ACO Name and Location

Lancaster General Health Community Care Collaborative, LLC
Previous Names: N/A
555 North Duke Street
PO Box 3555
Lancaster, PA 17604

ACO Primary Contact

Primary Contact Name Kevin Bogari
Primary Contact Phone Number 717-544-4766
Primary Contact Email Address info@lghealth.org
 

Organizational Information 

ACO Participants

ACO Participants ACO Participant
in Joint Venture
John J. Eichenlaub, MD, PC (Drs. Eichenlaub and May) N
Quarryville Family Foot Care, PC N
Darren Barbacci N
Lancaster Rehabilitation Hospital, LLP Y
Lancaster General Health - Columbia Center (Twin Rose Family Medicine) N
Lancaster General Hospital N
Susquehanna Valley Women's Health Care, PC (May-Grant) N
Lancaster Pediatric Associates, Ltd. N
Lancaster Emergency Associates, Ltd. N
Lancaster Radiology Associates, Ltd. N
Orthopedic Associates of Lancaster, Ltd. N
Campus Eye Center, Ltd. N
Allergy and Asthma Center, PC N
Riverside Anesthesia Associates, Ltd. N
Hospice & Community Care N
Nephrology Associates of Lancaster, Ltd. (Hypertension and Kidney Spc) N
Martin Podiatry, PC
N
Pulmonary Associates of Lancaster, Ltd.
N
Marilyn C. Henderson, DPM
N
Lancaster General Medical Group
N
Regional Gastroenterology Associates of Lancaster, Ltd.
N
Lancaster Skin Center PC N
Lancaster Orthopedic Group, PC
N
EMG Group Ltd. LLC
N
Otolaryngology Physicians of Lancaster, Ltd.
N
Lancaster Otolaryngology
N
Family Eye Group, PC
N
Lancaster PET Partnership, LLP
Y
Palliative Medicine Consultants
N
Foot & Ankle Associates of Lancaster, LLC
N
The Heart Group of Lancaster General Health
N
MRI Group, LLP
Y
Westphal Associates, Ltd.
N
RGAL Anesthesia Services, LLC
N
Lancaster Ear Nose And Throat LLC
N
Westphal Orthopedics, LLC
N
Lancaster Retina Specialists, PC
N
Francis J. Manning, MD, PC
N
Prime Anesthesia Associates PC
N
Anesthesia Associates of Lancaster, LTD N
Conestoga Eye, PC N

ACO Governing Body

Last
Name
First
Name
Title/
Position
Member's
Voting Power -
Expressed
as a Percentage
or Number
Membership
Type
ACO Participant
Legal Business
Name/DBA,
if Applicable
Foley, MD T. Raymond Chairperson 1

ACO
Participant
Representative

Lancaster
General
Medical Group
Bogari, RN Kevin President 1 ACO
Participant
Representative
Lancaster
General
Hospital
Wood, MD John Medical
Director
1 ACO
Participant
Representative
Lancaster
General
Medical Group
Addis, MD Christopher Voting
Member
1 ACO
Participant
Representative
Lancaster
General
Hospital
Shepherd, MD Rebecca Voting
Member
1 ACO
Participant
Representative
Lancaster
General
Medical Group
Kraybill, MD Leon Voting
Member
1 ACO
Participant
Representative
Lancaster
General
Hospital
Young, MD Brian Voting
Member
1 ACO
Participant
Representative
Lancaster General
Health -
Columbia Center
(Twin Rose
Family Medicine)
Pulliam, MD Ward Voting
Member
1 ACO
Participant
Representative
The Heart
Group of
LG Health
Tifft, MD Stephen Voting
Member
1 ACO
Participant
Representative
Lancaster
General
Medical Group
Wesbury, PhD Stuart Voting
Member
1 Medicare
Beneficiary
N/A
Legenstein Walt Voting
Member
1 Community
Representative
N/A
Polin, MD David Voting
Member
1 ACO
Participant
Representative
EMG Group
Boben, MD William Voting
Member
1 ACO
Participant
Representative
Lancaster
Pediatric
Associates
Roberts, MD Karen Voting
Member
1 ACO
Participant
Representative
Susquehanna
Valley Women's
Health Care, P.C.
(May-Grant)
Pavlica, MD Michael Voting
Member
1 ACO
Participant
Representative
Family Eye
Group
Derrico, MD Ann Marie Voting
Member
1 ACO
Participant
Representative
SouthEast
Lancaster
Health Services
Briguglio, MD John Voting
Member
1 ACO
Participant
Representative
Lancaster
Radiology
Associates
Troxell,MD Corey Voting
Member
1 ACO
Participant
Representative
Lancaster
Orthopedic
Group
Harrold, MD Joan Voting
Member
1 ACO
Participant
Representative
Palliative
Medicine
Consultants
Horvat, MD Craig Voting
Member
1 ACO
Participant
Representative
Pulmonary
Associates
of Lancaster

Key ACO Clinical and Administrative Leadership

Kevin Bogari ACO Executive
John Wood, MD Medical Director
Elizabeth Katz Compliance Officer
Michael Ripchinski, MD Quality Assurance/Improvement Officer

Associated Committees and Committee Leadership

Committee Name Committee Leader Name and Position
Quality Committee Jeffrey Martin, MD - Chair
Finance Committee Stephen Tifft, MD - Chair
Clinical Integration Committee David Polin, MD - Chair

Types of ACO Participants, or Combinations of Participants, that Formed the ACO

  • Partnerships or joint venture arrangements between hospitals and ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2018, $0
    • Performance Year 2017, $0
  • First Agreement Period
    • Performance Year 2016, $0
    • Performance Year 2015, $0
    • Performance Year 2014, $0

Shared Savings Distribution

  • Second Agreement Period
    • 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
    • Performance Year 2017
      • 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 2016
      • 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 2015
    • 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 2014
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A

2018 Quality Performance Results 

ACO # Measure Name Rate Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 84.30 86.14
ACO-2 CAHPS: How Well Your Providers Communicate 94.93 93.93
ACO-3 CAHPS: Patients’ Rating of Provider 92.18 92.45
ACO-4 CAHPS: Access to Specialists 78.74 81.50
ACO-5 CAHPS: Health Promotion and Education 62.74 59.26
ACO-6 CAHPS: Shared Decision Making 62.25 61.94
ACO-7 CAHPS: Health Status/Functional Status 76.30 73.35
ACO-34 CAHPS: Stewardship of Patient Resources 22.69 26.26
ACO-8 Risk Standardized, All Condition Readmission 13.66 14.98
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 16.21 18.59
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 30.06 37.01
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 59.55 76.75
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 47.25 59.00
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.04 1.98
ACO-11 Use of Certified EHR Technology 99.18 98.20
ACO-12 Medication Reconciliation 96.41 85.91
ACO-13 Falls: Screening for Future Fall Risk 65.94 79.73
ACO-44 Imaging Studies for Low Back Pain 43.08 64.36
ACO-14 Preventive Care and Screening: Influenza Immunization 80.00 72.71
ACO-15 Pneumonia Vaccination Status for Older Adults 92.42 75.97
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 63.09 76.83
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 87.50 72.81
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 75.37 66.74
ACO-19 Colorectal Cancer Screening 78.99 68.27
ACO-20 Breast Cancer Screening 78.53 71.96
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 73.75 81.47
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 7.02 15.51
ACO-41 Diabetes: Eye Exam 61.87 52.42
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 71.98 73.10
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 87.64 88.92

For previous years' Financial and Quality Performance Results, please visit 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.

Medicare Shared Savings Program Participation Waiver Disclosures

The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that might otherwise limit innovations by ACOs participating in the Medicare Shared Savings Program ACO Model (See “Final Waivers in Connection with the Shared Savings Program” (80 Fed. Reg. 66,726 (Oct. 29, 2015))).  Pursuant to the notice, Lancaster General Health Community Care Collaborative, LLC (“LGHCCC”) seeks waiver for the arrangement described below:

LGHCCC has developed a program of clinical integration (“CIP”) designed to: (i) improve the quality of and access to, and control the cost of, health care for the patients and populations served by LGHCCC’s participating providers and Lancaster General Health; (ii) improve the health of such patients and populations; (iii) monitor the health care services provided directly or indirectly through and arranged for by LGHCCC; (iv) integrate and coordinate the provision of such health care services by, and establish collaboration and accountability for such health care services by and among, participating providers; and (v) improve the patient experience for individuals receiving such health care services.

As part of the CIP, LGHCCC has entered into agreements, as recently amended, (the “Participating Provider Agreements”) with providers in LGHCCC’s community (the “ACO Participants”) for the purposes of functioning as a clinically-integrated network focused on implementing evidence-based medical practice, clinical guidelines, disease management programs and other quality improvement programs developed and implemented by LGHCCC.

The Board of Managers of LGHCCC (the “Board”) has determined that the obligations of LGHCCC and the ACO Participants, as specifically described in the amended Participating Provider Agreements,  constitute an arrangement that is reasonably related the purposes of the MSSP in that the ACO Participants agree, among other commitments, to actively and meaningfully participate in the CIP, including all initiatives, efforts, and requirements related to the design, development, implementation, and operation of LGHCCC’s CIP, including, without limitation:

  • Committing to accomplishing and demonstrating the triple aim of improved patient experience of care, improved health of populations, and lower per-capita cost of care;
  • Actively participating in governance matters, LGHCCC committees, and workgroups;
  • Encouraging investment in infrastructure and redesigned care processes for high-quality and efficient service delivery for patients, including Medicare beneficiaries, by requiring adherence to LGHCCC-adopted clinical protocols, clinical performance initiatives, measures and metrics designed to improve the quality of health care services rendered by ACO Participants.
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