Medicare

Medicare

Medicare fee-for-service beneficiaries whose providers participate in an ACO maintain all of their Medicare rights, including the right to choose any doctors and providers that accept Medicare.

ACOs are motivated to provide the highest quality of care to its Medicare Fee-for-Service patients. When an ACO succeeds in both delivering quality care and spending healthcare dollars wisely, it will share in the savings it achieves for the government’s Medicare program.

An ACO’s coordinated care helps ensure that Medicare fee-for-service beneficiaries, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors.

MSSP Participation Waivers

ACO Frequently Asked Questions (PDF)

ACO Name and location:

Healthier You Alliance in Accountable Care
8200 E. Thorn
Wichita, KS 67226

ACO primary contact

Joy Scott
joy.scott@ascension.org or 316-858-4970

Organizational information

ACO participants:  

ACO participant Participant in joint venture (Y or N)
Advanced Orthopaedic Associates, P.A N
GraceMed Health Clinic, Inc. N
Kansas Imaging Consultants, P.A. N
Kansas Nephrology Physicians, P.A. N
Via Christi Clinic, P.A. N
Via Christi Hospitals Wichita, Inc. N
Via Christi Hospital in Manhattan N
Via Christi Rehabilitation Hospital, Inc. N
Wamego Hospital Association N

ACO Governing Body:

Last name First name Title/position Member's voting power Membership type ACO participant TIN legal business name/DBA, if applicable
Nickel, DO Terri Chairperson Y ACO participant Via Christi Clinic, P.A.
Hett, MD Edward Vice Chairperson Y ACO participant Via Christi Clinic, P.A.
Benning, MD Timothy Chairperson Y ACO participant Kansas Imaging Consultants, P.A.
Ross, MD Dennis Y ACO participant Kansas Nephrology Physicians, P.A.
Jansson, MD Kenneth Y ACO participant Advanced Orthopaedic Associates, P.A.
Neff Phil Y Medicare beneficiary N/A
Reed, DO Jacob Y Community stakeholder representative CEP America
Neil, MD Tara Y ACO participant Via Christi Hospitals Wichita, Inc

Key ACO clinical and administrative leadership:

Terri NickelTerri Nickel, DO, Chairperson, Medical Director, Chief Quality Officer

  • ACO participant, Via Christi Clinic, P.A.
  • Board certified in Family Medicine
  • Develops and manages the ACO quality assurance and improvement program

 

 

 

 


Edward HettEdward Hett, MD, Vice Chairperson and Chief Executive Officer

  • ACO participant, Via Christi Clinic, P.A.
  • Board certified in Family Medicine
  • Manages and oversees the operational aspects of ACO to promote the three-part aim of improved care for individuals, improved health for populations, and lower growth in expenditures for beneficiaries

 

 

 


Jenni Meyer Chief Compliance Officer

 

 

 

 


Associated committees and committee leadership:

Quality Assurance Committee: Moneeshindra S. Mittal, MD, chair
Develops and manages quality assurance and improvement programs for patient care outcomes, safety and services; Provides oversight for management of the clinical evaluation/operations, and improvement of healthcare for beneficiaries, including development of the following care paths:

ADHD
Adult obesity
Asthma
Back pain
Bipolar disorder
Bronchiolitis
Chronic kidney disease
Community-acquired pneumonia
COPD
Depression
Diabetes
Heart failure
Hypertension
Osteoarthritis
Pediatric diabetes
Pediatric obesity
Preventative screening

Network Management Committee: Dr. Lowell Ebersole, chair
Develops and manages the participant network to ensure a comprehensive continuum of care to meet goals of the three-part aim.

Compliance/Finance Committee: Dr. Thomas Flynn, chair
Provides oversight for the development and management of the ACO compliance plan and shared savings distribution methodology.

Types of ACO participants or combinations of participants that formed the ACO:

ACO professionals in a group practice arrangement, hospital employing ACO professionals, Federally Qualified Health Center (FQHC)

Shared Savings and Losses:

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2016: $0.00
    • Performance Year 2015: $0.00
    • Performance Year 2014: $0.00
    • Performance Year 2013: $0.00

Shared Savings Distribution

  • Agreement period beginning 2013, Performance Year1
    • Primary Care Physicians-40% of available shared savings
    • Specialty Care Physicians - 25% of available shared savings
    • Inpatient Facilities-20% of available shared savings
    • ACO, VCAAC-15% of available shared savings
  • Agreement period beginning 2013, Performance Year 2014,2015
    • Primary Care Physicians-40% of available shared savings
    • Specialty Care Physicians-25% of available shared savings
    • Inpatient Facilities-20% of available shared savings
    • ACO, VCAAC-15% of available shared savings

Payment Rule Waivers

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

Quality performance results