ACO Leadership & Organization

For information about our governing body and our organization, please click here.

Questions

If you have questions or concerns, please call us toll-free at 1‑855‑336‑9005 or talk with your doctor during your next visit. You can also visit www.medicare.gov or call 1‑800‑MEDICARE (1‑800‑633‑4227; TTY users should call 1‑877‑486‑2048) for questions or additional information about Accountable Care Organizations.

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ACO Leadership & Organization

ACO Name and Location

Carilion Clinic Medicare Shared Savings Company, LLC
213 S. Jefferson St., Suite 1600
Roanoke, VA 24011

ACO Primary Contact

Zachary Smith
540-581-0270
zrsmith@carilionclinic.org

Organizational Information

ACO Participants:

ACO Participants	ACO Participant in Joint Venture
ACV, Inc.	N
Anesthesiology Associates of Radford, Inc.	N
Carilion Emergency Services, Inc.	N
Carilion Franklin Memorial Hospital	N
Carilion Giles Community Hospital	N
Carilion Healthcare Corporation	Y
Carilion Medical Center	Y
Carilion New River Valley Medical Center	N
Carilion Professional Services, LLC	N
Carilion Rockbridge Community Hospital (previously Carilion Stonewall Jackson Hospital)	N
Carilion Tazewell Community Hospital	N
Urology Associates, Ltd.	N

ACO Governing Body:

Member First Name	Member Last Name	Member Title/Position	Member's Voting Power (Expressed as a percentage)	Membership Type	ACO Participant Legal Business Name, if Applicable
John	Epling, M.D.	Chair	10%	ACO Participant Representative	Carilion Healthcare Corporation
M. Suzanne	Kraemer, M.D.	ACO Board Member	9%	ACO Participant Representative	Carilion Medical Center
Stephen	Morgan, M.D.	ACO Board Member	9%	ACO Participant Representative	Carilion Medical Center
Robert	Trestman, M.D.	ACO Board Member	9%	ACO Participant Representative	Carilion Healthcare Corporation
Jeanne	Armentrout	ACO Board Member	9%	Medicare Beneficiary Representative	N/A
Zachary	Smith	ACO Board Member	9%	ACO Participant Representative	Carilion Healthcare Corporation
Paul	Davenport	ACO Board Member	9%	ACO Participant Representative	ACV, Inc.
William	Flattery	ACO Board Member	9%	ACO Participant Representative	Carilion New River Valley Medical Center
Donald	Halliwill	ACO Board Member	9%	ACO Participant Representative	Carilion Medical Center
Rawle (Tony)	Seupaul	ACO Board Member	9%	ACO Participant Representative	Carilion Medical Center
Roger	Roper	ACO Board Member	9%	ACO Participant Representative	Carilion Healthcare Corporation

Key ACO Clinical and Administrative Leadership:
ACO Executive: John W. Epling, M.D.
Medical Director: John W. Epling, M.D.
Compliance Officer: Kristin Meador
Quality Assurance/Improvement Officer: Jason Semones

Associated Committees and Committee Leadership:

Committee Name	Committee Leader Name and Position
Doctors Connected Specialty Council	Trevor M. Owen, M.D., Co-Chair, and Christopher P. Mertes, M.D., Co-Chair
Doctors Connected ACO Executive Committee	Zachary Smith, Interim Chair

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:
ACO professionals in a group practice arrangement
Networks of individual practices of ACO professionals
Hospital employing ACO professionals
Critical Access Hospital (CAH) billing under Method II
Rural Health Clinic (RHC)

Shared Savings and Losses

Amount of Shared Savings/Losses:

Third Agreement Period
- Performance Year 2024, $16,217,943
Second Agreement Period
- Performance Year 2023, $2,215,720
First Agreement Period
- Performance Year 2022, $2,988,804

Shared Savings Distribution:

Third Agreement Period
- Performance Year 2024
  - Proportion invested in infrastructure: 10%
  - Proportion invested in redesigned care processes/resources: 90%
  - Proportion of distribution to ACO participants: 0%
Second Agreement Period
- Performance Year 2023
  - Proportion invested in infrastructure: 10%
  - Proportion invested in redesigned care processes/resources: 90%
  - Proportion of distribution to ACO participants: 0%
First Agreement Period
- Performance Year 2022
  - Proportion invested in infrastructure: 10%
  - Proportion invested in redesigned care processes/resources: 90%
  - Proportion of distribution to ACO participants: 0%

Quality Performance Results

2024 Quality Performance Results:

Quality performance results based on CMS Web Interface collection type.

Measure #	Measure Name	Collection Type	Reported Performance Rate	10th Percentile Benchmark	40th Percentile Benchmark
Quality ID# 001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control	eCQM	25.71%	93.62%	41.62%
Quality ID# 134	Preventative Care and Screening for Depression and Follow-up Plan	eCQM	29.21%	N/A	31.79%
Quality ID# 236	Controlling High Blood Pressure	eCQM	68.34%	45.28%	65.61%
Quality ID# 321	CAHPS for MIPS	CAHPS for MIPS Survey	7.84	N/A	6.44
Measure# 479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups	Administrative Claims	0.1479	0.1671	0.1538
Measure# 484	Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions	Administrative Claims	-	47.58	37.70

Measure #	Measure Name	Collection Type	Reported Performance Rate	Current Year Mean Performance Rate (SSP ACOs)
CAHPS-1	Getting Timely Care, Appointments, and Information	CAHPS for MIPS Survey	83.62	83.70
CAHPS-2	How Well Providers Communicate	CAHPS for MIPS Survey	95.42	93.96
CAHPS-3	Patient's Rating of Provider	CAHPS for MIPS Survey	94.08	92.43
CAHPS-4	Access to Specialists	CAHPS for MIPS Survey	69.73	75.76
CAHPS-5	Health Promotion and Education	CAHPS for MIPS Survey	66.32	65.48
CAHPS-6	Shared Decision Making	CAHPS for MIPS Survey	61.41	62.31
CAHPS-7	Health Status and Functional Status	CAHPS for MIPS Survey	75.31	74.14
CAHPS-8	Care Coordination	CAHPS for MIPS Survey	88.03	85.89
CAHPS-9	Courteous and Helpful Office Staff	CAHPS for MIPS Survey	95.29	92.89
CAHPS-11	Stewardship of Patient Resources	CAHPS for MIPS Survey	28.53	26.98

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.