ACO Leadership & Organization

For information about our governing body and our organization, please click here.

Questions

If you have questions or concerns, please call us toll-free at 1‑855‑336‑9005 or talk with your doctor during your next visit. You can also visit www.medicare.gov or call 1‑800‑MEDICARE (1‑800‑633‑4227; TTY users should call 1‑877‑486‑2048) for questions or additional information about Accountable Care Organizations.

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ACO Leadership & Organization

ACO Name and Location

Carilion Clinic Medicare Shared Savings Company, LLC
213 S. Jefferson St., Suite 1600
Roanoke, VA 24011

ACO Primary Contact

Zachary Smith
540-581-0270
zrsmith@carilionclinic.org

Organizational Information

ACO Participants:

ACO Participants	ACO Participant in Joint Venture
ACV, Inc.	N
Anesthesiology Associates of Radford, Inc.	N
Carilion Emergency Services, Inc.	N
Carilion Franklin Memorial Hospital	N
Carilion Giles Community Hospital	N
Carilion Healthcare Corporation	Y
Carilion Medical Center	Y
Carilion New River Valley Medical Center	N
Carilion Professional Services, LLC	N
Carilion Rockbridge Community Hospital (previously Carilion Stonewall Jackson Hospital)	N
Carilion Tazewell Community Hospital	N
Urology Associates, Ltd.	N

ACO Governing Body:

Member First Name	Member Last Name	Member Title/Position	Member's Voting Power (Expressed as a percentage)	Membership Type	ACO Participant Legal Business Name, if Applicable
John	Epling, M.D.	Chair	10%	ACO Participant Representative	Carilion Healthcare Corporation
M. Suzanne	Kraemer, M.D.	ACO Board Member	9%	ACO Participant Representative	Carilion Medical Center
Stephen	Morgan, M.D.	ACO Board Member	9%	ACO Participant Representative	Carilion Medical Center
Robert	Trestman, M.D.	ACO Board Member	9%	ACO Participant Representative	Carilion Healthcare Corporation
Warner	Bonderman	ACO Board Member	9%	Medicare Beneficiary Representative	N/A
Zachary	Smith	ACO Board Member	9%	ACO Participant Representative	Carilion Healthcare Corporation
Paul	Davenport	ACO Board Member	9%	ACO Participant Representative	ACV, Inc.
William	Flattery	ACO Board Member	9%	ACO Participant Representative	Carilion New River Valley Medical Center
Donald	Halliwill	ACO Board Member	9%	ACO Participant Representative	Carilion Medical Center
Rawle (Tony)	Seupaul	ACO Board Member	9%	ACO Participant Representative	Carilion Medical Center
Roger	Roper	ACO Board Member	9%	ACO Participant Representative	Carilion Healthcare Corporation

Key ACO Clinical and Administrative Leadership:
ACO Executive: John W. Epling, M.D.
Medical Director: John W. Epling, M.D.
Compliance Officer: Kristin Meador
Quality Assurance/Improvement Officer: Jason Semones

Associated Committees and Committee Leadership:

Committee Name	Committee Leader Name and Position
Doctors Connected Specialty Council	Trevor M. Owen, M.D., Co-Chair, and Christopher P. Mertes, M.D., Co-Chair
Doctors Connected ACO Executive Committee	Zachary Smith, Interim Chair

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:
ACO professionals in a group practice arrangement
Networks of individual practices of ACO professionals
Hospital employing ACO professionals
Critical Access Hospital (CAH) billing under Method II
Rural Health Clinic (RHC)

Shared Savings and Losses

Amount of Shared Savings/Losses:

Second Agreement Period
- Performance Year 2023, $2,215,720
First Agreement Period
- Performance Year 2022, $2,988,804

Shared Savings Distribution:

Second Agreement Period
- Performance Year 2023
  - Proportion invested in infrastructure: 10%
  - Proportion invested in redesigned care processes/resources: 90%
  - Proportion of distribution to ACO participants: 0%
First Agreement Period
- Performance Year 2022
  - Proportion invested in infrastructure: 10%
  - Proportion invested in redesigned care processes/resources: 90%
  - Proportion of distribution to ACO participants: 0%

Quality Performance Results

2023 Quality Performance Results:

Quality performance results based on CMS Web Interface collection type.

Measure #	Measure Name	Collection Type	Reported Performance Rate	Current Year Mean Performance Rate (SSP ACOs)
Quality ID# 001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control	CMS Web Interface	8.18	9.84
Quality ID# 134	Preventative Care and Screening for Depression and Follow-up Plan	CMS Web Interface	53.90	80.97
Quality ID# 236	Controlling High Blood Pressure	CMS Web Interface	66.38	77.80
Quality ID# 318	Falls: Screening for Future Risk	CMS Web Interface	82.27	89.42
Quality ID# 110	Preventative Care and Screening: Influenza Immunization	CMS Web Interface	73.83	70.76
Quality ID# 226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	CMS Web Interface	63.41	79.29
Quality ID# 113	Colorectal Cancer Screening	CMS Web Interface	73.60	77.14
Quality ID# 112	Breast Cancer Screening	CMS Web Interface	72.48	80.36
Quality ID# 438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	CMS Web Interface	87.10	87.05
Quality ID# 370	Depression Remission at Twelve Months	CMS Web Interface	0.00	16.58
Quality ID# 321	CAHPS for MIPS	CAHPS for MIPS Survey	5.38	6.25
Measure# 479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups	Administrative Claims	0.1410	0.1553
Measure# 484	Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions	Administrative Claims	-	35.39
CAHPS-1	Getting Timely Care, Appointments, and Information	CAHPS for MIPS Survey	84.70	83.68
CAHPS-2	How Well Providers Communicate	CAHPS for MIPS Survey	93.18	93.69
CAHPS-3	Patient's Rating of Provider	CAHPS for MIPS Survey	92.40	92.14
CAHPS-4	Access to Specialists	CAHPS for MIPS Survey	69.10	75.97
CAHPS-5	Health Promotion and Education	CAHPS for MIPS Survey	61.55	63.93
CAHPS-6	Shared Decision Making	CAHPS for MIPS Survey	56.73	61.60
CAHPS-7	Health Status and Functional Status	CAHPS for MIPS Survey	73.22	74.12
CAHPS-8	Care Coordination	CAHPS for MIPS Survey	85.68	85.77
CAHPS-9	Courteous and Helpful Office Staff	CAHPS for MIPS Survey	92.38	92.31
CAHPS-11	Stewardship of Patient Resources	CAHPS for MIPS Survey	28.64	26.69

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

Payment Rule Waivers

Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
- Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.