MSSP Public Reporting

Public Reporting

ACO Name and Location
Prisma Health Midlands Network, LLC
Previous Names: Palmetto Health Quality Collaborative, LLC

1301 Taylor Street
STE 9A
Columbia, South Carolina 29201

ACO Primary Contact
Tami Swart
803-296-6315

Tamara.Swart@prismahealth.org

Organizational Information

ACO Participants:

ACO Governing Body

Board of Managers

Due to rounding, “Member’s Voting Power” may not equal 100 percent.

Key ACO Clinical and Administrative Leadership

• ACO Executive: Anna Kay
• Medical Director: Bill Gerard, MD
• Compliance Officer: Scott Pietras
• Quality Assurance/Improvement Officer: Anna Kay

Associated Committees and Committee Leadership

Types of ACO participants, or combinations of participants, that formed the ACO

• ACO professionals in a group practice arrangement
• Federally Qualified Health Centers (FQHCs)
• Hospital Employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

• Second Agreement Period
  • Performance Year 2019: $1,673,163.57
  • Performance Year 2020: $1,756,523.86
  • Performance Year 2021: $0
  • Performance Year 2022: $0
• First Agreement Period
  • Performance Year 2016: $0
  • Performance Year 2017: $0
  • Performance Year 2018: $0
  • Performance Year 2019: $1,673,163.57

Note: Our ACO participated in multiple performance years during Calendar Year 2019. The shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Shared Savings Distribution

• Second Agreement Period
  • Performance Year 2022
    • Portion invested in infrastructure: N/A
    • Portion invested in redesigned care processes/resources: N/A
    • Portion of distribution to ACO participants: N/A
  • Performance Year 2021
    • Portion invested in infrastructure: N/A
    • Portion invested in redesigned care processes/resources: N/A
    • Portion of distribution to ACO participants: N/A
  • Performance Year 2020
    • Portion invested in infrastructure: 10%
    • Portion invested in redesigned care processes/resources: 10%
    • Portion of distribution to ACO participants: 80%
  • Performance Year 2019
    • Portion invested in infrastructure: 10%
    • Portion invested in redesigned care processes/resources: 10%
    • Portion of distribution to ACO participants: 80%
  • First Agreement Period
    • Performance Year 2019
      • Portion invested in infrastructure: 10%
      • Portion invested in redesigned care processes/resources: 10%
      • Portion of distribution to ACO participants: 80%
    • Performance Year 2018
      • Portion invested in infrastructure: N/A
      • Portion invested in redesigned care processes/resources: N/A
      • Portion of distribution to ACO participants: N/A
    • Performance Year 2017
      • Portion invested in infrastructure: N/A
      • Portion invested in redesigned care processes/resources: N/A
      • Portion of distribution to ACO participants: N/A
    • Performance Year 2016
      • Portion invested in infrastructure: N/A
      • Portion invested in redesigned care processes/resources: N/A
      • Portion of distribution to ACO participants: N/A
    • Note: Our ACO participated in multiple performance years during Calendar Year 2019. The distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Quality Performance Results

2022 Quality Performance Results

Quality performance results are based on CMS Web Interface.

For previous years’ Financial and Quality Performance Results, please visit data.cms.gov.

Payment Rule Waivers

• 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 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: Prisma Health Midlands Network, LLC and Prisma Health Midlands
• Date of the arrangement: September 29, 2020
• Items, services, goods, or facility provided: Education and Training Programs
• Date and nature of any amendments to the arrangement, if applicable: Not applicable at this time

• Parties to the arrangement: Prisma Health Midlands Network, LLC and Prisma Health Midlands
• Date of the arrangement: September 29, 2020
• Items, services, goods, or facility provided: Contact Center Services and Solutions
• Date and nature of any amendments to the arrangement, if applicable: Not applicable at this time

• Parties to the arrangement: Prisma Health Midlands Network, LLC and Prisma Health Midlands
• Date of the arrangement: September 29, 2020
• Items, services, goods, or facility provided: Information Technology Solutions
• Date and nature of any amendments to the arrangement, if applicable: Not applicable at this time

• Parties to the arrangement: Prisma Health Midlands Network, LLC and Prisma Health Midlands
• Date of the arrangement: February 24, 2021
• Items, services, goods, or facility provided: Physician Recruitment Services
• Date and nature of any amendments to the arrangement, if applicable: March 30, 2022 – Arrangement was amended to adjust cost-sharing amounts from a 50/50 split for financial expense to a 75/25 split, to allow Prisma Health to bear up to 75% of the financial expense for Recruitment services provided to ACO Participants by Prisma Health Personnel.

• Parties to the arrangement: Prisma Health Midlands Network, LLC and Prisma Health Midlands
• Date of the arrangement: May 26, 2021
• Items, services, goods, or facility provided: Supply Chain Management Services
• Date and nature of any amendments to the arrangement, if applicable: Not applicable at this time

• Parties to the arrangement: Prisma Health Midlands Network, LLC and Prisma Health Midlands
• Date of the arrangement: August 25, 2021
• Items, services, goods, or facility provided: Community Connect User Access Value-Based Agreement
• Date and nature of any amendments to the arrangement, if applicable: Not applicable at this time

• Parties to the arrangement: Prisma Health Midlands Network, LLC and Prisma Health Midlands
• Date of the arrangement: June 22, 2022
• Items, services, goods, or facility provided: Clinical Services Offerings

• Chronic Care Services: transitional care management and remote patient monitoring services with seamless enrollment, clinical staff communication, and claim submission through the “HealthSnap” platform or otherwise;
• Embedded Clinical Support: in-person or virtual pharmacists, nurse practitioners, medical assistants and other clinical staff from the CIN;
• Automated Patient Intake: digital intake and scheduling through the “Notable” platform or otherwise; and
• Automated Claim Submission Support: AI-enabled technology to reduce A/R days and claim denials.
• Date and nature of any amendments to the arrangement, if applicable: Not applicable at this time