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

Robynn Butler

803-391-2877
Robynn.Butler@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
  • SANDHILLS OBGYN ASSOCIATES, P.A. – N
  • Cardiology Associates of Sumter LLC – N
  • Prisma Health Tuomey – N
  • CENTA MEDICAL GROUP PA – N
  • Carolina Anesthesiology Associates, PA – N
  • Midland Ear Nose and Throat – N
  • CAROLINA KIDNEY SPECIALISTS, LLC – N
  • PIERRE JAFFE – N
  • Sumter Family Medicine Associates, P.A. – N
  • South Carolina Oncology Assoc Pa – N
  • MCCAIN ORTHOPAEDIC CLINIC – N
  • Palmetto Retina Center LLC – 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 MIDLANDS – N
  • CARYN M WEST & ASSOC PC – N
  • Columbia Heart Clinic
  • PRISMA HEALTH MEDICAL GROUP-MIDLANDS

ACO Governing Body

Board of Managers

  • William (Bill) Gerard, MD—Chair, Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health
  • Joseph Brannigan, MD—Vice Chair, Voting Member Power – 1, Other Entity Representative (Non-MSSP Participant, but Clinically Integrated Network Participant), Columbia Nephrology Associates, PA
  • Joseph (Joey) Campbell, MD—Secretary, Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health
  • Michael (Mike) 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, Prisma Health Midlands Medical Group
  • Donen Davis, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Donen Davis Plastic Surgery, LLC
  • James (Jim) Ellis, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health Midlands 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
  • Bradley Presnal, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health Midlands Medical Group
  • Thomas (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
  • 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
  • Kimberly Goode, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health Midlands Medical Group
  • Jamee Steen, MD—Voting Member, Voting Member Power – 1, ACO Participant Representative, Prisma Health Midlands Medical Group

Key ACO Clinical and Administrative Leadership

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

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
  • Compliance Committee: Scott Pietras, 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
    • Note: Our ACO participated in multiple performance years during Calendar Year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Quality Performance Results

2019 Quality Performance Results

ACO # Measure Name Rate ACO Mean
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 measure is not included in public reporting due to low sample size. In addition, the Centers for Medicare & Medicaid Services (CMS) waived the requirement for ACOs to field a CAHPS for ACOs survey data

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

  • Waiver for Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.