About

ACO Name and Location:

Northwest Ohio ACO, LLC
4235 Secor Rd
Toledo, OH 43623

ACO Primary Contact

Primary Contact Name

Tim Poplawski

Primary Contact Phone Number

419-318-9447

Primary Contact Email Address

tpoplawski@toledoclinic.com

 

Organizational Information

 

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Perrysburg Eye Center, Inc

Y

Toledo Clinic Incorporated

Y

Northwest Surgical Specialists Inc

Y

James M Croak Do Inc

Y

Neurosurgical Network, Inc

Y

Ophthalmology Associates of Northwestern Ohio,Inc

Y

Gary Swann DO

Y

John Rosenthal

Y

Wellcare Physicians Group, LLC

Y

 

Shared Savings and Losses:

Amount of Shared Savings/Losses

Shared Savings Distribution

 

Quality Performance Results

2016 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

80.96

79.9

ACO-2

CAHPS: How Well Your Providers Communicate

92.03

92.63

ACO-3

CAHPS: Patients' Rating of Provider

91.47

91.93

ACO-4

CAHPS: Access to Specialists

81.92

83.52

ACO-5

CAHPS: Health Promotion and Education

61.24

60

ACO-6

CAHPS: Shared Decision Making

76.27

75.28

ACO-7

CAHPS: Health Status/Functional Status

71.31

71.82

ACO-34

CAHPS: Stewardship of Patient Resources

31.01

27.52

ACO-8

Risk-Standardized, All Condition Readmission

13.62

14.7

ACO-35

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

16.35

18.17

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

51.04

53.2

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

68.14

75.23

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

53.49

59.81

ACO-9

Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)

9.35

9.27

ACO-10

Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 )

15.6

14.53

ACO-11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

98.59

82.72

ACO-39

Documentation of Current Medications in the Medical Record

99.27

87.54

ACO-13

Falls: Screening for Future Fall Risk

67.48

64.04

ACO-14

Preventive Care and Screening: Influenza Immunization

47.18

68.32

ACO-15

Pneumonia Vaccination Status for Older Adults

63.44

69.21

ACO-16

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

75.77

74.45

ACO-17

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

93.15

90.98

ACO-18

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

55.99

53.63

ACO-19

Colorectal Cancer Screening

62.65

61.52

ACO-20

Breast Cancer Screening

62.95

67.61

ACO-21

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

58.67

76.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

79.04

77.72

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

20.62

18.24

ACO-41

Diabetes: Eye Exam  

52.92

44.94

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

72.95

70.52

ACO-30

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

85.75

85.05

ACO-31

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

87.23

88.67

ACO-33

Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)

82.52

79.67

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.   

 

Note: In the Quality Performance Results file(s) above, search for “Northwest Ohio ACO, LLC to view the quality performance results. This ACO can also be found by using the ACO ID A71510 in the public use files on data.cms.gov.

Payment Rule Waivers

·         No, our ACO does not use the SNF 3-Day Rule Waiver.
  • Participation Waiver
    • The Centers for Medicare and Medicaid Services (“CMS”) and the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) have made available waivers of certain federal fraud and abuse laws in connection with the operation of accountable care organizations (“ACOs”) that have entered into a participation agreement under the Medicare Shared Savings Program (“MSSP”).
    • In order to receive the benefit of such waivers, the governing body of Northwest Ohio ACO, LLC (“Northwest Ohio ACO”) has made a bona fide, detailed determination that the following arrangement is reasonably related to the purposes of the MSSP.
    • Northwest Ohio ACO has authorized a waiver of certain federal fraud and abuse laws for the development of an ambulatory surgery center (“ASC”) among certain physicians, some of whom are participating providers in Northwest Ohio ACO and/or affiliated with The Toledo Clinic, Inc., a participant in Northwest Ohio ACO, which provides dialysis vascular and peripheral arterial disease services to patients within the community, including Medicare beneficiaries attributed to Northwest Ohio ACO (the “Arrangement”). As part of the Arrangement, the ASC will create a plan of clinical integration with Northwest Ohio ACO, which may include, without limitation, the ASC sharing quality and claims data for purposes of enhancing the triple aim.
    • The governing body of Northwest Ohio ACO authorized the application of the waiver to the Arrangement on April 11, 2017, following a determination that the Arrangement supports the goals of Northwest Ohio ACO and is reasonably related to the purposes of the MSSP, in each case because the Arrangement: (i) increases the quality of vascular/PAD services and reduces the costs of healthcare for the community, which include Medicare beneficiaries attributed to Northwest Ohio ACO; (ii) allows for greater access to vascular/PAD services in the community, including for Medicare beneficiaries attributed to Northwest Ohio ACO; (iii) encourages investment in infrastructure for high quality and efficient service delivery for patients, including Medicare beneficiaries attributed to Northwest Ohio ACO; and (iv) enhances physician engagement for driving true performance and clinical integration, including for physicians affiliated with Northwest Ohio ACO participants.
  • DME Waiver
    • The Centers for Medicare and Medicaid Services (“CMS”) and the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) have made available waivers of certain federal fraud and abuse laws in connection with the operation of accountable care organizations (“ACOs”) that have entered into a participation agreement under the Medicare Shared Savings Program (“MSSP”).
    • In order to receive the benefit of such waivers, the governing body of Northwest Ohio ACO, LLC (“Northwest Ohio ACO”) has made a bona fide, detailed determination that the following arrangement is reasonably related to the purposes of the MSSP.
    • Northwest Ohio ACO has authorized a waiver of certain federal fraud and abuse laws for the development of an ambulatory surgery center (“ASC”) among certain physicians, some of whom are participating providers in Northwest Ohio ACO and/or affiliated with The Toledo Clinic, Inc., a participant in Northwest Ohio ACO, which provides dialysis vascular and peripheral arterial disease services to patients within the community, including Medicare beneficiaries attributed to Northwest Ohio ACO (the “Arrangement”).  As part of the Arrangement, the ASC will create a plan of clinical integration with Northwest Ohio ACO, which may include, without limitation, the ASC sharing quality and claims data for purposes of enhancing the triple aim.
    • The governing body of Northwest Ohio ACO authorized the application of the waiver to the Arrangement on April 11, 2017, following a determination that the Arrangement supports the goals of Northwest Ohio ACO and is reasonably related to the purposes of the MSSP, in each case because the Arrangement: (i) increases the quality of vascular/PAD services and reduces the costs of healthcare for the community, which include Medicare beneficiaries attributed to Northwest Ohio ACO; (ii) allows for greater access to vascular/PAD services in the community, including for Medicare beneficiaries attributed to Northwest Ohio ACO; (iii) encourages investment in infrastructure for high quality and efficient service delivery for patients, including Medicare beneficiaries attributed to Northwest Ohio ACO; and (iv) enhances physician engagement for driving true performance and clinical integration, including for physicians affiliated with Northwest Ohio ACO participants


Contact Info

Northwest Ohio ACO
4235 Secor Rd.
Toledo, OH 43623

P: 419-318-9447

E: tpoplawski@toledoclinic.com