Wellvana Essential Care ACO, LLC

Wellvana Essential Care ACO, LLC

An Accountable Care Organization (ACO) committed to improving patient outcomes through elevated value-based care.

An Accountable Care Organization (ACO) committed to improving patient outcomes through elevated value-based care.

ACO Name and Location
ACO Name and Location

Wellvana Essential Care, LLC
20 Burton Hills Blvd
Nashville, TN 37215

ACO Primary Contact
ACO Primary Contact

Kristine Miller
Phone: (916) 542-4568
Email: krmiller@wellvana.com

Organizational Information:

Organizational Information:

ACO Participants:

ACO Governing Body

ACO Governing Body

Member's voting power may have been rounded to reflect a total voting power of 100 percent.

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

ACO Executive: Aria Sameni

ACO Executive: Aria Sameni

Medical Director: Dr. Cameron Nelson

Medical Director: Dr. Cameron Nelson

Compliance Officer: Kristen McKenna

Compliance Officer: Kristen McKenna

Quality Assurance/Improvement Officer: Kristin Kohl

Quality Assurance/Improvement Officer: Kristin Kohl

Associated Committees and Committee Leadership:

Associated Committees and Committee Leadership:

Committee Name

Committee Leader Name and Position

N/A

N/A

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

• Networks of individual practices of ACO professionals

Shared Savings and Losses:

Shared Savings and Losses:

Shared Savings and Losses:

Shared Savings and Losses:

Amount of Shared Savings/Losses:

Amount of Shared Savings/Losses:

Second Agreement Period

  • Performance Year 2026, N/A

  • Performance Year 2025, N/A

First Agreement Period

  • Performance Year 2024, $1,571,072.66

Shared Savings Distribution:

Shared Savings Distribution:

Shared Savings Distribution:

Shared Savings Distribution:

Shared Savings Distribution:

Shared Savings Distribution:

Second Agreement Period

  • Performance Year 2026

    • 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 2025

    • 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 2024

    • Proportion invested in infrastructure: N/A

    • Proportion invested in redesigned care processes/resources: N/A

    • Proportion of distribution to ACO participants: N/A

2024 Quality Performance Results

2024 Quality Performance Results

Quality performance results are based on the CMS Web Interface collection type.

Measure #

Measure Title

Collection Type

Performance Rate

Current Year Mean Performance Rate (Shared Savings Program ACOs)

321

CAHPS for MIPS

CAHPS for MIPS Survey

7.51

6.67

479^

Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups

Administrative Claims

0.1501

0.1517

484^

Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC)

Administrative Claims

32.14

37

318

Falls: Screening for Future Fall Risk

CMS Web Interface

71.15

88.99

110

Preventative Care and Screening: Influenza Immunization

CMS Web Interface

55.44

68.6

226

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

CMS Web Interface

50

79.98

113

Colorectal Cancer Screening

CMS Web Interface

40.27

77.81

112

Breast Cancer Screening

CMS Web Interface

50.29

80.93

438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

CMS Web Interface

76.45

86.5

370

Depression Remission at Twelve Months

CMS Web Interface

12

17.35

001^

Diabetes: Hemoglobin A1c (HbA1c) Poor Control

CMS Web Interface

24.68

9.44

134

Preventative Care and Screening: Screening for Depression and Follow-up Plan

CMS Web Interface

54.02

81.46

236

Controlling High Blood Pressure

CMS Web Interface

69.32

79.49

CAHPS-1

Getting Timely Care, Appointments, and Information

CAHPS for MIPS Survey

86.33

83.7

CAHPS-2

How Well Providers Communicate

CAHPS for MIPS Survey

94.66

93.96

CAHPS-3

Patient's Rating of Provider

CAHPS for MIPS Survey

93.41

92.43

CAHPS-4

Access to Specialists

CAHPS for MIPS Survey

81.09

75.76

CAHPS-5

Health Promotion and Education

CAHPS for MIPS Survey

57.37

65.48

CAHPS-6

Shared Decision Making

CAHPS for MIPS Survey

64.43

62.31

CAHPS-7

Health Status and Functional Status

CAHPS for MIPS Survey

75.72

74.14

CAHPS-8

Care Coordination

CAHPS for MIPS Survey

85.2

85.89

CAHPS-9

Courteous and Helpful Office Staff

CAHPS for MIPS Survey

93.02

92.89

CAHPS-11

Stewardship of Patient Resources

CAHPS for MIPS Survey

29.89

26.98

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

^For Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [Quality ID #001], Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [Measure #479], and Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], a lower performance rate indicates better measure performance.

^For Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], patients are excluded if they were attributed to Qualifying Alternative Payment Model (APM) Participants (QPs). Most providers participating in Track E and ENHANCED track ACOs are QPs, and so performance rates for Track E and ENHANCED track ACOs may not be representative of the care provided by these ACOs' providers overall. Additionally, many of these ACOs do not have a performance rate calculated due to not meeting the minimum of 18 beneficiaries attributed to non-QP providers.

Advance Investment Payments (AIP)

Advance Investment Payments (AIP)

In accordance with 42 CFR § 425.630(i)(1), an ACO must publicly report information about the ACO's use of advance investment payments for each performance year, as set forth in 42 CFR § 425.308(b)(8). Advance investment payments used for any expenses other than allowable uses under 42 CFR § 425.630(e)(1) are subject to compliance action. Spend Plan:

Payment Use

General Spend Category

General Spend Subcategory

Projected Spending 2024

Actual Spending 2024

Projected Spending 2025

Actual Spending 2025

Projected Spending 2026

Actual Spending 2026

Projected Spending 2027

Actual Spending 2027

Projected Spending 2028

Actual Spending 2028

Care Coordinator

Increased Staffing

Case Manager

$116,206.00

$0.00

$116,206.00

$0.00

$116,206.00

$0.00

$116,206.00

$0.00

$116,206.00

$0.00

Clinical RN

Increased Staffing

Case Manager

$224,712.00

$0.00

$224,712.00

$0.00

$224,712.00

$0.00

$224,712.00

$0.00

$224,712.00

$0.00

Wiseman - CM System

Health Information Technology

Case Management System

$6,300.00

$0.00

$6,300.00

$0.00

$6,300.00

$0.00

$6,300.00

$0.00

$6,300.00

$0.00

Social Worker

Increased Staffing

Licensed Clinical Social Worker

$35,071.00

$0.00

$35,071.00

$0.00

$35,071.00

$0.00

$35,071.00

$0.00

$35,071.00

$0.00

Pharmacist and Pharma Tech

Increased Staffing

Physician

$17,800.00

$0.00

$17,800.00

$0.00

$17,800.00

$0.00

$17,800.00

$0.00

$17,800.00

$0.00

Quality Educator

Increased Staffing

Other

$14,667.00

$0.00

$14,667.00

$0.00

$14,667.00

$0.00

$14,667.00

$0.00

$14,667.00

$0.00

Practice Transformation Specialist

Increased Staffing

Other

$57,300.00

$0.00

$57,300.00

$0.00

$57,300.00

$0.00

$57,300.00

$0.00

$57,300.00

$0.00

Clinical Documentation

Increased Staffing

Other

$0.00

$270,151.24

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Patient Scheduling Specialist

Increased Staffing

Other

$0.00

$121,087.26

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Patient Scheduling Software

Health Care Infrastructure

Other

$0.00

$3,154.59

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

ADTs

Health Care Infrastructure

Health information exchange and health information network participation

$0.00

$67,045.90

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Patient Outreach Team

Increased Staffing

Other

$0.00

$60,338.78

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Patient Outreach Software

Health Care Infrastructure

Other

$0.00

$30,847.96

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Data Analytics

Increased Staffing

Other

$0.00

$263,627.01

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Remote Access Technologies

Health Care Infrastructure

Remote Access Technologies

$0.00

$46,103.42

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

IT Support

Health Care Infrastructure

Other

$0.00

$129,136.51

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Data Analytics

Health Care Infrastructure

Other

$0.00

$41,416.54

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Pop Health Tools

Health Care Infrastructure

Case Management System

$0.00

$81,556.54

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Field Management Software

Health Care Infrastructure

Other

$0.00

$5,291.57

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Electronic Quality Reporting

Health Care Infrastructure

Electronic Quality Reporting

$0.00

$57,000.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Subtotals

$472,056.00

$1,176,757.00

$472,056.00

$0.00

$472,056.00

$0.00

$472,056.00

$0.00

$472,056.00

$0.00

Spend Plan Summary:

Projected Total Advance Investment Payments

$1,305,140.00

Actual Spending

$1,176,757.32

Future Projected Spending

$1,416,168.00

Remaining Funding to Allocate

$-1,341,282.32

Remaining Funding to Allocate

$1,251,643.00

Our ACO has established a separate designated account for the deposit and expenditure of all advance investment payments in accordance with 42 CFR 425.630(e)(4).

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