Tidewater Accountable Care Organization

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Tidewater Accountable Care Organization Name and Location

Tidewater Accountable Care Organization
Tidewater Medical Center
860 Omni Boulevard, Suite 401
Newport News, Virginia  23606

Tidewater Accountable Care Organization Primary Contact

Contact:  Sibyl Wilson

Phone:  (757) 232-8764

Email:  Sibby.Wilson@tpmgpc.com


Organizational Information

Tidewater Accountable Care Organization Participants

Tidewater Physicians Multispecialty Group (TPMG)
(No participants are involved in a joint venture between ACO professionals and hospitals)

Tidewater Accountable Care Organization (TACO) Governing Body

  • Jennifer Sharp-Warthan, MD, TACO Executive, TACO participant representative, TPMG
  • Scott Banning, MD, President, TACO participant representative, TPMG
  • Jeffrey Morrison, DO, Vice-President, TACO participant representative, TPMG
  • Webb Jones, MD, Voting Member, Medicare beneficiary representative (N/A)
  • Sibyl Wilson, Secretary, TACO participant representative, TPMG
  • P. Marlene Capps, MD, Voting Member, TACO participant representative, TPMG
  • Stephen Norfleet, MD, Voting Member, TACO participant representative, TPMG
  • John Bryant, MD, Voting Member, TACO participant representative, TPMG
  • Mark Winters, MD, Voting Member, TACO participant representative, TPMG
  • Louis Rossiter, PhD, Voting Member, TACO participant representative (N/A)

Key Clinical and Administrative Leadership

  • ACO Executive:  Jeffrey Morrison, DO
  • Medical Director:  Jennifer Sharp-Warthan, MD
  • Compliance Official:  Sibby Wilson

Tidewater Accountable Care Organization Associated Committees and Committee Leadership

Practice Standards Committee
  • Jennifer Sharp-Warthan, MD
  • Sibby Wilson
Finance/Shared Savings Committee
  • Jennifer Sharp-Warthan, MD
  • Michael J. Corcoran, Jr.
Utilization Management Committee
  • Jeffrey Morrison, DO
  • Brett Brickey
Quality and Performance Monitoring Committee
  • Jennifer Sharp-Warthan, MD
  • Jeffrey Morrison, DO
  • Brett Brickey

Tidewater Accountable Care Organization Key ACO Clinical and Administrative Leadership

  • Apostolos “Paul” Hiotellis, MD, Committee Chair
  • Jeffrey Morrison, DO
  • Christopher Ciccone, MD
  • P. Marlene Capps, MD
  • Matthew Hopson, DPM
  • Jennifer Sharp-Warthan, MD

Types of Accountable Care Organization Participants, or Combinations of Participants, that Formed the Accountable Care Organization

ACO professionals in a group practice arrangement


Shared Savings and Losses

Amount of Shared Savings/Losses

  • Performance Year 1: Not in Operation
  • Agreement Period beginning 2014, Performance Year 2014: $0
  • Agreement Period beginning 2014, Performance Year 2015: $0

How Shared Savings Are Distributed

Agreement period beginning 2014, Performance year 2014:

  • Proportion invested in infrastructure 100%

Agreement period beginning 2014, Performance year 2015:

  • Proportion of distribution to ACO participants 20%
  • Proportion invested in infrastructure 80%

Agreement period beginning 2014, Performance year 2016:

  • Proportion invested in redesigned care processes/resources 30%
  • Proportion invested in IT infrastructure 30%
  • Proportion of distribution to ACO participants 40%

Payment Rule Waivers

  • Our ACO does not utilize the SNF 3-day rule waiver

Quality Performance Results

See 2015 Quality Performance Results Table here (will open in new tab/window)
See 2013-2014 Quality Performance Results Table here (will open in new tab/window)


CMS Press Release

Tidewater Accountable Care Organization, LLC, has been selected as one of 123 new Accountable Care Organizations (ACO) in Medicare, providing approximately 1.5 million more Medicare beneficiaries with access to high-quality, coordinated care across the United States, Health and Human Services (HHS) as announced by Secretary Kathleen Sebelius.

Doctors, hospitals and health care providers establish ACOs in order to work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth. Since passage of the Affordable Care Act, more than 360 (ACOs) have been established, serving over 5.3 million Americans with Medicare. Beneficiaries seeing health care providers in ACOs always have the freedom to choose doctors inside or outside of the ACO. ACOs share with Medicare any savings generated from lowering the growth in health care costs when they meet standards for high quality care.

“Accountable Care Organizations are delivering higher-quality care to Medicare beneficiaries and are using Medicare dollars more efficiently,” Secretary Sebelius said. “This is a great example of the Affordable Care Act rewarding hospitals and doctors that work together to help our beneficiaries get the best possible care.”

The ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) evaluates ACO quality performance using 33 quality measures on patient and caregiver experience of care, care coordination and patient safety, appropriate use of preventive health services, and improved care for at-risk populations.

The new ACOs include a diverse cross-section of healthcare providers across the country including providers delivering care in underserved areas. More than half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately one in five ACOs include community health centers, rural health clinics, and critical access hospitals that serve low-income and rural communities.

Affordable Care Act provisions have a substantial effect on reducing the growth rate of Medicare spending. Growth in Medicare spending per beneficiary hit historic lows during the 2010 to 2012 period, and this trend has continued into 2013.  Projections by both the Office of the Actuary at CMS and by the Congressional budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades-old pattern of spending growth outstripping economic growth.

The next application period for organizations interested in participating in the Shared Savings Program beginning January 2015 will be in summer 2014.

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

More information about the Shared Savings Program is available at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html?redirect=/sharedsavingsprogram/

For a list of the 123 new ACOs announced today, visit:http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/2014-ACO-Contacts-Directory.pdf


Medicare Annual Wellness Visit


 

 

 

 

 

 

 

 

 

 

 

 

 

For additional information, please visit: Data.CMS.gov


Public Announcement of Renewal into the Shared Savings Program