Type of Waiver Utilized:
ACO Participation Waiver
All Parties Involved:
Christiana Care Quality Partners ACO
Christiana Care Quality Partners ACO Participants
Anticipated Program Start Date:
August 1, 2016
Description and Purpose of Arrangement:
Christiana Care Health System has invested in software to support its population health efforts, which includes participation in the Medicare Shared Savings Program through its wholly owned subsidiary, Christiana Care Quality Partners ACO. This software platform contains multiple modules that facilitate care coordination, closing gaps in care, trending cost and utilization, risk predictions, and a variety of other functions that contribute to improved quality, reduced cost and better health outcomes.
In order to provide more direct and immediate access to this information, CCQP ACO participants may be provided with a User ID and password. This could include clinical staff or their designees receiving access to one or more modules/functions within the overall platform based on the business need. To limit disclosure, access will be restricted to the patients who have a pre-existing relationship with a particular user’s practice. In the instance where a user has responsibility for the performance of an affiliated practice1, the user may also be granted access to patients who have a pre-existing relationship with an affiliated practice. Policies will be established regarding the creation, management, utilization and termination of these user accounts.
Financial Aspects of Arrangement:
Christiana Care Health System, the parent company of CCQP ACO, will finance the majority of expense associated with implementing, maintaining and optimizing this software platform. As indicated in the Facility Clinically Integrated Participant Agreement, facility participants may be asked to participate in cost sharing. Independent physician practice participants will assume no expense.
Items, services, facilities or goods covered by the arrangement:
This arrangement would provide CCQP ACO participants with access to a software application designed to support population health initiatives. It includes a variety of modules and functions, including but not limited to:
- Prompting and documenting care coordination services
- Identifying gaps in care based on standard or customized quality measurements and tracking closure of those gaps
- Utilizing a variety of information regarding the demographic and health information for an individual to determine their predictive risk of health problems
- Calculating utilization and spend information at the individual and aggregate level based on claims information received by CMS
Date and manner of the Governing Body’s Authorization:
1 A practice will be considered affiliated with an entity if the entity:
- Employs the healthcare providers working in the practice; or
- Owns or controls the practice; or
- Operates a clinically integrated network in which the practice participates; or
- And CCQP ACO mutually agree that the practice will be considered affiliated