CMS Reporting
Caravan Health ACO 41 LLC
ACO Name and Location
Caravan Health ACO 41 LLC
dba Avera Prairie View ACO
7509 NW Tiffany Springs Parkway
Ste. 310
Kansas City, Missouri 64153
ACO Primary Contact
| Primary Contact Name | Teri Bergeleen |
| Primary Contact Phone Number | 605-322-4576 |
| Primary Contact Email Address | Teri.Bergeleen@avera.org |
Organizational Information
ACO participants:
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
| Avera McKennan | Y |
| City of Brookings | N |
| Heart Hospital of South Dakota LLC | Y |
| Avera St. Marys | Y |
| Avera St. Lukes | Y |
| Avera Queen of Peace | Y |
| Lakes Regional Hospital | Y |
| Floyd Valley Hospital | Y |
| Spencer Municipal Hospital | Y |
| Rural Health Care Inc | Y |
| Anesthesiology Associates, Inc. | N |
| Midwest Ear, Nose & Throat Associates PC | N |
| Northwest Iowa Urologist OC | N |
| NWIA Bone, Joint & Sports Surgeons, PC | N |
| Northwest Iowa Ear Nose and Throat PC | N |
| Opthalmology LTD | N |
| Surgical Institute of South Dakota PC | N |
| Midwest Radiology and Imaging PC | N |
| Ophthalmology LTD Eye Surgery Center LLC | N |
| Northwest Iowa Surgeons PC | N |
| Northwest Iowa Anesthesia Associates | N |
| Physicians Laboratory, LTD. | N |
| Physicians Laboratory of Northwest Iowa LTD | N |
| USC Ambulatory Surgical Center Prof LLC | N |
| Urology Specialists Chartered | N |
| Yankton Medical Clinic PC | N |
| Sacred Heart Health Services | Y |
| Avera At Home | N |
| Orthopaedics PC | Y |
ACO governing body:
| Member | Member’s Voting Power (expressed as a percentage or a number) | Membership Type | ACO Participant TIN Legal Business Name/DBA, if Applicable |
||
| Last Name | First Name | Title/Position | |||
| Bates | Rob | Board Member | 1 | ACO Participant Representative | Avera St. Marys |
| Flicek | David | Board Member | 1 | ACO Participant Representative | Avera Mckennan |
| Bumgarner | William | Board Member | 1 | ACO Participant Representative | Spencer Municipal Hospital |
| Basel, MD | David | Board Member | 1 | ACO Participant Representative | Avera McKennan |
| Ekeren | Doug | Board Member | 1 | ACO Participant Representative | Sacred Heart Health Services |
| Forkel | Todd | Board Member | 1 | ACO Participant Representative | Avera St. Luke |
| Gibbs | Michael | Board Member | 1 | ACO Participant Representative | Heart Hospital of South Dakota LLC |
| Hardwick | Jim | Board Member | 1 | ACO Participant Representative | Rural Health Care Inc. |
| Harrington | Jason | Board Member | 1 | ACO Participant Representative | Lakes Regional Healthcare |
| Wright | Dustin | Board Member | 1 | ACO Participant Representative | Floyd Valley |
| Fanta, MD | Susan | Board Member | 1 | ACO Participant Representative | Yankton Medical Clinic |
| Clark | Patrick | Board Member | 1 | ACO Medicare Beneficiary | Avera McKennan |
| Timpe | David | Board Member | 0 | ACO Participant Representative | Avera McKennan |
| Clark | Tom | Board Member | 1 | ACO Participant Representative | Avera Queen of Peace |
| Merkley | Jason | Board Member | 1 | ACO Participant Representative | City of Brookings |
| Bergeleen | Teri | Board Member | 0 | N/A | N/A |
Key ACO clinical and administrative leadership:
| David Flicek | ACO Executive |
| Dr. David Basel | Medical Director |
| Compliance Officer | |
| Eric Boyce | Quality Assurance/Improvement Officer |
Associated committees and committee leadership:
| Committee Name | Committee Leader Name and Position |
| Executive Committee | David Flicek-Chairman |
| Steering Committee | David Basel, MD- Vice-Chairman |
Types of ACO participants, or combinations of participants, that formed the ACO:
- Partnerships or joint venture arrangements between hospitals and ACO professionals
- Hospital employing ACO professionals
- Critical Access Hospital (CAH) billing under Method II
Shared Savings and Losses
mount of Shared Savings/Losses
- First Agreement Period
- Performance Year 2019, $0
- Performance Year 2020, $0
- Performance Year 2021, $0
Shared Savings Distribution
- First Agreement Period
- Performance Year 2021
- 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 2020
- 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 2021
Quality Performance Results
2021 Quality Performance Results:
| Measure# | Measure Name | Rate | ACO Mean |
| 001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control2 | 14.43 | 12.46 |
| 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | 73.41 | 74.38 |
| 236 | Controlling High Blood Pressure | 76.3 | 74.87 |
| 318 | Falls: Screening for Future Fall Risk | 97.45 | 87.03 |
| 110 | Preventative Care and Screening: Influenza Immunization | 82.35 | 80.52 |
| 226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | 91.67 | 80.97 |
| 113 | Colorectal Cancer Screening | 74.36 | 73.63 |
| 112 | Breast Cancer Screening | 78.29 | 75.11 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 83.16 | 84.24 |
| 321 | CAHPS for MIPS3 | N/A | N/A |
| 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2 | 0.1416 | 0.154 |
| MCC1 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2 | 34.37 | 33.99 |
Please note, the Quality ID #: 370 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
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.
