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Collectively committed to clinical excellence by improving the quality and value of care for the patients we serve.

Seamless Care for Medicare Patients

PPWPA believes in setting the highest care for our Medicare patients, we've become an Accountable Care Organization (ACO) through the Centers for Medicare & Medicaid Services. As an Enhanced Track ACO, we're committed to providing patients the right care at the right time while avoiding errors and unnecessary duplications of services.

In 2017, Physician Partners of Western Pennsylvania (PPWPA) was selected to be an Accountable Care Organization (ACO), a program sponsored by the Centers for Medicare and Medicaid Services (CMS). This information explains PPWPA’s participation in that program.

ACO Name and Location

Physician Partners of Western PA LLC

120 Fifth Avenue Place

FAP AHN-CORP

Pittsburgh, PA 15222

ACO Primary Contact

Tracey Ryan - President and Executive Director

Phone: 412-330-2429

Email: tracey.ryan@ahn.org

Organizational Information

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Allegheny Clinic N
Allegheny Clinic Radiology N
Associates in Neurology of Pittsburgh N
Cardiovascular Disease Specialists of Pittsburgh PC N
Chautauqua Medical Practice, P.C. N
Cherry Tree Medical Associates Inc N
Dr Edward Jew III Internal Medicine N
Dudzinski Enterprises, Inc N
Emmanuel Family Practice Associates, PC N
Golla ENT N
Indiana Diabetes & Endocrinology PLLC N
Izzo Foot and Ankle P.C. N
Jefferson Cardiology Association N
Jefferson Internal Medicine PC N
Johnstown Heart and Vascular Center, Inc N
KLAIN, HEASLEY, NETTLETON MD, PC N
Levi Walker, M.D., P.C. N
OB-GYN Associates of Erie, PC N
Partners in Family Care P C N
Premier Medical Associates, PC N
Raja Chakrapani N
Rc Medical Associates Pc N
Saint Vincent Consultants in Cardiovascular Diseases N
Sciamanda Total Health and Wellness N
South Hills Family Medicine, LLC N
St Vincent Medical Education and Research Institute Inc N
Warren General Hospital N

ACO GOVERNING BODY

Member

First 

Last Name

Member Title/Position

Member's Voting Power (Expressed as a percentage)

Membership Type

ACO Participant Legal Business Name/DBA, if Applicable

Amy Crawford-Faucher Chair/Voting Member 5.50% ACO Participant Representative Allegheny Clinic
Bethany Casagranda Voting Member 5.40% ACO Participant Representative Allegheny Clinic Radiology
Brian Johnson Medical Director 0% ACO Participant Representative Allegheny Clinic
Daniel Holt Voting Member 4.00% Community Stakeholder Representative Centerville Clinics
Danielle Hanson Voting Member 4.00% Community Stakeholder Representative N/A
David Shin Voting Member 5.40% ACO Participant Representative Allegheny Clinic
Diana Raub Voting Member 5.40% ACO Participant Representative Allegheny Clinic
Ezz-Eldin Moukamal Voting Member 5.40% ACO Participant Representative Premier Medical Associates PC
James Solova Voting Member 5.40% ACO Participant Representative Prime Medical Group PCG1
Matthew Nettleton Voting Member 5.40% ACO Participant Representative Indiana 
Joseph Aracri Voting Member 5.50% ACO Participant Representative Allegheny Clinic
Kevin Kraeling Voting Member 4.00% Community Stakeholder Representative N/A
Kevin Kusic Secretary/Voting Member 4.00% Other N/A
Natalie Furlong Voting Member 5.40% ACO Participant Representative South Hills Family Medicine
Paul Gausman Voting Member 5.40% ACO Participant Representative St Vincent Medical Education and Research Institute Inc
Richard Neff Voting Member 4.00% Community Stakeholder Representative Indiana Regional Medical Center
Robert Crossey Vice Chair/Voting Member 5.50% ACO Participant Representative Premier Medical Associates PC
Sam  Reynolds Voting Member 5.40% ACO Participant Representative Allegheny Clinic
Timothy Sauber Voting Member 5.40% ACO Participant Representative Allegheny Clinic
Raymond Madia Voting Member 4.0% Medicare Beneficiary Representative N/A
Tony Farah Voting Member 5.50% ACO Participant Representative Allegheny Clinic

KEY ACO CLINICAL AND ADMINISTRATIVE LEADERSHIP

ACO Executive: Tracey Ryan
Medical Director: Brian Johnson, MD
Compliance Officer: Kelle Jones, JD, RN, CHC, CHPC
Quality Assurance/Improvement Officer: Brian Johnson, MD

ASSOCIATED COMMITTEES AND COMMITTEE LEADERSHIP

Committee Name

Committee Leader Name and Position

Finance and Contracting Committee Kevin Kusic - Chair
Clinical, Quality Improvement and Credentialing Committee Sam Reynolds, MD - Chair
Nominating Committee Brian Johnson, MD - Chair

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

Networks of individual practices of ACO professionals

SHARED SAVINGS AND LOSSES

Amount of Shared Savings/Losses

Amount of Shared Savings/Losses

Second Agreement Period

  • Performance Year 2024: $5,316,632.91
  • Performance Year 2023: $0
  • Performance Year 2022: $0

First Agreement Period

  • Performance Year 2021: $8,857,581.75
  • Performance Year 2020: $6,126,529
  • Performance Year 2019: $11,573,492.92
  • Performance Year 2018: $0
Shared Savings Distribution

Second Agreement Period

  • Performance Year 2024
    • Proportion invested in infrastructure: 5%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 80%
  • Performance Year 2023
    • Proportion invested in infrastructure: n/a
    • Proportion invested in redesigned care processes/resources: n/a
    • Proportion of distribution to ACO participants: n/a
  • Performance Year 2022
    • Proportion invested in infrastructure: n/a
    • Proportion invested in redesigned care processes/resources: n/a
    • Proportion of distribution to ACO participants: n/a

First Agreement Period

  • Performance Year 2021
    • Proportion invested in infrastructure: 5%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 80%
  • Performance Year 2020
    • Proportion invested in infrastructure: 5%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 80%
  • Performance Year 2019
    • Proportion invested in infrastructure: 5%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 80%
  • Performance Year 2018
    • Proportion invested in infrastructure: n/a
    • Proportion invested in redesigned care processes/resources: n/a
    • Proportion of distribution to ACO participants: n/a

PAYMENT RULE WAIVERS

  • Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
    • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR Section 425.612
  • Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR Section 425.612(f) and 42 CFR Section 425.613.

QUALITY PERFORMANCE RESULTS

2024 QUALITY PERFORMANCE RESULTS

Quality Performance Results are based on CMS Web Interface

Measure ID #

Measure Name

Rate

ACO Mean


001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control 7.51 9.44
110 Preventative Care and Screening: Influenza Immunization 75.59 68.6
112 Breast Cancer Screening 88.52 80.93
113 Colorectal Cancer Screening 82.16 77.81
134 Preventative Care and Screening: Screening for Depression and Follow-up Plan 91.63 81.46
226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Invervention 91.67 79.98
236 Controlling High Blood Pressure 83.04 79.49
318 Falls: Screening for Future Fall Risk 95.68 88.99
370 Depression Remission at Twelve Months 14.29 17.35
438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 89.33 86.50
479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS .01597 0.1517
484 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions 39.42 37.00
CAHPS-1 Getting Timely Care, Appointments, and Information 89.19 83.70
CAHPS-2 How Well Providers Communicate 95.85 93.96
CAHPS-3 Patient's Rating of Provider 94.45 92.43
CAHPS-4 Access to Specialists 73.26 75.76
CAHPS-5 Health Promotion and Education 68.69 65.48
CAHPS-6 Shared Decision Making 69.27 62.31
CAHPS-7 Health Status and Functional Status 74.97 74.14
CAHPS-8 Care Coordination 87.37 85.89
CAHPS-9 Courteous and Helpful Office Staff 93.61 92.89
CAHPS-11 Stewardship of Patient Resources 31.56 26.98
For Previous Years' Financial and Quality Performance Results, please visits data.cms.gov. 

ACO Primary Care Flex Model