Others titles
- What is an ACO?
- Medicare ACO Quality Performance for 2013-2015 Results
- Quality Measures to Assess Healthcare ACO
Keywords
- Medicare Shared Savings Program
- ACO
- ACO Healthcare
- Medicare ACO
- Healthcare ACO
- Shared Savings Program
- Medicare Shared Savings Program Results
Medicare Shared Savings Program Performance Year 2013-2015 Results
This dataset contains the results of Medicare Shared Savings Program Performance Accountable Care Organizations (ACO) coverage for years 2013, 2014 and 2015.
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Description
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.
About this Dataset
Data Info
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 | |
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 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
ACO_Year | Coverage year of Medicare Shared Savings Program Performance Accountable Care Organizations (ACO) (2013, 2014 and 2015) | date | - |
ACO_Number | ACO 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_Name | ACO Legal or Business Name | string | - |
Beneficiaries_State | States where beneficiaries reside | string | - |
Agreement_Start_Date | Start date of ACO agreement | date | - |
Is_Participating_In_Advance_Payment_Model | ACO Participation In Advance Payment Model | boolean | - |
Total_Assigned_Beneficiaries | Total number of assigned beneficiaries | integer | level : Ratio |
Total_Benchmark_Expenditures | Benchmark total expenditures in dollars | number | level : Ratio |
Total_Expenditures | Total expenditure in dollars | number | level : Ratio |
Difference_Of_Expenditures | Shows total benchmark minus from assigned beneficiary expense in dollars | number | level : Ratio |
Difference_Percentage | Shows total benchmark minus from assigned beneficiary expense in percentage | number | level : Ratio |
Generated_Savings_Or_Losses | Shows generated saving or loss in dollars | number | level : Ratio |
Earned_Shared_Savings_Payments | Earned shared savings payments or owe loss in dollars | number | level : Ratio |
Is_Reported_Quality_Successful | Does the reported quality is successful or not | boolean | - |
Quality_Score_Percentage | ACO quality score shown in percentage | number | level : Ratio |
ACO_Performance_Result_1 | Getting Timely Care, Appointments, and Information | number | level : Ratio |
ACO_Performance_Result_2 | How Well Your Providers Communicate | number | level : Ratio |
ACO_Performance_Result_3 | Patients’ Rating of Provider | number | level : Ratio |
ACO_Performance_Result_4 | Access to Specialists | number | level : Ratio |
ACO_Performance_Result_5 | Health Promotion and Education | number | level : Ratio |
ACO_Performance_Result_6 | Shared Decision Making | number | level : Ratio |
ACO_Performance_Result_7 | Health Status/Functional Status | number | level : Ratio |
ACO_Performance_Result_8 | Risk Standardized, All Condition Readmission | number | level : Ratio |
ACO_Performance_Result_9 | Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) | number | level : Ratio |
ACO_Performance_Result_10 | Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) | number | level : Ratio |
ACO_Performance_Result_11 | Percent of PCPs who Successfully Meet Meaningful Use Requirements | number | level : Ratio |
ACO_Performance_Result_12 | Accountable 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%). | number | level : Ratio |
ACO_Performance_Result_13 | Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period. | number | level : Ratio |
ACO_Performance_Result_14 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_15 | Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine. | number | level : Ratio |
ACO_Performance_Result_16 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_17 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_18 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_19 | Percentage of adults 50 - 75 years of age who had appropriate screening for colorectal cancer. | number | level : Ratio |
ACO_Performance_Result_20 | Percentage of women 50 through 74 years of age who had a mammogram to screen for breast cancer within 27 months. | number | level : Ratio |
ACO_Performance_Result_21 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_22 | Accountable 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%). | number | level : Ratio |
ACO_Performance_Result_23 | Accountable 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%). | number | level : Ratio |
ACO_Performance_Result_24 | Accountable 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%). | number | level : Ratio |
ACO_Performance_Result_25 | Accountable 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%). | number | level : Ratio |
ACO_Performance_Result_26 | Accountable 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%). | number | level : Ratio |
ACO_Performance_Result_27 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_28 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_29 | Accountable 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%). | number | level : Ratio |
ACO_Performance_Result_30 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_31 | Percentage 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. | number | level : Ratio |
ACO_Performance_Result_32 | Accountable 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%). | number | level : Ratio |
ACO_Performance_Result_33 | Percentage 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. | number | level : Ratio |
Data Preview
ACO Year | ACO Number | ACO Organization Name | Beneficiaries State | Agreement Start Date | Is Participating In Advance Payment Model | Total Assigned Beneficiaries | Total Benchmark Expenditures | Total Expenditures | Difference Of Expenditures | Difference Percentage | Generated Savings Or Losses | Earned Shared Savings Payments | Is Reported Quality Successful | Quality Score Percentage | ACO Performance Result 1 | ACO Performance Result 2 | ACO Performance Result 3 | ACO Performance Result 4 | ACO Performance Result 5 | ACO Performance Result 6 | ACO Performance Result 7 | ACO Performance Result 8 | ACO Performance Result 9 | ACO Performance Result 10 | ACO Performance Result 11 | ACO Performance Result 12 | ACO Performance Result 13 | ACO Performance Result 14 | ACO Performance Result 15 | ACO Performance Result 16 | ACO Performance Result 17 | ACO Performance Result 18 | ACO Performance Result 19 | ACO Performance Result 20 | ACO Performance Result 21 | ACO Performance Result 22 | ACO Performance Result 23 | ACO Performance Result 24 | ACO Performance Result 25 | ACO Performance Result 26 | ACO Performance Result 27 | ACO Performance Result 28 | ACO Performance Result 29 | ACO Performance Result 30 | ACO Performance Result 31 | ACO Performance Result 32 | ACO Performance Result 33 |
2015 | A66307 | Copeland Beajow Medical Institute, Chtd DBA Internal Medicine Associates | NV | 2013-01-01 | 5259 | 71604902 | 68113593 | 3491309 | 4.88 | 3491309.0 | 1580006.0 | True | 92.36 | 75.29 | 90.29 | 89.69 | 79.1 | 58.25 | 73.67 | 71.97 | 19.25 | 15.71 | 18.6 | 57.94 | 76.21 | 64.01 | 1.06 | 1.66 | 64.71 | 100.0 | 95.02 | 82.68 | 69.47 | 99.17 | 99.01 | 98.34 | 68.7 | 70.81 | 99.83 | 17.29 | 51.69 | 86.45 | 88.03 | 96.67 | 91.78 | ||
2015 | A65526 | Memorial Hermann Accountable Care Organization | TX | 2012-07-01 | 50055 | 636117708 | 546988936 | 89128773 | 14.01 | 89128773.0 | 41912527.0 | True | 95.97 | 73.6 | 91.92 | 90.14 | 83.16 | 59.19 | 77.49 | 71.61 | 28.39 | 14.7 | 19.17 | 47.7 | 73.41 | 59.69 | 1.29 | 0.95 | 88.6 | 94.16 | 52.4 | 60.98 | 51.15 | 81.38 | 95.9 | 33.33 | 62.85 | 55.79 | 88.57 | 16.38 | 37.54 | 65.52 | 90.91 | 93.01 | 89.04 | ||
2015 | A07386 | CaroMont ACO | NC, SC | 2014-01-01 | 9311 | 83905204 | 75945939 | 7959265 | 9.49 | 7959265.0 | 3784257.0 | True | 97.03 | 82.72 | 92.47 | 90.8 | 85.22 | 58.16 | 76.49 | 68.15 | 39.72 | 14.23 | 15.56 | 56.69 | 72.37 | 61.79 | 0.61 | 1.16 | 97.78 | 50.87 | 68.68 | 60.7 | 72.43 | 72.16 | 92.28 | 46.1 | 58.58 | 68.85 | 75.3 | 11.5 | 43.77 | 65.86 | 86.67 | 93.1 | 75.31 | ||
2015 | A70756 | Accountable Care Coalition of Coastal Georgia, LLC | GA, SC | 2012-04-01 | 9459 | 93411313 | 93147847 | 263466 | 0.28 | True | 92.42 | 77.61 | 93.11 | 92.89 | 82.35 | 60.98 | 74.9 | 73.01 | 28.14 | 14.05 | 17.79 | 51.26 | 74.0 | 61.53 | 0.8 | 1.08 | 100.0 | 96.78 | 67.87 | 79.15 | 73.33 | 81.25 | 92.68 | 65.6 | 61.29 | 76.84 | 85.86 | 16.67 | 13.89 | 55.56 | 77.17 | 86.47 | 88.37 | 67.07 | |||
2015 | A48017 | SSMOK ACO, LLC | OK | 2015-01-01 | 6666 | 62334496 | 63717109 | 1382613 | 2.22 | True | 79.2 | 91.18 | 91.84 | 80.91 | 56.33 | 75.46 | 69.48 | 25.52 | 14.45 | 18.6 | 46.94 | 69.26 | 54.64 | 0.76 | 0.76 | 100.0 | 93.31 | 56.22 | 61.6 | 55.42 | 42.75 | 88.76 | 46.77 | 39.76 | 62.11 | 25.12 | 18.33 | 16.33 | 62.27 | 80.66 | 95.96 | 74.32 | |||||
2015 | A60323 | Physicians ACO, LLC | FL | 2015-01-01 | 6841 | 77509841 | 71576595 | 5933246 | 7.65 | 5933246.0 | 2907291.0 | True | 73.7 | 89.06 | 87.25 | 80.8 | 58.17 | 70.59 | 72.2 | 25.9 | 14.4 | 17.09 | 41.58 | 54.48 | 46.12 | 0.8 | 0.74 | 67.74 | 99.58 | 69.97 | 67.96 | 50.0 | 84.77 | 90.79 | 53.38 | 65.33 | 68.67 | 92.27 | 13.04 | 36.36 | 78.49 | 81.13 | 87.5 | 80.3 | |||
2015 | A67273 | UnityPoint Health Partners | IL, IA, WI | 2012-07-01 | 92589 | 813803834 | 823899337 | 10095503 | 1.24 | True | 94.5 | 81.96 | 93.0 | 90.96 | 85.9 | 59.82 | 75.16 | 73.6 | 23.47 | 14.95 | 18.93 | 55.19 | 81.85 | 67.55 | 0.98 | 1.03 | 98.08 | 93.53 | 61.45 | 62.53 | 70.73 | 83.71 | 87.0 | 64.3 | 62.53 | 70.4 | 78.82 | 13.04 | 28.99 | 82.85 | 91.55 | 79.9 | 81.18 | ||||
2015 | A07334 | Connected Care, LLC | MI | 2015-01-01 | 8615 | 78766974 | 79341077 | 574103 | 0.73 | True | 82.43 | 94.32 | 93.1 | 84.49 | 57.59 | 73.86 | 72.66 | 30.64 | 15.17 | 19.36 | 56.34 | 79.62 | 62.33 | 1.67 | 0.68 | 75.86 | 64.44 | 20.91 | 57.88 | 52.31 | 63.87 | 85.3 | 23.31 | 51.75 | 57.54 | 51.7 | 21.66 | 35.01 | 70.43 | 86.97 | 85.0 | 82.49 | |||||
2015 | A34708 | MissionPoint Evansville, LLC | IL, IN, KY | 2015-01-01 | 12487 | 115478533 | 115710422 | 231890 | 0.2 | True | 82.18 | 92.6 | 92.74 | 84.15 | 60.07 | 75.76 | 71.44 | 34.44 | 14.18 | 17.4 | 65.79 | 80.76 | 72.1 | 0.99 | 0.98 | 96.05 | 97.1 | 37.92 | 60.41 | 71.62 | 53.92 | 87.66 | 26.19 | 35.25 | 81.38 | 63.59 | 10.0 | 66.89 | 81.77 | 69.65 | 66.41 | 95.0 | 78.9 | ||||
2015 | A62243 | Accountable Care Coalition of Greater Augusta & Statesboro, LLC. | GA, SC | 2013-01-01 | 20407 | 197777596 | 197408946 | 368650 | 0.19 | True | 100.0 | 84.65 | 95.02 | 94.6 | 84.72 | 63.93 | 76.1 | 72.25 | 28.64 | 15.01 | 19.63 | 59.59 | 80.5 | 68.31 | 1.19 | 1.12 | 93.85 | 89.41 | 69.75 | 81.67 | 75.23 | 89.49 | 97.98 | 50.55 | 80.2 | 61.15 | 59.38 | 12.11 | 61.59 | 63.38 | 87.5 | 94.69 | 85.88 |