ACO Public Reporting Information for Southern Illinois

ACO Name & Location

SSM IL ACO, LLC
10101 Woodfield Lane
St. Louis, MO 63132

ACO Primary Contact

Lisa Crouch
618-436-8564
Email: lisa.crouch@ssmhealth.com

Organizational Information

ACO Participants

ACO ParticipantsACO Participant in Joint Venture
Physicians Services Corporation of Southern IL, Inc.
(SSM Health Medical Group)
Y
County of Clay
(Clay County Hospital)
Y
Washington County Hospital District
(Washington County Hospital)
Y
Maamoun JunidiY

ACO Governing Body

Member First NameMember Last NameMember Title or PositionMember's Voting Power (expressed as a percentage)Membership TypeACO Participant Legal Business Name and D/B/A, if applicable
JayceenEnsrudeVoting Member & Chair, SSM Health14.3%ACO Participant RepresentativePhysicians Services Corporation of Southern IL, Inc. (SSM Health Medical Group)
SudeepNair, MDVoting Member14.3%ACO Participant RepresentativePhysicians Services Corporation of Southern IL, Inc. (SSM Health Medical Group)
RalphLatta, MDVoting Member14.3%ACO Participant RepresentativePhysicians Services Corporation of Southern IL, Inc. (SSM Health Medical Group)
VishnuMohan, MDVoting Member14.3%ACO Participant RepresentativePhysicians Services Corporation of Southern IL, Inc. (SSM Health Medical Group)
BrandonCycholl, MDVoting Member14.3%ACO Participant RepresentativeCounty of Clay (Clay County Hospital)
GingerFewell, MDVoting Member14.3%ACO Participant RepresentativeWashington County Hospital District (Washington County Hospital)
WendyLupaVoting Member14.3%Medicare Beneficiary RepresentativeN/A

Key ACO Clinical & Administrative Leadership

  • ACO Executive: Jayceen Ensrude
  • Medical Director: Sudeep Nair, MD
  • Compliance Officer: Angela Distler
  • Quality Assurance/Improvement Officer: Lisa Crouch, RN

Associated Committees & Committee Leadership

Committee NameCommittee Leader Name & Position
Finance CommitteeJohn Snodsmith, CFO, Regional Vice President of Finance
Quality Assurance and Improvement CommitteeLisa Crouch, RN-Director, Quality Assurance/Improvement Officer
Compliance CommitteeAngela Distler, Director Corporate Responsibility, Compliance Officer

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

  • ACO professionals in a group practice arrangement
    Critical Access Hospital (CAH) billing under Method II

Shared Savings and Losses

Amount of Shared Savings / Losses:

  • Third Agreement Period
    • Performance Year 2022, $1,465,602.01
  • Second Agreement Period
    • Performance Year 2021, $910,954.10
  • First Agreement Period
    • Performance Year 2020, $1,131,015.42

Shared Savings Distribution:

  • Third Agreement Period
    • Performance Year 2022
      • Proportion invested in infrastructure: 60%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 40%
  • Second Agreement Period
    • Performance Year 2021
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 70%
  • First Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 36%
      • Proportion invested in redesigned care processes/resources: 14%
      • Proportion of distribution to ACO participants: 50%

Quality Performance Results

2022 Quality Performance Results

Quality performance results are based on CMS Web Interface Measure Set.

Measure #Measure NameCollection RateRateACO Mean
0001Diabetes: Hemoglobin A1c (HbA1c) Poor ControlCMS Web Interface14.1010.71
134Preventative Care and Screening: Screening for Depression and Follow-Up PlanCMS Web Interface96.7976.16
236Controlling High Blood PressureCMS Web Interface67.9674.87
318Falls: Screening for Future Fall RiskCMS Web Interface85.8887.803
110Preventative Care and Screening: Influenza ImmunizationCMS Web Interface64.0777.34
226Preventative Care and Screening: Tobacco Use: Screening and Cessation InterventionCMS Web Interface70.9379.27
113Colorectal Cancer ScreeningCMS Web Interface56.2875.32
112Breast Cancer ScreeningCMS Web Interface72.378.07
438Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseCMS Web Interface73.5186.37
370Depression Remission at Twelve MonthsCMS Web Interface14.2916.03
321CAHPS for MIPSCAHPS for MIPS SurveyN/AN/A
479Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS GroupsAdministrative Claims0.1739.0151
MCC1All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)Administrative Claims36.2130.97
CAHPS-1Getting Timely Care, Appointments, and InformationCAHPS for MIPS Survey87.2583.96
CAHPS-2How Well Providers CommunicateCAHPS for MIPS Survey95.2793.47
CAHPS-3Patient's Rating of ProviderCAHPS for MIPS Survey92.492.06
CAHPS-4Access to SpecialistsCAHPS for MIPS Survey81.977
CAHPS-5Health Promotion and EducationCAHPS for MIPS Survey65.7462.68
CAHPS-6Shared Decision MakingCAHPS for MIPS Survey66.260.97
CAHPS-7Health Status and Functional StatusCAHPS for MIPS Survey71.373.06
CAHPS-8Care CoordinationCAHPS for MIPS Survey88.185.46
CAHPS-9Courteous and Helpful Office StaffCAHPS for MIPS Survey95.3491.97

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. 
  • Waiver for Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR §425.612(f) and 42 CFR §425.613.

Fraud and Abuse Waivers

  • ACO Pre-Participation Waiver: N/A
  • ACO Participation Waiver: N/A

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