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Meritage Accountable Care Organization (ACO)

In January 2013, Meritage Medical Network was designated as an Accountable Care Organization (ACO) by Medicare. One of the most publicized facets of the Affordable Care Act, ACOs seek to provide quality care while keeping costs low. With 55 percent of the US population living within an area serviced by 227 ACOs, it’s important for anyone seeking out a healthcare provider to understand how this program works.

What is an Accountable Care Organization?

An ACO is a network of healthcare providers that share responsibility and work collaboratively to provide care for a group of patients. For all patients, an ACO is designed to improve quality of care and reduce costs. Intended to hold providers jointly accountable for the health of their patients, there is a strong incentive for cooperation and avoidance of unnecessary tests and procedures. For Medicare patients, ACOs create opportunities for better quality of healthcare. Putting the patient at the center of care, doctors will be better able to keep them informed, listen to their needs and helping them to make the right decisions for their health.

While designed to be a flexible healthcare model, in general Accountable Care Organizations should:

● Possess sufficient infrastructure and management to support comprehensive care

● Share information seamlessly between providers in the network for the benefit of the patients and providers

● Utilize health information technology to manage patients across the continuum of care and within different institutional settings.

Cost savings anticipated by the Congressional Budget Office are projected at approximately 5.3 billion during 2010-2019. However, the true value of an ACO lies in the improvement of our healthcare system. Insuring accountability by quality performance measures such as care coordination, patient safety, and appropriate use of preventive health services ACOs are a step towards managing our healthcare dollars and delivering effective quality care to all Americans.

ACO Name and Location:

Meritage ACO
4 Hamilton Landing, Suite 100
Novato, CA 94949

ACO Primary Contact:

Marcy Norenius, MPH
Director Strategy, Network, & Growth
mnorenius@meritagemed.com
415-884-1825

Organizational Information:

ACO Participants:

Download the Provider Roster
No participants are involved in a joint venture between ACO professionals and hospitals.

ACO Governing Body:
  1. Keith Chamberlin, M.D., M.B.A, Voting Member, President, & Chair, Anesthesiologist
  2. Joseph Habis, M.D., Voting Member & Medical Director, Internal Medicine Physician with Prima Medical Group
  3. Mark Wexman, M.D., Voting Member & Treasurer, Cardiologist with Cardiovascular Center of Marin
  4. Clinton Lane, M.D., Voting Member & Secretary, Internal Medicine Physician in Sonoma Valley
  5. Ed Johnson, Voting Member, Medicare Beneficiary Representative
  6. Jon Friedenberg, Voting Member, Marin General Hospital Representative
Key ACO clinical and administrative leadership:
  1. ACO Executive: Keith Chamberlin, MD, MBA, Chair
  2. Medical Director: Joseph Habis, M.D.
  3. Compliance Official: Marcy Norenius
  4. Quality Assurance/Improvement Officer: Andrea Kmetz, RN
Associated committees and committee leadership:
  1. Quality Assurance and Improvement Committee: Joseph Habis, MD, Chair
  2. Post-Acute Care Committee: Joseph Habis, MD, Chair
  3. Compliance Committee: Joel Criste, Chair
  4. Steering Committee: Keith Chamberlin, MD, Chair
  5. Skilled Nursing Facility Committee: Larry Posner, MD, Chair
  6. Home Health Committee: Joseph Habis, MD, Chair
Types of ACO participants or combinations of participants that formed the ACO:
  1. Network of individual practices of ACO professionals
Shared Savings and Losses:
Amount of Shared Savings/Losses

ACO in first year of second agreement period

  • Agreement period beginning 2013, Performance Year 1: $0
  • Agreement period beginning 2013, Performance Year 2014: $0
  • Agreement period beginning 2013, Performance Year 2015: $0
  • Agreement period beginning 2016, Performance Year 2016: $0

Shared losses are designated with a minus sign (-) in front of the dollar amount and red font.

Shared Savings Distribution:

ACO in first year of second agreement period

  • Agreement period beginning 2013, Performance Year 1
    • Proportion invested in infrastructure: 50%
    • Proportion invested in redesigned care processes/resources: 0%
    • Proportion of distribution to ACO participants: 50%
  • Agreement period beginning 2013, Performance Year 2014, 2015
    • Proportion invested in infrastructure: 50%
    • Proportion invested in redesigned care processes/resources: 0%
    • Proportion of distribution to ACO participants: 50%
  • Agreement period beginning 2016, Performance Year 2016
    • Proportion invested in infrastructure: 50%
    • Proportion invested in redesigned care processes/resources: 0%
    • Proportion of distribution to ACO participants: 50%
Payment Rule Waivers

No, our ACO does not utilize the SNF 3-Day Rule Waiver

How Shared Savings Are Distributed:
  • Repay investment by Meritage Medical Network
  • Remaining Dollars:
    • Reinvest in infrastructure: 50%
    • Distribution to ACO Participants: 50%
      • Primary Care Professionals: TBD
      • Specialists: TBD
      • Hospital: TBD
Quality Performance Results

Measure Number

Performance Measure

2013 Reporting Period

2014 Reporting Period

2015 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 #8

Risk Standardized, All Condition Readmissions

14.02

14.90

14.34

15.15

TBD

TBD

ACO #9

ASC Admissions: COPD or Asthma in Older 8 Adults

0.5

1.17

0.53

1.08

TBD

TBD

ACO #10

ASC Admission: Heart Failure

0.91

1.20

0.92

1.19

TBD

TBD

ACO #11

Percent of Primary Care Providers who Qualified for EHR Incentive Payment

69.09

66.21

82.86

76.71

TBD

TBD

Additional Downloads:

See 2015 Quality Performance Results Table
See 2013-2014 Quality Performance Results Table