ACO Name and Location

Mission Health Partners

1940 Hendersonville Road,  Asheville, NC 28803


ACO Primary Contact
Amanda Gerlach
amanda.gerlach@msj.org
(828)213-5384

Organizational Information

ACO Participants

  • ABC Pediatrics of Asheville PA
  • Albert B Anderson MD PA
  • Allan Nash
  • AllCare Clinical Associates PA
  • Andrews Internal Medicine PA
  • Angel Medical Center, Inc.
  • Appalachian Foot & Ankle Associates PA
  • Appalachian Mountain Community Health Centers
  • Apple Valley Family Medicine PA
  • Art of Internal Medicine & Pediatrics PA
  • Asheville Arthritis and Osteoporosis Center, P.A.
  • Asheville Children's Medical Center PA
  • Asheville Endocrinology Consultants, PA
  • Asheville Eye Associates PLLC
  • Asheville Gynecology & Wellness Pllc
  • Asheville Internal Medicine, P.A.
  • Asheville Medicine And Pediatrics
  • Asheville Pediatric Associates
  • Asheville Plastic Surgery PA
  • Asheville Pulmonary & Critical Care Associates PA
  • Asheville Radiology Associates, PA
  • Bakersville Community Medical Clinic,Inc
  • Blue Ridge Regional Hospital Inc.
  • Blue Sky Pediatrics Asheville PA
  • Brie Folkner MD PC
  • Brosnan Eye Associates
  • Cannon Family Health, PLLC
  • Carolina Hand and Sports Medicine, P.A.
  • Carolina Internal Medicine Associates, PA
  • Carolina Mountain Dermatology, PA
  • Carolina Mountain Emergency Medicine PA
  • Carolina Mountain Gastroenterology Endoscopy Center, LLC
  • Carolina Ophthalmology, PA
  • Celo Health Education Corporation
  • Chad Smoker MD PC
  • Charles J. DePaolo, M.D, P.A.
  • Charles J. McGraw MD, LTD
  • Clay Comprehensive Health Services, Inc.
  • Community CarePartners, Inc.
  • Community Family Practice, PA
  • Digestive Health Partners PA
  • Dry Ridge Family Medicine PLLC
  • East Asheville Family Health Care P.A.
  • Franklin Family Practice, PA
  • French Broad Pediatric Associates
  • Haywood Pediatric and Adolescent Medicine Group, P.A.
  • Hazelwood Family Medicine, PLLC 
  • Henderson County Hospital Corporation
  • Highlands-Cashiers Hospital, Inc.
  • Highlands-Cashiers Physician Services Inc
  • James J. Caserio, M.D., PA
  • John Baker
  • Krishna Internal Medicine, P.C.
  • MemoryCare
  • Mission Community Anesthesiology Specialists LLC
  • Mission Hospital, Inc.
  • Mission Medical Associates Inc.
  • Moore Foot & Ankle Specialists, PA
  • Mountain Area Health Education Center, Inc.
  • Mountain Area Pathology PA
  • Mountain Area Pediatric Associates, P.A.
  • Mountain Diabetes and Endocrine Center PLLC
  • Mountain Docs Family Medicine P.A
  • Mountain Kidney & Hypertension Associates, P.A.
  • Mountain Radiation Oncology, P.A.
  • Murphy Medical Center, Inc.
  • North Buncombe Family Medicine, P.A.
  • October Road, Inc.
  • Our Family Doctor, PLLC
  • Park Hill Medicine, PA
  • Pineiro Family Practice, PLLC
  • Pisgah Family Health
  • Plastic Surgery of Asheville, PA
  • Primary Eye Care Associates, OD, PA
  • Radiation Therapy Associates of Western North Carolina, Pa
  • Rainbow Pediatrics, P.A.
  • Steven L Cahan MD PA
  • STMD LLC
  • Sylva Family Practice, PA
  • The Family Health Centers PA
  • The McDowell Hospital Inc.
  • The Pisgah Institute for Psychotherapy & Education PA
  • Transylvania Community Hospital, Inc.
  • Transylvania Physician Services Inc
  • Trillium Family Medicine, PLLC
  • UWH of North Carolina, LLP
  • Vickery Family Medicine, Pllc
  • Weaverville Family Medicine Associates, PA
  • Western North Carolina Community Health Services, Inc.
  • Wellspring Family Practice, PA
  • W.N.C. Ear Nose Throat Head and Neck Surgeons, PA
  • WNC INTERNAL MEDICINE, PLLC
  • WNC Family Medical Center PLLC

 

ACO Participants in Joint Ventures Between ACO Professionals and Hospitals

No participants are involved in a joint venture between ACO professionals and hospitals.

 

ACO Governing Body

  • Dr. Robert Moore, Class I Voting Director and Chair, ACO Participant Representative, North Buncombe Family Medicine
  • Dr. Alan Baumgarten, Class I Voting Director, ACO Participant Representative, The Family Health Centers PA
  • Dr. Beth Buys, Class I Voting Director, ACO Participant Representative, Mountain Area Health Education Center
  • Dr. Jason Cook, Class I Voting Director, ACO Participant Representative, The Family Health Centers PA
  • Dr. Jeffery Heck, Class I Voting Director and Vice Chair, ACO Participant Representative, Mountain Area Health Education Center
  • Dr. Kenneth Kubitschek, Class I Voting Director, ACO Participant Representative, Carolina Internal Medicine Associates
  • Dr. Scott Love, Class I Voting Director, ACO Participant Representative, ABC Pediatrics of Asheville PA
  • Dr. Jeffrey Moreadith, Class I Voting Director, ACO Participant Representative, Mission Medical Associates
  • Dr. Nunzio Pagano, Class I Voting Director, ACO Participant Representative, Asheville Internal Medicine
  • Dr. Amy Russell, Class I Voting Director, ACO Participant Representative, Mountain Area Health Education Center
  • Dr. Calvin Tomkins, Class I Voting Director, ACO Participant Representative, Asheville Pediatrics Associates
  • Dr. Michael Weizman, Class I Voting Director, ACO Participant Representative, Our Family Doctor
  • Dr. David Franklin, Class II Voting Director, ACO Participant Representative, Mission Medical Associates
  • Dr. Seth Glickman, Class II Voting Director, ACO Participant Representative, Henderson County Hospital Corporation
  • Dr. Jill Hoggard Green, Class II Voting Director, ACO Participant Representative, Mission Medical Associates
  • Dr. Susan Mims, Class II Voting Director, ACO Participant Representative, Mission Medical Associates
  • Dr. Ronald Paulus, Class II Voting Director, ACO Participant Representative, Mission Hospital
  • Dr. John Ball, Class II Voting Director, Medicare Beneficiary Representative
  • Mr. John Cecil, Class II Voting Director, Community Stakeholder Representative
  • Dr. John Garrett, Class II Voting Director, Community Stakeholder Representative
  • Ms. Amanda Gerlach, Ex officio Non-voting Member, Executive Director
  • Dr. Robert Fields, Ex officio Non-voting Member, Medical Director

 

ACO Key Clinical and Administrative Leadership

  • ACO Executive - Amanda Gerlach
  • Medical Director - Dr. Robert Fields
  • Assistant Medical Director - Dr. Calvin Tomkins
  • Director, Clinical Operations - Lori Brown
  • Compliance Officer - Gwen McKinney

 

Associated Committees and Committee Leadership

  • Finance Committee: Dr. Alan Baumgarten, Chair
  • Quality Committee: Dr. Robert Fields, Chair

 

Types of ACO Participants, or Combinations of Participants, that Formed the ACO

  • Partnerships or joint venture arrangements between hospitals and ACO professionals
  • Critical Access Hospitals (CAH) billing under Method II
  • Federally Qualified Health Centers (FQHC)
  • Rural Health Clinic (RHC)

 

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Agreement period beginning 2015, Performance Year 2015:  $0

 

Shared Savings Distribution

Any earned shared savings will first be allocated to cover 100% of infrastructure and operational costs.

Fifty percent (50%) of any available margin after infrastructure and operating costs are covered will be paid to participant physicians to create an incentive pool to reward providers for achieving metrics established to promote the principal mission to achieve better health for individuals, better health for populations, and lower growth in healthcare expenditures. Fifty percent (50%) of any available margin after infrastructure and operating costs are covered will be paid to Mission Health to support its centralization of MHP’s care coordination efforts. The health system may also choose to retain some of this dividend for future infrastructure investment and/or to build reserves for future risk-based agreements.

 

Payment Rule Waivers

  • No, our ACO does not utilize the SNF 3-Day Rule Waiver

 

Quality Performance Results

  

For more information on how to interpret scores on the above quality performance measures, see
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/MSSP-QM-Benchmarks.pdf

 

Waivers:

To further the purposes of the Medicare Shared Savings Program and the clinical integration efforts of Mission Health Partners, Inc., and its participants, Mission Health Partners, Inc. Board of Directors has approved the following participation waivers and authorizes the provision of the following items/services for all network participants and their employed providers:

  •       Clinical Documentation Integrity "CDI" services which will include documentation specificity queries, code reviews, data analysis and education on findings related to documentation requirements and tools to support processes.  These services will ensure that accurate documentation and code capture is at the most appropriate level of specificity to support patient condition identification and the appropriate delivery of quality care. 

  • Mission Health Partners, Inc. (“MHP”) has implemented a Telepsychiatry Program that will provide tablets and software, free of charge, to selected MHP member primary care practices. The Program will allow the selected primary care practices to facilitate telepsychiatry visits in their offices for their patients through telemedicine equipment. Using telemedicine will reduce the need and costs for patients to travel for psychiatric care.  If successful, the piloted program will expand into other practices in the near future.

  •       A common electronic platform that will enhance clinical integration required under the MSSP and will promote accountability for quality, cost and overall care of the Medicare population.  An integrated or shared electronic health record system (“EHR”) will facilitate high quality medical care for beneficiaries, increase MHP participant access to beneficiary medical records and clinical information specific to beneficiaries, facilitate the communication and coordination of care across the continuum, reduce the number of disparate patient records, improve quality reporting capabilities, and increase patient engagement.

  • ICD-10 training modules and readiness checklists which will be covered as part of the MHP Participation Fee. The express purpose of this provision is to facilitate an accurate transition to the revised medical classification system and aid in coding improvements to increase quality and decrease cost of care according to the requirements of the Medicare Shared Savings Program.

  • A Quality Incentive Program that is designed to incentivize quality improvement behaviors among network providers, set a culture of communication and collaboration, build infrastructure and establish goodwill by providing financial incentives to providers who meet or exceed pre-established connectivity, reporting and quality metrics.  The Quality Incentive Program will contribute to the promotion of high quality and efficient care to network patients by encouraging providers to adhere to quality metrics and facilitate management and coordination of care.
  • QlikView, a quality improvement tool which offers an online analytics dashboard that gives network providers access to patient-level quality data, will increase the quality of care provided to their patients by targeting patients who need a specific screening.  This tool will also ensure that providers complete reporting on all quality measures for each tier threshold in a timely and efficient manner.  QlikView supports the provision of high quality and efficient care for MHP’s beneficiary population at a lower cost.

To further the purposes of the Medicare Shared Savings Program and the clinical integration efforts of Mission Health Partners, Inc., and its participants, Mission Health Partners, Inc. Board of Directors has approved the following patient incentive waivers and authorizes the provision of the following items/services for all network participants and their employed providers

  • Mission Health Partners, Inc. (“MHP”) is implementing a program designed to assist high-risk patients with transportation to appointments for follow-up care (the “Program”).  The Program will advance MHP’s clinical goals by helping patients adhere to a treatment or drug regime, follow-up care plan, or to facilitate management of a chronic disease.  The Program will improve access to primary care by facilitating transportation which would eliminate the need for more expensive intervention and/or Emergency Room visits.    

 

Additional Information

For additional information or general beneficiary questions, please visit www.medicare.gov/acos.html. You can also call 1-800-MEDICARE (1-800-633-4227 (TTY users should call 1-877-486-2048)) for questions about Accountable Care Organizations.


Hours of Operation


Monday through Friday
8 a.m. - 5 p.m.