St. Luke’s Medicare ACO

ACO Name and Location

St. Luke’s Shared Savings Plan, LLC
Previous Names: N/A
801 Ostrum Street
Bethlehem, PA 18015

ACO Primary Contact

Christina Lewis
484-658-0713
christina.lewis@sluhn.org


Organizational Information

ACO Participants:

ACO Participants

ACO Participant in Joint Venture

Camille Eyvazzadeh, MD, PC

N

Darell Covington, MD, PC

N

David Bub, MD, PC

N

East Penn Rheumatology, PC

N

Easton Family Practice

N

Ellen Rubbo, MD

N

Gastroenterology Associates, LTD

N

GSLPG, INC

N

Integrated Health Solutions, PC

N

Jolanta Zelaznicka, MD

N

Joseph Bacak, MD

N

Mark Durback, MD

N

Mark Grusso, DPM, PC

N

Northeastern Anesthesia Physicians, PC

N

Om Sharma, MD, PC

N

Otorhinolaryngology Associates, PC

N

Penn Foundation, INC

N

Pocono Adult & Pediatric Medical Group, LLC

N

Progressive Physician Associates, INC

N

Specialty Physician Associates, LLC

N

St. Luke’s Warren Physician Group, PC

N

St. Luke’s Physician Group, INC

N

T Ramakrishnan, MD, PC

N

Whitehall Medical Associates, LLC

N

 

ACO Governing Body:

Member

Last Name

Member

First Name

Member

Title/Position

Member's Voting Power (Expressed as a percentage or number)

Membership Type

ACO Participant Legal Business Name and D/B/A, if applicable

Bertka

Ken

Member

1 Vote

ACO Participant Representative

St. Luke’s Physician Group Inc

Botek

Francine

Member

1 Vote

Stakeholder Representative

St. Luke’s Hospital

Bowers

Daniel

Member

1 Vote

ACO Participant Representative

Eyvazzadeh and Reilly Colon and Rectal Center

Brinker

John

Member

1 Vote

ACO Participant Representative

St. Luke’s Physician Group Inc

Carmona

Aldo

Chair

1 Vote

ACO Participant Representative

St. Luke’s Physician Group Inc

Conron

Richard

Member

1 Vote

ACO Participant Representative

St. Luke’s Physician Group Inc

Evans

Dean

Member

1 Vote

Medicare Beneficiary

N/A

Fagerstrom

Joel

Member

1 Vote

Stakeholder Representative

St. Luke’s Hospital

Gately

Linda

Member

None

ACO Participant Representative

St. Luke’s Physician Group Inc

Keeler

Jarrod

Member

1 Vote

ACO Participant Representative

Specialty Physician Associates, LLC

Lewis

Christina

Member

None

ACO Participant Representative

St. Luke’s Physician Group Inc

McGorry

Dennis

Member

1 Vote

ACO Participant Representative

St. Luke’s Physician Group Inc

Minahan

Joseph

Member

1 Vote

ACO Participant Representative

St. Luke’s Physician Group Inc

Sabol

Donna

Member

None

Stakeholder Representative

St. Luke’s Hospital

Ufondu

Solibe

Member

1 Vote

ACO Participant Representative

Pocono Adult & Pediatric Medical Group, LLC

 

Key ACO Clinical and Administrative Leadership:

ACO Executive: Robert Wax
Medical Director: Ken Bertka MD
Compliance Officer: Linda Gately
Quality Assurance/Improvement Officer: Donna Sabol

 

Associated Committees and Committee Leadership:

Committee Name

Committee Leader Name and Position

Clinical Council

Ken Bertka MD, VP Clinical Integration

Quality Committee

Donna Sabol, RN MSN, SVP Quality

 

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

  • Network of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • First Agreement Period
    • Performance Year 2020, $9,087,692
    • Performance Year 2019, $ 0
    • Performance Year 2018, $ 0

Shared Savings Distribution:

  • First Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 23%
      • Proportion invested in redesigned care processes/resources: 10%
      • Proportion of distribution to ACO participants: 58%
    • 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 2018
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A


Quality Performance Results

2020 Quality Performance Results:

ACO Quality Measure Number

Measure Name

Rate

ACO Mean

ACO-43

Ambulatory Sensitive Admission Acute Composite

0.60

0.95

ACO-13

Falls: Screening for Future Fall Risk

85.96

84.97

ACO-14

Preventive Care and Screening: Influenza Immunization

72.36

76.03

ACO-17

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

81.25

81.67

ACO-18

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

80.84

71.46

ACO-19

Colorectal Cancer Screening

71.58

72.59

ACO-20

Breast Cancer Screening

77.11

74.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

73.42

83.37

ACO-27

Diabetes Mellitus: Hemoglobin A1C Poor Control

12.72

14.70

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

76.58

72.87

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


Fraud and Abuse Waivers

  • ACO Participation Waiver:

    The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement. 

    • Parties to the arrangement: St. Luke’s Shared Savings, LLC and the following ACO participants:
      Ellen Fields MD 07/1/2021
      Camille Eyvazzadeh MD PC  09/19/2018
      Gastroenterology Associates 10/22/2019
      ORL Associates  03/20/2019
      Specialty Physician Associates 02/20/2019
      Whitehall Medical Associates 08/12/2019
    • Date of arrangement: 1/1/2018 – 12/31/2021
    • Items, services, goods, or facility provided: Electronic Health Record
    • Date and nature of any amendments to the arrangement, if applicable: 1/1/2022 Amended with new agreement years
  •