Southern Kentucky Healthcare Alliance ACO Information

Southern Kentucky Health Care Alliance


121 College Street
Smiths Grove, Kentucky 42171

ACO Primary Contact

Primary Contact Name

Pravin Avula, MD

Primary Contact Phone Number

270-563-3000

Primary Contact Email Address

docalcures@yahoo.com

Organizational Information

ACO participants:

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Ghayth M Hammad, M.D., PSC

N

Glk Enterprises, Llc

N

William D. Kirk M.D., PLLC

N

Dr. Tim Long, M.D., PSC

N

Miles Gibson

N

Family First Health Care, PLLC

N

Gilbert,Barbee,Moore & Mcilvoy, P.S.C.

N

Family Medical Center of Hart Co

N

Drs Godfrey Godfrey & Eklund PSC

N

Henry County Medical Center, P.S.C.

N

Mohana R. Arla MD., P.S.C.

N

Miles Gibson

N

Patrick K. Hayden Logan Family Practice

N

Charles S. GIles, MD, PSC

N

Bullitt County Family Practioners

N

Family & Internal Medicine Associates Pllc

N

Lily Creek Medical Group, PSC

N

 

ACO governing body:

Member

Member's Voting Power

Membership Type

ACO Participant TIN Legal Business Name/DBA, if Applicable

Last Name

First Name

Title/Position

Avula

Pravin

Voting Member

12.5

ACO Participant Representative

 

Singh

Kamal

Voting Member

12.5

ACO Participant Representative

 

George

David

Voting Member

12.5

ACO Participant Representative

 

Kirk

William

Voting Member

12.5

ACO Participant Representative

 

Kaul

Sanjay

Voting Member

12.5

ACO Participant Representative

 

Godfrey

Chris

Voting Member

12.5

ACO Participant Representative

 

Hemmer

Ann Marie

Voting Member

12.5

ACO Participant Representative

 

Hughes

Daniel

Voting Member

12.5

Medicare Beneficiary Representative

N/A

 

Key ACO clinical and administrative leadership:

Pravin Avula

ACO Executive

Praveen Arla

Medical Director

Gary Albers

Compliance Officer

Kamal Singh

Quality Assurance/Improvement Officer

 

Associated committees and committee leadership:

Committee Name

Committee Leader Name and Position

Clinical Policy Committee

Praveen Arla, MD

Quality Assurance/Improvement Committee

Kamal Singh, MD

Finance/Compliance Committee

Pravin Avula, MD

 

 

 

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

  • Second Agreement Period
    • Performance Year 2016, $5,231,065
  • First Agreement Period
    • Performance Year 2015, $6,366,990
    • Performance Year 2014, $2,554,879
    • Performance Year 2013, $2,761,951

Shared Savings Distribution

  • Second Agreement Period
    • Performance Year 2016
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 65%
  • First Agreement Period
    • Performance Year 2015
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 65%
    • Performance Year 2014
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 65%
    • Performance Year 2013
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 65%

 

Quality Performance Results

2016 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

83.35

79.9

ACO-2

CAHPS: How Well Your Providers Communicate

92.88

92.63

ACO-3

CAHPS: Patients' Rating of Provider

92.23

91.93

ACO-4

CAHPS: Access to Specialists

86.36

83.52

ACO-5

CAHPS: Health Promotion and Education

51.18

60

ACO-6

CAHPS: Shared Decision Making

73.78

75.28

ACO-7

CAHPS: Health Status/Functional Status

70.02

71.82

ACO-34

CAHPS: Stewardship of Patient Resources

23.9

27.52

ACO-8

Risk-Standardized, All Condition Readmission

15

14.7

ACO-35

Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)

18

18.17

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

58.9

53.2

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

78.38

75.23

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

61.48

59.81

ACO-9

Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)

9.82

9.27

ACO-10

Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 )

15.19

14.53

ACO-11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

75.81

82.72

ACO-39

Documentation of Current Medications in the Medical Record

94.24

87.54

ACO-13

Falls: Screening for Future Fall Risk

78.65

64.04

ACO-14

Preventive Care and Screening: Influenza Immunization

78.47

68.32

ACO-15

Pneumonia Vaccination Status for Older Adults

77.87

69.21

ACO-16

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up

85.77

74.45

ACO-17

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

93.7

90.98

ACO-18

Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan

72.36

53.63

ACO-19

Colorectal Cancer Screening

69.44

61.52

ACO-20

Breast Cancer Screening

76.4

67.61

ACO-21

Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented

81.84

76.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

82.11

77.72

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

14.73

18.24

ACO-41

Diabetes: Eye Exam  

53.77

44.94

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

77.55

70.52

ACO-30

Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

88.4

85.05

ACO-31

Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

88.89

88.67

ACO-33

Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)

84.46

79.67

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.   

 

Note: In the Quality Performance Results file(s) above, search for “Southern Kentucky Health Care Alliance” to view the quality performance results. This ACO can also be found by using the ACO ID A46075 in the public use files on data.cms.gov.

Payment Rule Waivers

·         No, our ACO does not use the SNF 3-Day Rule Waiver.