Public Reporting

ACO Name and Location

Prisma Health Midlands Network, LLC

Previous Names: Palmetto Health Quality Collaborative, LLC

1301 Taylor Street
STE 9A
Columbia, South Carolina 29201

ACO Primary Contact

Sarah Perry Orsinger,

803-296-2352
Sarah.Orsinger@prismahealth.org

Organizational Information

ACO Participants and Participation in ACO Joint Venture, Yes (Y) or No (N)

  • Professional Pathology Services PC – N
  • Plastic Surgery Consultants, LLC – N
  • Wellspring Family Medicine, PA – N
  • Donen Davis Plastic Surgery, LLC – N
  • South Carolina ENT Allergy & Sleep Medicine PA – N
  • Kraemer Womens Care, LLC – N
  • Elgin Podiatry Institute, LLC – N
  • University Specialty Clinics – Neurology – N
  • Sandhills OBGYN Associates, P.A. – N
  • Cardiology Associates of Sumter LLC – N
  • Palmetto Health-University of South Carolina Medical Group – N
  • Prisma Health Tuomey – N
  • Centa Medical Group PA – N
  • Carolina Anesthesiology Associates, PA – N
  • Midland Ear Nose and Throat – N
  • University Specialty Clinics – Surgery – N
  • University Specialty Clinics – Neuropsychiatry and Behavioral Science – N
  • CAROLINA KIDNEY SPECIALISTS, LLC – N
  • Pinner Clinic PA – N
  • PIERRE JAFFE – N
  • Sumter Family Medicine Associates, P.A. – N
  • University Pediatrics – N
  • Department of Internal Medicine – N
  • South Carolina Oncology Assoc Pa – N
  • MCCAIN ORTHOPAEDIC CLINIC – N
  • South Carolina Neurological Clinic PA – N
  • University Specialty Clinics – Obstetrics/Gynecology – N
  • Palmetto Retina Center LLC – N
  • University Specialty Clinics – Orthopaedics – N
  • University Specialty Clinic, Dept. Family & Preventive Medicine – N
  • Carolina Anesthesia Inc – N
  • Carolina Allergy & Asthma Consultants – N
  • TANDEM HEALTH SC – N
  • Palmetto Family Practice, LLC – N
  • The Dermatology Group LLC – N
  • Prisma Health – N
  • Caryn M West & Assoc PC – N

ACO Governing Body

Board of Managers

  • William (Bill) Gerard, MD—Chair, Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health
  • Albert Odom, Jr., MD—Vice Chair, Voting Member Power – 1, ACO Participant Representative, Palmetto Health-University of South Carolina Medical Group
  • Joseph Campbell, MD—Secretary, Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health
  • Michael Bundy—Treasurer, Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health
  • Gary Bell, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Palmetto Health-University of South Carolina Medical Group
  • Donen Davis, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Donen Davis Plastic Surgery, LLC
  • Jim Ellis, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Palmetto Health-University of South Carolina Medical Group
  • Jeff Haladay, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Carolina Anesthesiology Associates, PA
  • Fred Kudrik, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, South Carolina Oncology Assoc Pa
  • E.J. Mayeaux, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Palmetto Health-University of South Carolina Medical Group
  • Bradley Presnal, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Palmetto Health-University of South Carolina Medical Group
  • Tom Brown, DrPH—Voting Member, Voting Member Power – 1, Medicare Beneficiary Representative, NA
  • William Giles, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Centa Medical Group PA
  • Joseph Brannigan, MD—Voting Member, Voting Member Power – 1, Other Entity Representative (Non-MSSP Participant, but Clinically Integrated Network Participant), Columbia Nephrology Associates, PA
  • J. Mark Mitchiner, MD—Voting Member, Voting Member Power – 1, Other Entity Representative (Non-MSSP Participant, but Clinically Integrated Network Participant), Sumter Pediatrics
  • Kevin Wessinger, MD—Voting Member, Voting Member Power – 1, Other Entity Representative (Non-MSSP Participant, but Clinically Integrated Network Participant), South Carolina Pediatric Alliance

Key ACO Clinical and Administrative Leadership

  • ACO Executive: Anna Kay
  • Medical Director: Bill Gerard, MD
  • Compliance Officer: Anna Kay
  • Quality Assurance Improvement Officer: Anna Kay

Committees

  • Finance Committee: Jeff Haladay, MD Chair
  • Quality and Care Delivery Committee: Greta Harper, MD, Chair
  • Network Participation Committee: William Giles, MD, Chair
  • Sumter Steering Committee: J. Mark Mitchiner, MD Chair

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

  • ACO professionals in a group practice arrangement
  • Federally Qualified Health Centers (FQHCs)
  • Hospital Employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2016: $0
    • Performance Year 2017: $0
    • Performance Year 2018: $0
    • Performance Year 2019: $1,673,163.57

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2019
      • Portion invested in infrastructure: 10%
      • Portion invested in redesigned care processes/resources: 10%
      • Portion of distribution to ACO participants: 80%
    • Performance Year 2018
      • Portion invested in infrastructure: N/A
      • Portion invested in redesigned care processes/resources: N/A
      • Portion of distribution to ACO participants: N/A
    • Performance Year 2017
      • Portion invested in infrastructure: N/A
      • Portion invested in redesigned care processes/resources: N/A
      • Portion of distribution to ACO participants: N/A
    • Performance Year 2016
      • Portion invested in infrastructure: N/A
      • Portion invested in redesigned care processes/resources: N/A
      • Portion of distribution to ACO participants: N/A

Quality Performance Results

2019 Quality Performance Results

ACO # Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 86.59 85.86
ACO-2 CAHPS: How Well Your Providers Communicate 93.86 94.11
ACO-3 CAHPS: Patients’ Rating of Provider 93.80 92.69
ACO-4 CAHPS: Access to Specialists 83.55 81.54
ACO-5 CAHPS: Health Promotion and Education 58.21 60.44
ACO-6 CAHPS: Shared Decision Making 63.04 62.78
ACO-7 CAHPS: Health Status/Functional Status 74.48 73.79
ACO-34 CAHPS: Stewardship of Patient Resources 23.15 26.17
ACO-45 CAHPS: Courteous and Helpful Office Staff 92.38 92.84
ACO-46 CAHPS: Care Coordination 86.82 86.89
ACO-8 Risk Standardized, All Condition Readmission 14.13 14.86
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 54.13 58.15
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.80 1.87
ACO-13 Falls: Screening for Future Fall Risk 92.57 84.04
ACO-14 Preventive Care and Screening: Influenza Immunization 77.50 74.77
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 77.27 78.04
ACO-18 Preventive Care and Screening: Screening for Depression and Follow-up Plan 80.14 70.40
ACO-19 Colorectal Cancer Screening 81.05 70.76
ACO-20 Breast Cancer Screening 79.52 73.84
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 84.08 82.17
ACO-27 Diabetes: Hemoglobin A1c Poor Control (>9%) 11.07 13.88
ACO-28 Controlling High Blood Pressure 76.98 75.04

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

For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.

Note: In data.cms.gov, search for “Palmetto Health Quality Collaborative, LLC” to view the previous years’ quality performance results. This ACO can also be found by using the ACO ID A99911 in the public use files on data.cms.gov.

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-day Rule Waiver:
    • No, our ACO does not use the SNF 3-Day Rule Waiver, pursuant to 42 CFR 425.612
  • Waiver for Payment for Telehealth Services:
    • No, our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.