Participant DBA if applicable
William	Boles	Voting Member	10%	ACO Participant Representative	Novant Health Medical Group Coastal Region, LLC	N/A
Patrick	Craig	Voting Member	10%	ACO Participant Representative	Novant Health Medical Group Coastal Region, LLC	N/A
Charin	Hanlon	Voting Member, Chair	10%	ACO Participant Representative	Novant Health Medical Group Coastal Region, LLC	N/A
Bill	Schiff	Voting Member, ACO Executive	10%	Other Representative	N/A	N/A
Amy	Messier	Voting Member	10%	ACO Participant Representative	Novant Health Medical Group Coastal Region, LLC	N/A
Rick	Morrison	Voting Member, Beneficiary	10%	Medicare Beneficiary Representative	N/A	N/A
Michele	Miller	Voting Member	10%	ACO Participant Representative	Novant Health Medical Group Coastal Region, LLC	N/A
John	Rommel	Voting Member	10%	ACO Participant Representative	Novant Health Medical Group Coastal Region, LLC	N/A
Jeffrey	Warhaftig	Voting Member, Medical Director	10%	ACO Participant Representative	Novant Health Medical Group Coastal Region, LLC	N/A
Laurie	Whalin	Voting Member	10%	ACO Participant Representative	Novant Health Medical Group Coastal Region, LLC	N/A

Key ACO Clinical and Administrative Leadership:

ACO Executive: Bill Schiff
Medical Director: Jeffrey Warhaftig, MD
Compliance Officer: Kelly Patterson
Quality Assurance/Improvement Officer: Ashley Perrott, MD

Associated Committees and Committee Leadership:

Committee Name	Committee Leader Name and Position
Physician Network Compliance Committee	Kelly Patterson, Chair
Quality Committee	David Priest, MD, Chair
Finance Committee	Andrew Wampler, Chair

Types of ACO Participants, or Combinations of Participants, that formed the ACO:

Hospital employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

Third Agreement Period
- Performance Year 2024, $2,974,122
Second Agreement Period
- Performance Year 2023, $4,028,434.16
- Performance Year 2022, $2,307,408
- Performance Year 2021, $0
- Performance Year 2020, $0
- Performance Year 2019, $4,445,524
First Agreement Period
- Performance Year 2018, $2,471,136
- Performance Year 2017, $0

Note: Our ACO participated in multiple performance years during Calendar Year 2019. The distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings 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

Third Agreement Period
- Performance Year 2024
  - Proportion invested in infrastructure: 15%
  - Proportion invested in redesigned care processes/resources: 15%
  - Proportion of distribution to ACO participants: 70%
Second Agreement Period
- Performance Year 2023
  - Proportion invested in infrastructure: 15%
  - Proportion invested in redesigned care processes/resources: 15%
  - Proportion of distribution to ACO participants: 70%
- Performance Year 2022
  - Proportion invested in infrastructure: 15%
  - Proportion invested in redesigned care processes/resources: 15%
  - Proportion of distribution to ACO participants: 70%
- Performance Year 2021
  - 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 2020
  - 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
  - Proportion invested in infrastructure: 36%
  - Proportion invested in redesigned care processes/resources: 13%
  - Proportion of distribution to ACO participants: 51%
First Agreement Period
- Performance Year 2018
  - Proportion invested in infrastructure: 54%
  - Proportion invested in redesigned care processes/resources: 9%
  - Proportion of distribution to ACO participants: 37%
- 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. The distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings 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

2024 Quality Performance Results:

Quality performance results are based on the CMS Web Interface collection type.

Measure #	Measure Title	Collection Type	Performance Rate*	Current Year Mean Performance Rate (Shared Savings Program ACOs)
Measure #: 001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)	CMS Web Interface	4.84	9.44
Measure #: 134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	CMS Web Interface	97.05	81.46
Measure #: 236	Controlling High Blood Pressure	CMS Web Interface	82.14	79.49
Measure #: 318	Falls: Screening for Future Fall Risk	CMS Web Interface	98.53	88.99
Measure #: 110	Preventative Care and Screening: Influenza Immunization	CMS Web Interface	83.63	68.60
Measure #: 226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	CMS Web Interface	97.30	79.98
Measure #: 113	Colorectal Cancer Screening	CMS Web Interface	88.31	77.81
Measure #: 112	Breast Cancer Screening	CMS Web Interface	91.21	80.93
Measure #: 438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	CMS Web Interface	87.64	86.50
Measure #: 370	Depression Remission at Twelve Months	CMS Web Interface	9.09	17.35
CAHPS-1	Getting Timely Care, Appointments, and Information	CAHPS for MIPS Survey	83.58	83.70
CAHPS-2	How Well Providers Communicate	CAHPS for MIPS Survey	94.04	93.96
CAHPS-3	Patient’s Rating of Provider	CAHPS for MIPS Survey	92.53	92.43
CAHPS-4	Access to Specialists	CAHPS for MIPS Survey	69.17	75.76
CAHPS-5	Health Promotion and Education	CAHPS for MIPS Survey	71.14	65.48
CAHPS-6	Shared Decision Making	CAHPS for MIPS Survey	66.18	62.31
CAHPS-7	Health Status and Functional Status	CAHPS for MIPS Survey	78.42	74.14
CAHPS-8	Care Coordination	CAHPS for MIPS Survey	88.06	85.89
CAHPS-9	Courteous and Helpful Office Staff	CAHPS for MIPS Survey	94.56	92.89
CAHPS-11	Stewardship of Patient Resources	CAHPS for MIPS Survey	31.19	26.98
Measure #: 321	CAHPS for MIPS Survey	CAHPS for MIPS Survey	7.82	6.67
Measure #: 479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups	Administrative Claims	0.13	0.15
Measure #: 484	Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC)	Administrative Claims	---	37.00

*For Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [Quality ID #001], Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [Measure #479], and Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], a lower performance rate indicates better measure performance.

*For Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], patients are excluded if they were attributed to Qualifying Alternative Payment Model (APM) Participants (QPs). Most providers participating in Track E and ENHANCED track ACOs are QPs, and so performance rates for Track E and ENHANCED track ACOs may not be representative of the care provided by these ACOs' providers overall. Additionally, many of these ACOs do not have a performance rate calculated due to not meeting the minimum of 18 beneficiaries attributed to non-QP providers.

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 uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.

Fraud and Abuse Waivers

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.

Parties to the arrangement: Physician Quality Partners, LLC and J. Arthur Dosher Memorial Hospital (Dosher)
Date of arrangement: 01/01/2017-
Items, services, goods, or facility provided: PQP will work with Dosher through consulting and support services based on PQP's experience with promoting accountability for quality, cost and overall care, and improving quality of care while lowering costs through investments in infrastructure and redesigned care processes.
Date and nature of any amendments to the arrangement, if applicable: First amendment – 2/15/18, Second amendment—2/1/19, Third amendment – 11/1/20, Fourth amendment –12/3/21, Fifth amendment – 11/14/22
Parties to the arrangement: Physician Quality Partners, LLC and Columbus Regional Healthcare System (CRHS)
Date of arrangement: 07/24/2018
Items, services, goods, or facility provided: POP will work with CRHS through consulting and support services based on PQP's experience with promoting accountability for quality, cost and overall care, and improving quality of care while lowering costs through investments in infrastructure and redesigned care processes.
Date and nature of any amendments to the arrangement, if applicable: N/A

Physician Quality Partners Accountable Care Organization (ACO)