Medicare Shared Savings Program Performance Year 2013-2015 Results

$79 / year

This dataset contains the results of Medicare Shared Savings Program Performance Accountable Care Organizations (ACO) coverage for years 2013, 2014 and 2015.

Complexity

This dataset presents data on Calendar Year 2015 financial reconciliation and quality performance results for ACOs with 2012, 2013, 2014 and 2015 agreement start dates. ACOs that generated savings earned a performance payment if they met the quality standard. Quality performance for ACOs with 2015 start dates that are in their first performance year is based on complete and accurate reporting of all required quality measures for calendar year 2013-2015.

Participation in ACOs creates incentives for health care providers to work together voluntarily to coordinate care and improve quality for their patient population. Since the 2011 Shared Savings Program final rule, updates have been made to the Shared Savings Program quality measures, scoring, and quality performance standard have been made in subsequent Shared Savings Program and Physician Fee Schedule rules.

ACOs are required to completely and accurately report quality data that are used to calculate and assess their quality performance. In addition, in order to be eligible to share in any savings generated, an ACO must meet the established quality performance standard that corresponds to its performance year. CMS most recently updated the quality measure set in the 2016 Physician Fee Schedule Final Rule by adding a Statin Therapy for the Prevention and Treatment of Cardiovascular Disease measure in the Preventive Health Domain to address National Quality Strategy and CMS Strategy goals and to align with PQRS and the Million Hearts Initiative. This document presents the 34 quality measures used to assess ACO quality performance for the 2016 quality reporting year ACOs participating in the Shared Savings Program.

Date Created

2014-11-06

Last Modified

2017-03-30

Version

2017-03-30

Update Frequency

Irregular

Temporal Coverage

2015

Spatial Coverage

United States

Source

John Snow Labs => Centers for Medicare and Medicaid Services

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

Medicare Shared Savings Program, ACO, ACO Healthcare, Medicare ACO, Healthcare ACO, Shared Savings Program, Medicare Shared Savings Program Results

Other Titles

What is an ACO?, Medicare ACO Quality Performance for 2013-2015 Results, Quality Measures to Assess Healthcare ACO

Name Description Type Constraints
ACO_YearCoverage year of Medicare Shared Savings Program Performance Accountable Care Organizations (ACO) (2013, 2014 and 2015)date-
ACO_NumberACO Number assigned to groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients.string-
ACO_Organization_NameACO Legal or Business Namestring-
Beneficiaries_StateStates where beneficiaries residestring-
Agreement_Start_DateStart date of ACO agreementdate-
Is_Participating_In_Advance_Payment_ModelACO Participation In Advance Payment Modelboolean-
Total_Assigned_BeneficiariesTotal number of assigned beneficiariesintegerlevel : Ratio
Total_Benchmark_ExpendituresBenchmark total expenditures in dollarsnumberlevel : Ratio
Total_ExpendituresTotal expenditure in dollarsnumberlevel : Ratio
Difference_Of_ExpendituresShows total benchmark minus from assigned beneficiary expense in dollarsnumberlevel : Ratio
Difference_PercentageShows total benchmark minus from assigned beneficiary expense in percentagenumberlevel : Ratio
Generated_Savings_Or_LossesShows generated saving or loss in dollarsnumberlevel : Ratio
Earned_Shared_Savings_PaymentsEarned shared savings payments or owe loss in dollarsnumberlevel : Ratio
Is_Reported_Quality_SuccessfulDoes the reported quality is successful or notboolean-
Quality_Score_PercentageACO quality score shown in percentagenumberlevel : Ratio
ACO_Performance_Result_1Getting Timely Care, Appointments, and Informationnumberlevel : Ratio
ACO_Performance_Result_2How Well Your Providers Communicatenumberlevel : Ratio
ACO_Performance_Result_3Patients’ Rating of Providernumberlevel : Ratio
ACO_Performance_Result_4Access to Specialistsnumberlevel : Ratio
ACO_Performance_Result_5Health Promotion and Educationnumberlevel : Ratio
ACO_Performance_Result_6Shared Decision Makingnumberlevel : Ratio
ACO_Performance_Result_7Health Status/Functional Statusnumberlevel : Ratio
ACO_Performance_Result_8Risk Standardized, All Condition Readmissionnumberlevel : Ratio
ACO_Performance_Result_9Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI)numberlevel : Ratio
ACO_Performance_Result_10Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI)numberlevel : Ratio
ACO_Performance_Result_11Percent of PCPs who Successfully Meet Meaningful Use Requirementsnumberlevel : Ratio
ACO_Performance_Result_12Accountable care organizations performance results 12 for: Coronary Artery disease: Angiotensin- Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Therapy—Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%).numberlevel : Ratio
ACO_Performance_Result_13Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period.numberlevel : Ratio
ACO_Performance_Result_14Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization.numberlevel : Ratio
ACO_Performance_Result_15Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine.numberlevel : Ratio
ACO_Performance_Result_16Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous six months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous six months of the current encounter.numberlevel : Ratio
ACO_Performance_Result_17Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user.numberlevel : Ratio
ACO_Performance_Result_18Percentage of patients aged 12 years and older screened for clinical depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen.numberlevel : Ratio
ACO_Performance_Result_19Percentage of adults 50 - 75 years of age who had appropriate screening for colorectal cancer.numberlevel : Ratio
ACO_Performance_Result_20Percentage of women 50 through 74 years of age who had a mammogram to screen for breast cancer within 27 months.numberlevel : Ratio
ACO_Performance_Result_21Percentage of patients aged 18 years and older seen during the reporting period who were screened for high blood pressure AND a recommended follow-up plan is documented based on the current blood pressure (BP) reading as indicated.numberlevel : Ratio
ACO_Performance_Result_22Accountable care organizations performance results 22 for: Coronary Artery disease: Angiotensin- Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Therapy—Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%).numberlevel : Ratio
ACO_Performance_Result_23Accountable care organizations performance results 23 for: Coronary Artery disease: Angiotensin- Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Therapy—Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%).numberlevel : Ratio
ACO_Performance_Result_24Accountable care organizations performance results 24 for: Coronary Artery disease: Angiotensin- Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Therapy—Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%).numberlevel : Ratio
ACO_Performance_Result_25Accountable care organizations performance results 25 for: Coronary Artery disease: Angiotensin- Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Therapy—Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%).numberlevel : Ratio
ACO_Performance_Result_26Accountable care organizations performance results 26 for: Coronary Artery disease: Angiotensin- Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Therapy—Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%).numberlevel : Ratio
ACO_Performance_Result_27Percentage of patients 18 - 75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period. Note that a lower performance rate is indicative of better quality.numberlevel : Ratio
ACO_Performance_Result_28Percentage of patients 18 - 85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (< 140/90 mmHg) during the measurement period.numberlevel : Ratio
ACO_Performance_Result_29Accountable care organizations performance results 29 for: Coronary Artery disease: Angiotensin- Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Therapy—Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%).numberlevel : Ratio
ACO_Performance_Result_30Percentage of patients 18 years of age and older who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had documentation of use of aspirin or another antithrombotic during the measurement period.numberlevel : Ratio
ACO_Performance_Result_31Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed beta-blocker therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge.numberlevel : Ratio
ACO_Performance_Result_32Accountable care organizations performance results 32 for: Coronary Artery disease: Angiotensin- Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Therapy—Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%).numberlevel : Ratio
ACO_Performance_Result_33Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12 month period who also have diabetes OR a current or prior Left Ventricular Ejection Fraction (LVEF) < 40% who were prescribed ACE inhibitor or ARB therapy.numberlevel : Ratio
ACO_YearACO_NumberACO_Organization_NameBeneficiaries_StateAgreement_Start_DateIs_Participating_In_Advance_Payment_ModelTotal_Assigned_BeneficiariesTotal_Benchmark_ExpendituresTotal_ExpendituresDifference_Of_ExpendituresDifference_PercentageGenerated_Savings_Or_LossesEarned_Shared_Savings_PaymentsIs_Reported_Quality_SuccessfulQuality_Score_PercentageACO_Performance_Result_1ACO_Performance_Result_2ACO_Performance_Result_3ACO_Performance_Result_4ACO_Performance_Result_5ACO_Performance_Result_6ACO_Performance_Result_7ACO_Performance_Result_8ACO_Performance_Result_9ACO_Performance_Result_10ACO_Performance_Result_11ACO_Performance_Result_12ACO_Performance_Result_13ACO_Performance_Result_14ACO_Performance_Result_15ACO_Performance_Result_16ACO_Performance_Result_17ACO_Performance_Result_18ACO_Performance_Result_19ACO_Performance_Result_20ACO_Performance_Result_21ACO_Performance_Result_22ACO_Performance_Result_23ACO_Performance_Result_24ACO_Performance_Result_25ACO_Performance_Result_26ACO_Performance_Result_27ACO_Performance_Result_28ACO_Performance_Result_29ACO_Performance_Result_30ACO_Performance_Result_31ACO_Performance_Result_32ACO_Performance_Result_33
2014Yuma Connected CommunityArizona2013-01-01false40123263655835325853-2689295-8.24false
2014UR Care LLCMaryland2014-01-01false6048691200796619387229262084.232926208false14.572.331.8931.25
2014Independent San Diego ACOCalifornia2013-01-01false559211825261910957549786771227.348677122false16.360.810.8221.43
2013NOMS ACO, LLCOhio2013-01-01true8495857384988455957211789261.4false80.7794.4993.8182.4556.7178.4669.9715.941.581.5583.87
2014Affiliated Physicians Medical Group ACO, Inc.California2013-01-01false762911017881410754212326366922.39false14.591.070.7256.82
2013Physicians ACOTexas2012-07-01true7802149496454137487324120091308120091300false73.9289.6388.8584.9756.3174.7669.9514.011.080.9747.37
2013Allcare Options, LLCFlorida2012-07-01false579690520697833037107216988872169880false77.8990.2589.7184.256.170.5672.9615.342.021.7883.33
2015A97296Physicians Accountable Care Organization, LLC NM 2013-01-014777360015663801676720152005.6false14.4817.9445.0868.5954.410.440.7150
2014Southern NMIPA ACO LLCNew Mexico2014-01-01false74195881382062989567-4175748-7.1false72.490.8389.880.8758.9771.9671.0515.291.081.3146.43
2013Morehouse Choice ACO-ESGeorgia2013-01-01false6003443258524240496119208904.319208900false68.791.4688.3478.6959.0466.4274.0815.131.551.7125.68