ACO Name and Location:

Cumberland Center for Healthcare Innovation

3300 Williams Enterprise Drive, Suite 2

Cookeville, TN 38506

ACO Primary Contact:

Dr. Brent Staton M.D.

BStaton@CCHI-TN.com

931-400-0011

ACO Participants:

Practice Name

Physician's  Name

Mid-Level Provider

Address

City

ST

County

Alan R. Drake

Alan R. Drake, MD

Katina Jones PAC

133 Churchill Drive

Sparta

TN

White

Armadillo Medical Services P.C.

Philip Hunt, MD

Lisa Claiborne NP

204 Highway 52 Bypass West

Lafayette

TN

Macon

Bienvenido T. Samson

Bienvenido Samson, MD

None

755 East McMurry Blvd

Hartsville

TN

Trousdale

Blue Sky House Calls

Bruce Wallstedt, MD

Casey Lamb, FNP

6323 Canterbury Close

Brentwood

TN

Williamson

Jeff Beard, PA-C

Bowdoin G. Smith D.O., P.C

Bowdoin Smith, DO

None

9 Maggart Circle

Carthage

TN

Smith

Brett L. Ferrell MD

Brett Ferrell, MD

None

100 William Northern Blvd

Tullahoma

TN

Coffee

C.S. Sewell

Christopher Sewell, MD

Chad Hull PA

341 W. Central Ave

Jamestown

TN

Fentress

Katy Flowers

Cornerstone Family Medicine LLC

Chad Griffin, MD

Anna Benningfield NP

433 Sewell Drive

Sparta

TN

White

Kelly Lyons NP

Family Medical Center &         Alexandria Family Medical

 Doug Hooper, MD

Natalie Gilley NP

302 N. Congress BLVD

Smithville

TN

 

Hugh Don Cripps, MD

Brenda Tramel NP

400 E. Public Sq.

Alexandria

DeKalb

Jack Rhody, MD

Deborah Haggard APRN

Kevin Rhody, MD

 

Steven Cooper, MD

 

William Sherwood, MD

 

Cumberland Adult Medicine

Susan Harlow, MD

Angela Moore NP

140 Vo-Tech Drive, Suite 2

McMinnville

TN

Warren

Cumberland Family Care PC

Ty Webb, MD

Marla Moore FNP

457 Vista Drive

Sparta

TN

White & Van Buren

Diana Turner FNP

Stephen Clark, MD

April Thornton APN

476 Spring St

Spencer

Cameron Heady PA

Debora Daniel MD

Debora C. Daniel, MD

Bradley Hatcher FNP

15166 Rankin Avenue

Dunlap

TN

Sequatchie

Family Medical, P.C.                  

Bill Robertson, MD

Jason Black, FNP

1407 Baddour Parkway

Lebanon

TN

Wilson

Roger McKinney, MD

Richard Kincaid, FNP

Bernie Sy, MD

Tracy Moss, FNP

Sam Crutcher, MD

Lindsey Lattimore, FNP

John Fisk, MD

Erin Crisp, PA

George Robertson, MD

Anna Locke, PA

 

Benita Qualls, PA

Family Practice Center of Tullahoma, LLC

John D. Patsimas, MD

Lauren E. Martin, PA-C

100 William Northern Blvd

Tullahoma

TN

Coffee

Donald Tucker, Jr, MD

Lori A. Russell, PA-C

Frix-Jennings Clinic

Carey W. Frix, MD

Pamela Riley FNP

116 West Main Street

Henderson

TN

Chester

Alison Montgomery Moore FNP

59 South Main

Memphis

Shelby

Nicole M. Jennings, MD

Brandi Crowe PA

1700 West Market St, Suite J

Bolivar

Hardeman

Tammi M Ferguson FNP

124 West Court Avenue

Selmer

McNairy

 

Charles Aldrich PA-C

50 Skyline Lane

Parsons

Decatur

 

Betty Roe FNP

 

 

 

 

 

Health Group of McMinnville PC

Bryan Chastain, MD

Elizabeth Jenkins NP

155 Health Way, STE 1

McMinnville

TN

Warren

Sherry Kinkade

Infinity Healthcare Center

Stacey B Carlton, MD

Tommy Hindman

229 Interstate Dr, STE 105

Crossville

TN

Cumberland

Innovative Family Care

Chet Gentry, MD

Melissa Alison Hicks FNP

3300 Williams Enterprise Drive, STE 1

Cookeville

TN

Putnam

Jennifer Carter NP

Megan E. Taylor, PA

Johnson Family Medicine

James Johnson, MD

Sheila Blalock APN

1720 West Avenue, Suite 106

Crossville

TN

Cumberland

Larry Barnes                                                                

Larry Barnes, MD

None

2330 Thornton Taylor Pkwy, Ste A

Fayetteville

TN

Lincoln

Livingston Family Healthcare

Kenneth Beaty, MD

None

403 E. University St

Livingston

TN

Overton

Lynchburg Medical Clinic, LLC

 

Robert R. Yasui, PA

40 Lynchburg Hwy

Lynchburg

TN

Moore

Mountain View Medical & MVM Lascassas

James Spurlock, DO

Jamie Blaylock FNP

370 Doolittle Road, STE 1

Woodbury

TN

Cannon

Holly Blankenship, DO

 

4712 Lascassas Pike

Lascassas

Rutherford

Mutigen, LLC

Marcus W. Lee, MD

Leslie Meyers FNP

711 NW Atlantic Street

Tullahoma

TN

Coffee

Natalie Fraiser, FNP

Sarah Holmgren, FPA

Northside Medical Professionals, P.C.

Shawn Gentry, MD

Kristy Yentes, APRN-BC

1605 Nashville Highway,         Suite 200

Columbia

TN

Maury

Sharon Spears, APRN-BC

R. Reams Powers, Jr, MD

Melissa Moore, APRN-BC

Christy Cone, APRN-BC

Belinda Bart, MD

Allison Rolston, PA-C

Charles Cornett, PA-C

Peggy LeAnn King, PA

Oasis Medical Group

Kenneth Colburn, MD

Josha Cooper NP

4120 Bradford Hicks Drive

Livingston

TN

Overton

Katherine Little NP

Maggie Bullock FNP

Pinnacle Internal Medicine

Ephraim Gammada, MD

Elizabeth D Gammada NPC

1509 Old Cowan Road

Winchester

TN

Franklin

Priority Care Medical Clinic

John Clough, MD

Billie Lou Melton NP

5751 Bradford Hicks Drive

Livingston

TN

Overton

Greg Hargis NP

Kelly Norrod NP

Rebecca Vaughn NP

Maggie Bullock FNP

Seasons Family Medical PLLC

Pamela Sanders, MD

None

43 Church Avenue

Cookeville

TN

Putnam

Sequatchie Valley Primary Care

Karin Boeck, MD

Deborah Gaddis, FNP

24 Mountain View Dr., Ste A

Kimball

TN

Marion

Rory D. Justo MD

Silke Hoosier, NP

Spectrum Medical Associates

Richard Cole, MD

Jennifer Shetters ANPBC

2106 N. Jackson St.

Tullahoma

TN

Coffee

Kathryn Freeman FNP

Staton Southern Medical, PLLC

Brent Staton, MD

Joan "Sally" Anthony NP

1135 S. Walnut Ave

Cookeville

TN

Putnam

T. (Terry) Scott Holder

T. Scott Holder, MD

None

155 Hospital Rd., Ste A

Winchester

TN

Franklin

Tullahoma Immediate Care, PC

 

Tina A. Crabtree, NP

1210 South Jackson St

Tullahoma

TN

Coffee

Wayne O. Wells, M.D.

Wayne O Wells, MD

None

1430 Baddour Parkway, Suite A

Lebanon

TN

Wilson

Cannon County Healthcare

Jeff Todd, MD

Rachel Rivers NP

205 S. Mccrary St., STE 1

Woodbury

TN

Cannon

Keith Young, MD

Paula Todd FNP

Lisa Blair FNP

No participants are involved in a joint venture between ACO professionals and hospitals

ACO Governing Body:

James Spurlock DO, Voting Member and Chair, ACO participant representative for Mountain View Medical

Susan Harlow MD, Voting Member and Vice Chair, ACO participant representative for Cumberland Adult Medicine

Dr. Brent Staton MD, Voting Member, ACO participant representative for Staton Southern Medical PLLC

Dr. Ty Webb MD, Voting Member, ACO participant representative for Cumberland Family Care PC

Bill Robertson MD, Voting Member, ACO participant representative for Family Medical PC

Brett Ferrell MD, Voting Member, ACO participant representative for Brett Ferrell MD/ Family Practice Center of Tullahoma LLC

Steven Cooper MD, Voting Member, ACO participant representative for Family Medical Center

Jim Stafne, Voting Member, Medicare Beneficiary Representative

Key ACO Clinical and Administrative Leadership Personnel:

ACO Committees and ACO Committee Leadership:

Types of ACO Participants or Combinations of Participants that formed the ACO:

 

Shared Savings and Losses:

Amount of Shared Savings/Losses

Shared Savings Distribution:

Payment Rule Waivers:

None

Quality Performance Results:

2015 Quality Performance Results

Measure Number

Measure Name

2015 Reporting Period

ACO Performance Rate

Mean Performance Rate for All ACOs

ACO #1

CAHPS:  Getting Timely Care, Appointments, and Information

74.89

80.61

ACO #2

CAHPS:  How Well Your Providers Communicate

92.59

92.65

ACO #3

CAHPS:  Patients’ Rating of Doctor

91.11

91.94

ACO #4

CAHPS:  Access to Specialists

82.74

83.61

ACO #5

CAHPS:  Health Promotion and Education

55.49

59.06

ACO #6

CAHPS:  Shared Decision Making

77.67

75.17

ACO #7

CAHPS:  Health Status/Functional Status

67.50

72.30

ACO #34

CAHPS: Stewardship of Patient Resources*

30.83

26.87

ACO #8

Risk Standardized, All Condition Readmissions

15.39

14.86

ACO #35

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

18.82

18.07

ACO #36

All-Cause Unplanned Admissions for Patients with Diabetes*

66.06

54.60

ACO #37

All-Cause Unplanned Admissions for Patients with Heart Failure*

95.37

76.96

ACO #38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

79.93

62.92

ACO #9

Ambulatory Sensitive Condition (ASC) Admissions: COPD or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) # 5)

1.71

1.11

ACO #10

ASC Admission: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)

0.95

1.04

ACO #11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

73.53

80.14

ACO #39

Documentation of Current Medications in the Medical Record*

92.28

84.07

ACO #13

Falls: Screening for Fall Risk

57.42

56.46

ACO #14

Preventive Care and Screening: Influenza Immunization

69.44

62.03

ACO #15

Pneumonia Vaccination Status for Older Adults

65.31

63.73

ACO #16

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

76.23

71.15

ACO #17

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

89.53

90.16

ACO #18

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

49.91

45.25

ACO #19

Colorectal Cancer Screening

56.72

60.06

ACO #20

Breast Cancer Screening

64.75

65.67

ACO #21

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

88.93

70.04

ACO #40

Depression Readmission at Twelve Months

N/A

N/A

ACO #27

Diabetes Mellitus:  HbA1c in poor control (>9 percent)

11.48

20.38

ACO #41

Diabetes: Eye Exam*

38.27

41.05

ACO #28

Hypertension: Controlling High BP <140/90

69.35

69.62

ACO #30

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

88.33

83.82

ACO #31

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

85.92

87.22

ACO #33

Angiotensin-Converting Enzyme (ACE) Inhibitor or Angio Receptor Blocker (ARB) Therapy for Patients with CAD and Diabetes and/or LVSD

78.27

77.73

CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

*= Measure required beginning Reporting Year 2015.

N/A= Reporting on the depression remission measure is not required for 2015, as indicated by N/A

2012 through 2014 Quality Performance Results

Measure number

Performance Measure

2012 Reporting Period

2013 Reporting Period

2014 Reporting Period

ACO Performance Rate

Mean Performance Rate for All ACOs

ACO Performance Rate

Mean Performance Rate for All ACOs

ACO Performance Rate

Mean Performance Rate for All ACOs

ACO #1

Getting Timely Care, Appointments, and Information

Optional

Optional

Optional

Optional

85.11

80.13

ACO #2

How Well Your Doctors Communicate

Optional

Optional

Optional

Optional

93.71

92.39

ACO #3

Patients’ Rating of Doctor

Optional

Optional

Optional

Optional

91.94

91.58

ACO #4

Access to Specialists

Optional

Optional

Optional

Optional

83.04

83.97

ACO #5

Health Promotion and Education

Optional

Optional

Optional

Optional

56.10

58.29

ACO #6

Shared Decision Making

Optional

Optional

Optional

Optional

73.85

74.60

ACO #7

Health Status/Functional Status

Optional

Optional

Optional

Optional

68.70

71.10

ACO #8

Risk Standardized, All Condition Readmissions

16.22

15.42

15.54

14.90

15.52

15.15

ACO #9

ASC Admissions: COPD or Asthma in Older Adults

2.16

1.13

2.18

1.17

1.50

1.08

ACO #10

ASC Admission: Heart Failure

1.15

1.09

1.13

1.20

1.23

1.19

ACO #11

Percent of PCPs who Qualified for EHR Incentive Payment

37.50%

63.37%

66.67%

66.21%

75.68%

76.71%

ACO #12

Medication Reconciliation

Optional

Optional

Optional

Optional

92.00%

82.61%

ACO #13

Falls: Screening for Fall Risk

Optional

Optional

Optional

Optional

48.02%

45.60%

ACO #14

Influenza Immunization

Optional

Optional

Optional

Optional

66.32%

57.51%

ACO #15

Pneumococcal Vaccination

Optional

Optional

Optional

Optional

58.82%

55.03%

ACO #16

Adult Weight Screening and Follow-up

Optional

Optional

Optional

Optional

75.50%

66.75%

ACO #17

Tobacco Use Assessment and Cessation Intervention

Optional

Optional

Optional

Optional

90.49%

86.79%

ACO #18

Depression Screening

Optional

Optional

Optional

Optional

46.75%

39.27%

ACO #19

Colorectal Cancer Screening

Optional

Optional

Optional

Optional

56.30%

56.14%

ACO #20

Mammography Screening

Optional

Optional

Optional

Optional

63.44%

61.41%

ACO #21

Proportion of Adults who had blood pressure screened in past 2 years

Optional

Optional

Optional

Optional

86.74%

60.24%

ACO #22

Hemoglobin A1c Control (HbA1c) (<8 percent)

Optional

N/A

Optional

N/A

76.66%

N/A

ACO #23

Low Density Lipoprotein (LDL) (<100 mg/dL)

Optional

N/A

Optional

N/A

N/A

N/A

ACO #24

Blood Pressure (BP) <140/90

Optional

N/A

Optional

N/A

72.35%

N/A

ACO #25

Tobacco Non Use

Optional

N/A

Optional

N/A

66.23%

N/A

ACO #26

Aspirin Use

Optional

N/A

Optional

N/A

81.79%

N/A

ACO #27

Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent)

Optional

Optional

Optional

Optional

12.71%

20.35%

ACO #28

Percent of beneficiaries with hypertension whose BP <140/90

Optional

Optional

Optional

Optional

69.77%

68.02%

ACO #29

Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dl

Optional

Optional

Optional

Optional

N/A

N/A

ACO #30

Percent of beneficiaries with IVD who use Aspirin or other antithrombotic

Optional

Optional

Optional

Optional

89.96%

80.79%

ACO #31

Beta-Blocker Therapy for LVSD

Optional

Optional

Optional

Optional

89.68%

82.71%

ACO #32

Drug Therapy for Lowering LDL Cholesterol

Optional

N/A

Optional

N/A

N/A

N/A

ACO #33

ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD

Optional

N/A

Optional

N/A

80.52%

N/A

Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease,, EHR = electronic health record, IVD = ischemic vascular dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

disease,

LVSD = left ventricular systolic

For more information on how to interpret scores on the above quality performance measures, see http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/MSSP-QM-Benchmarks.pdf.

For any questions or additional information regarding the Accountable Care Organizations, you may go to Medicare.gov 

or call 1-800-MEDICARE(1-800-633-4227).

2/27/2017