CMS Reporting
Caravan Health ACO 43 LLC
ACO Name and Location
Caravan Health ACO 43 LLC
dba
4055 Valley View Ln, Suite 700
Dallas, TX 75244
ACO Primary Contact
Primary Contact Name | Kristine Miller |
Primary Contact Phone Number | 916-542-4568 |
Primary Contact Email Address | kmiller@signifyhealth.com |
Organizational Information
ACO participants:
ACO Participants |
ACO Participant in Joint Venture |
EAST PHILLIPS COUNTY HOSPITAL DISTRICT |
Y |
WEISER VALLEY HOSPITAL DISTRICT |
Y |
RIVERVIEW HOSPITAL |
Y |
MADISON HEALTHCARE SERVICES |
Y |
LAC QUI PARLE CLINIC OF MADISON, INC |
Y |
CUYUNA REGIONAL MEDICAL CENTER |
Y |
GLENDIVE MEDICAL CENTER, INC |
Y |
J. ARTHUR DOSHER MEMORIAL HOSPITAL |
Y |
P R HEALTH CORPORATION |
Y |
CALLAWAY HOSPITAL DISTRICT |
Y |
COQUILLE VALLEY HOSPITAL DISTRICT |
Y |
CAHRMC LLC |
Y |
DEWITT MEDICAL DISTRICT |
Y |
MITCHELL COUNTY HOSPITAL DISTRICT |
Y |
BAYLOR COUNTY HOSPITAL DISTRICT |
Y |
MEDINA COUNTY HOSPITAL DISTRICT |
Y |
ELECTRA HOSPITAL DISTRICT |
Y |
GRAHAM HOSPITAL DISTRICT |
Y |
GRAHAM HOSPITAL DISTRICT |
Y |
GPCH LLC |
Y |
GRAHAM HOSPITAL DISTRICT |
Y |
WILBARGER COUNTY HOSPITAL DISTRICT |
Y |
SHC MEDICAL CENTER - TOPPENISH |
Y |
LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1 |
Y |
ADAMS COUNTY HOSPITAL 2 |
Y |
MEMORIAL HOSPITAL OF LARAMIE COUNTY |
Y |
MONUMENT HEALTH RAPID CITY HOSPITAL INC |
Y |
MONUMENT HEALTH NETWORK INC |
Y |
SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION |
Y |
KNOXVILLE COMMUNITY HOSPITAL INC |
Y |
MERCY MEDICAL CENTER-CENTERVILLE |
Y |
DECATUR COUNTY HOSPITAL |
Y |
MEMORIAL HOSPITAL ASSOCIATION |
Y |
HAWARDEN REGIONAL HEALTHCARE CLINICS LLC |
Y |
PALO ALTO COUNTY HOSPITAL |
Y |
DALLAS COUNTY HOSPITAL |
Y |
HAMILTON COUNTY PUBLIC HOSPITAL |
Y |
MANNING REGIONAL HEALTHCARE CENTER |
Y |
HANCOCK COUNTY HEALTH SYSTEM |
Y |
RINGGOLD COUNTY HOSPITAL |
Y |
FRANKLIN GENERAL HOSPITAL |
Y |
KOSSUTH REGIONAL HEALTH CENTER |
Y |
ELLSWORTH MUNICIPAL HOSPITAL |
Y |
GUTTENBERG MUNICIPAL HOSPITAL |
Y |
DAVIS COUNTY HOSPITAL |
Y |
MITCHELL COUNTY MEMORIAL HOSPITAL |
Y |
ADAIR COUNTY MEMORIAL HOSPITAL |
Y |
MONROE COUNTY HOSPITAL |
Y |
BAUM HARMON MERCY HOSPITAL |
Y |
HAWARDEN REGIONAL HEALTHCARE |
Y |
MADISON COUNTY MEMORIAL HOSPITAL |
Y |
MERCY MEDICAL CENTER NEW HAMPTON |
Y |
EASTLAND MEMORIAL HOSPITAL DISTRICT |
Y |
DOUGLAS, GRANT, LINCOLN & OKANOGAN COUNTIES PUBLIC HOSPITAL DISTRICT 6 |
Y |
CENTRAL COMMUNITY HOSPITAL |
Y |
MERCY MEDICAL CENTER-NEWTON |
Y |
PHYSICIAN PRACTICES OF MSMC LLC |
Y |
COUNTY OF MURRAY |
Y |
KARNES COUNTY HOSPITAL DISTRICT |
Y |
DIMMIT REGIONAL HOSPITAL |
Y |
BOSQUE COUNTY HOSPITAL DISTRICT |
Y |
SOUTHERN COOS HEALTH DISTRICT |
Y |
FRIO HOSPITAL ASSOCIATION |
Y |
COMMONWEALTH HEALTHCARE CORPORATION |
Y |
MADELIA HEALTH |
Y |
TYLER COUNTY HOSPITAL DISTRICT |
Y |
HASKELL COUNTY HOSPITAL |
Y |
PECOS COUNTY MEMORIAL HOSPITAL |
Y |
ROLLING PLAINS MEMORIAL HOSPITAL |
Y |
ERICK MADRIGAL MD MBA INC |
Y |
OLNEY-HAMILTON HOSPITAL DISTRICT |
Y |
HANSFORD COUNTY HOSPITAL DISTRICT |
Y |
SCURRY COUNTY HOSPITAL DISTRICT |
Y |
ST ALOISIUS HOSPITAL INC |
Y |
LUTHERAN CHARITY ASSOCIATION |
Y |
NORTH WHEELER COUNTY HOSPITAL DISTRICT |
Y |
REGIONAL WEST MEDICAL CENTER |
Y |
ERLANGER HEALTH |
Y |
ST LUKES HOSPITAL |
Y |
NORTHWOOD DEACONESS HEALTH CENTER |
Y |
TOWNER COUNTY MEDICAL CENTER INC |
Y |
ASHLEY MEDICAL CENTER |
Y |
COOPERSTOWN MEDICAL CENTER |
Y |
NELSON COUNTY HEALTH SYSTEM |
Y |
TIOGA MEDICAL CENTER |
Y |
WISHEK HOSPITAL-CLINIC ASSOCIATION |
Y |
ST ANDREWS HOSPITAL |
Y |
REGIONAL WEST GARDEN COUNTY |
Y |
STONEWALL MEMORIAL HOSPITAL |
Y |
LYNN COUNTY HOSPITAL DISTRICT |
Y |
LINTON HOSPITAL |
Y |
MERCY MEDICAL CENTER-DYERSVILLE |
Y |
MERCY HOSPITAL OF FRANCISCAN SISTERS INC |
Y |
SYRINGA GENERAL HOSPITAL DISTRICT CIF |
Y |
JACKSON COUNTY PUBLIC HOSPITAL |
Y |
DANIELS MEMORIAL HOSPITAL |
Y |
MCKENZIE COUNTY HEALTHCARE SYSTEMS INC |
Y |
PEMBINA COUNTY MEMORIAL HOSPITAL ASSOCIATION |
Y |
OCHILTREE HOSPITAL DISTRICT |
Y |
DISCOVERY MEDICAL NETWORK SWEETWATER LLC |
Y |
WAYNE COUNTY HOSPITAL |
Y |
VAN BUREN COUNTY HOSPITAL |
Y |
CAMERON MEMORIAL COMMUNITY HOSPITAL INC |
Y |
CHRISTIAN UNITY HOSPITAL CORPORATION |
Y |
GENESIS MEDICAL CENTER, ALEDO |
Y |
MARTIN LUTHER KING JR COMMUNITY MEDICAL GROUP |
Y |
ACO governing body:
Member |
Member |
Member Title/Position |
Member’s Voting Power (Expressed as a percentage) |
Membership Type |
ACO Participant Legal Business Name, if applicable |
Jerry |
Neria |
Board Member |
2.857% |
ACO Participant Representative |
ERICK MADRIGAL MD MBA INC |
Kurt |
Stauder |
Board Member |
2.857% |
ACO Participant Representative |
MARTIN LUTHER KING JR COMMUNITY MEDICAL GROUP |
Michael |
Hassell |
Board Member |
2.857% |
ACO Participant Representative |
East Phillips County Hospital |
Lynda |
Barcelo |
Board Member |
2.857% |
ACO Participant Representative |
Physician Practices of MSMC, LLC |
Lillian |
Dittrick |
Board Member |
2.857% |
ACO Participant Representative |
Mercy Rural ACO, LLC |
Abner |
King |
Board Member |
2.857% |
ACO Participant Representative |
SYRINGA GENERAL HOSPITAL DISTRICT CIF |
Steven |
Hale |
Board Member |
2.857% |
ACO Participant Representative |
Weiser Memorial Hospital |
Eric |
Marcotte |
Board Member |
2.857% |
ACO Participant Representative |
Riverview Hospital |
Sarah |
Hagan |
Board Member |
2.857% |
ACO Participant Representative |
Cameron Memorial Community Hospital Inc |
Erik |
Bjerke |
Board Member |
2.857% |
ACO Participant Representative |
Madison Healthcare Services |
David |
Walz |
Board Member |
2.857% |
ACO Participant Representative |
MADELIA HEALTH |
Luke |
Schryvers |
Board Member |
2.857% |
ACO Participant Representative |
County Of Murray |
Amy |
Hart |
Board Member |
2.857% |
ACO Participant Representative |
Cuyuna Regional Medical Center |
Esther |
Muna |
Board Member |
2.857% |
ACO Participant Representative |
Commonwealth Healthcare Corporation |
Kody |
Brinton |
Board Member |
2.857% |
ACO Participant Representative |
DANIELS MEMORIAL HOSPITAL |
Jenn |
Keck |
Board Member |
2.857% |
ACO Participant Representative |
Memorial Hospital Association |
MJ |
Marx |
Board Member |
2.857% |
ACO Participant Representative |
Glendive Medical Center |
Lynda |
Stanley |
Board Member |
2.857% |
ACO Participant Representative |
J. Arthur Dosher Memorial Hospital |
Peter |
Edis |
Board Member |
2.857% |
ACO Participant Representative |
McKenzie County Healthcare Systems Inc |
Marcus |
Lewis |
Board Member |
2.857% |
ACO Participant Representative |
P R Health Corporation |
Alfred |
Sams |
Board Member |
2.857% |
ACO Participant Representative |
Rough Rider High Value Network |
Brett |
Eggleston |
Board Member |
2.857% |
ACO Participant Representative |
Callaway Hospital District |
Andrea |
Eaton |
Board Member |
2.857% |
ACO Participant Representative |
Regional West Medical Center |
Bradley |
Howell |
Board Member |
2.857% |
ACO Participant Representative |
REGIONAL WEST GARDEN COUNTY |
Jeff |
Lang |
Board Member |
2.857% |
ACO Participant Representative |
Coquille Valley Hospital District |
Raymond |
Hino |
Board Member |
2.857% |
ACO Participant Representative |
Southern Coos Health District |
Christine |
Papineau |
Board Member |
2.857% |
ACO Participant Representative |
Monument Health Rapid City Hospital Inc. |
Lynn |
DeJaco |
Board Member |
2.857% |
ACO Participant Representative |
Erlanger Health |
Paul |
Aslin |
Board Member |
2.857% |
ACO Participant Representative |
TORCH CIN LLC |
Ramona |
Hicks |
Board Member |
2.857% |
ACO Participant Representative |
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 |
Brian |
Gibbons |
Board Member |
2.857% |
ACO Participant Representative |
Sunnyside Community Hospital Association |
Jennifer |
Lewis |
Board Member |
2.857% |
ACO Participant Representative |
Lincoln County Public Hospital District 1 |
Corey |
Fedie |
Board Member |
2.857% |
ACO Participant Representative |
Adams County Hospital 2 |
Kerry |
Slater |
Board Member |
2.857% |
ACO Participant Representative |
Memorial Hospital of Laramie County |
Marla |
Christensen-Opitz |
Board Member |
2.857% |
Medicare Beneficiary |
N/A |
Key ACO clinical and administrative leadership:
Khue Nguyen | ACO Executive |
Jerry Neria, MD | Medical Director |
Emma Oakley | Compliance Officer |
Rayna Caplan | Quality Assurance/Improvement Officer |
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
Amount of Shared Savings/Losses
- First Agreement Period
- Performance Year 2019, $0
- Performance Year 2020, $0
- Performance Year 2021, $0
- Performance Year 2022, $0
Shared Savings Distribution
- First Agreement Period
- Performance Year 2019
- 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
- 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 2022
- 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 2019
Quality Performance Results
2022 Quality Performance Results:
*Quality performance results are based on CMS Web Interface.
Measure # | Measure Name | Collection Type | Rate | ACO Mean |
001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1] | CMS Web Interface | 19.70 | 10.71 |
134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 66.00 | 76.97 |
236 | Controlling High Blood Pressure | CMS Web Interface | 68.56 | 76.16 |
318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 67.91 | 87.83 |
110 | Preventative Care and Screening: Influenza Immunization | CMS Web Interface | 54.10 | 77.34 |
226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 54.55 | 79.27 |
113 | Colorectal Cancer Screening | CMS Web Interface | 57.03 | 75.32 |
112 | Breast Cancer Screening | CMS Web Interface | 67.89 | 78.07 |
438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 85.83 | 86.37 |
370 | Depression Remission at Twelve Months | CMS Web Interface | 0.00 | 16.03 |
321 | CAHPS for MIPS [3] | CMS Web Interface | N/A | N/A |
479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1] | CMS Web Interface | 0.1663 | 0.1510 |
484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] | CMS Web Interface | 29.96 | 30.97 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.
For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov.
Provider Incentive Waiver:
o Parties to the arrangement: Caravan Health ACO 43 and ACO Participants
o Date of arrangement: 05/02/2024
o Items, services, goods, or facility provided: See description below
o Date and nature of any amendments to the arrangement, if applicable: N/A
The board made a bona fide determination effective May 02, 2024, that the Primary Care Initiative is
reasonably related to the purpose of the MSSP to manage and coordinate care for Medicare fee-for-
service beneficiaries throughout the ACO. The Primary Care Initiative is intended to assist in increasing
the availability and performance of medically necessary annual wellness visits (“AWVs”) and other
primary care visits (“PCVs”) on beneficiaries whom CMS has identified as assigned to the ACO under the
MSSP. The Primary Care Initiative shall be adopted for an initial period not to exceed the remainder of
the current 2024 MSSP performance year, but subject to extension, consistent with the purposes of the
MSSP. The Executive Director of the ACO will designate which Principals and/or Participants are eligible
to participate in the Primary Care Initiative.
ACO shall direct Caravan Health, Inc. to provide select ACO Principal(s) and/or Participant(s) with a
payment, made on the ACO’s behalf, per AWV completed in the Performance Year. Each AWV must (1)
include all required elements and associated quality data for beneficiaries whom CMS has identified as
assigned to the ACO under the MSSP; and (2) be conducted in accordance with specific considerations
and criteria.
ACO shall direct Caravan to provide select ACO Principal(s) and/or Participant(s) with a payment, made
on the ACO’s behalf, per applicable PCV for up to three (3) completed medically necessary PCVs
(independent of an AWV) completed in the Performance Year. Only one (1) PCV per assigned beneficiary
per every three-month period is eligible for such payment. Each PCV must (1) be conducted on
beneficiaries whom CMS has identified as assigned to the ACO under the MSSP, (2) be conducted on
ACO beneficiaries whom the ACO, by and through Caravan, has identified as the top 20% high risk ACO
beneficiaries for emergency department admissions, inpatient hospital admissions or readmissions,
other acute events, or other high risk clinical criteria as determined by Caravan’s analytics tools; and (3)
include such specific considerations and criteria.
ACO shall not provide payments for visits that were completed prior to the Effective Date of the board
resolution approving this initiative.