Medicare Shared Savings Program

ACO Name and Location

Essentia Health
Previous Names: N/A
502 E Second Street
Duluth, Minnesota 55805

ACO Primary Contact

Primary Contact Name Jessica Martensen
Primary Contact Phone Number 218-786-6611
Primary Contact Email Address Jessica.Martensen@EssentiaHealth.org

Organizational Information

ACO participants:

ACO Participants ACO Participant in Joint Venture (Enter Y or N)
Bridges Medical Center N
Innovis Health, LLC N
Brainerd Medical Center, Inc. N
Polinsky Medical Rehabilitation Center N
St. Joseph's Medical Center N
St. Mary's Medical Center N
First Care Medical Services N
Graceville Health Center N
Northern Pines Medical Center N
Deer River Healthcare Center, Inc. N
The Duluth Clinic, Ltd. N
St. Marys Regional Health Center N
St. Mary's Hospital of Superior N
Essentia Health - Moose Lake N
SMDC Medical Center N
Pine Medical Center N
Essentia Health Virginia, LLC N

ACO governing body:

Member Member's Voting Power - Expressed as a percentage or number Membership Type ACO Participant Legal Business Name/DBA, if Applicable
Last Name First Name Title/Position
Ager Dean Member 1 Medicare Beneficiary Representative N/A
Anderson James Member 1 Community Stakeholder Representative N/A
Gaddie David Chair 1 Community Stakeholder Representative N/A
Gefroh Ellison Stefanie Member 1 ACO Participant Representative Innovis Health, LLC
Goldfarb George Member 1 Community Stakeholder Representative n/A
Herman David Ex-Officio Member 0 ACO Participant Representative The Duluth Clinic, Ltd.
Hodnik Al Member 1 Community Stakeholder Representative N/A
Hofer Kathleen Member 1 Community Stakeholder Representative N/A
Leino Walt Member 1 Medicare Beneficiary Representative N/A
Lewandowski Laurie Member 1 Medicare Beneficiary Representative N/A
Moug Kevin Member 1 Community Stakeholder Representative N/A
Raway Beverly Member 1 Community Stakeholder Representative N/A
Ronnei Mark Member 1 Community Stakeholder Representative N/A
Rudd Jane Member 1 ACO Participant Representative The Duluth Clinic, Ltd.
Stokes Kimberly Member 1 Community Stakeholder Representative N/A
Trettel Claire Marie Member 1 Community Stakeholder Representative N/A

Key ACO clinical and administrative leadership:

David Herman ACO Executive
Michael Van Scoy Medical Director
Torri Schramm Compliance Officer
Jessica Martensen Quality Assurance/Improvement Officer

Associated committees and committee leadership:

Committee Name Committee Leader Name and Position
Quality Committee Dan Collins, Chair
Population Health Committee Michael Van Scoy, Chair
Clinical Practice Committee Peter Henry, Chair
Compliance Committee Torri Schramm, Chair

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

  • Critical Access Hospital (CAH) billing under Method II
  • ACO professionals in a group practice arrangement
  • Hospital employing ACO professionals
  • Rural Health Clinic (RHC)

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Third Agreement Period
    • Performance Year 2020, $10,619,537
    • Performance Year 2019 & 2019A, $9,542,017
  • Second Agreement Period
    • Performance Year 2018, $0
    • Performance Year 2017, $2,837,135
    • Performance Year 2016, $0
  • First Agreement Period
    • Performance Year 2015, $0
    • Performance Year 2014, $0
    • Performance Year 2013, $0

Shared Savings Distribution

  • Third Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesign care processes/resources: 40%
      • Proportion of distribution to ACO participants: 40%
    • Performance Year 2019 & 2019A
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 40%
      • Proportion of distribution to ACO participants: 40%
  • Second Agreement Period
    • 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
    • Performance Year 2017
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 40%
      • Proportion of distribution to ACO participants: 40%
    • Performance Year 2016
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
  • First Agreement Period
    • Performance Year 2015
      • 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 2014
      • 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 2013
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A

Note: Our ACO participated in multiple performance year during Calendar Year 2019. Shared savings/losses amount reporting for Performance year 2019 therefore represent 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.

Quality Performance Results

2020 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-8 Risk Standardized, All Condition Readmission 14.30 15.07
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 47.15 49.50
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91) 1.04 0.95
ACO-13 Falls: Screening for Future Fall Risk 94.41 84.97
ACO-14 Preventative Care and Screening: Influenza Immunization 72.95 76.03
ACO-17 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention 92.05 81.67
ACO-18 Preventative Care and Screening: Screening for Clinical Depression and Follow-up Plan 94.89 71.46
ACO-19 Colorectal Cancer Screening 86.22 72.59
ACO-20 Breast Cancer Screening 81.88 74.05
ACO-42 Statin Therapy for the Prevention of Cardiovascular Disease 87.08 83.37
ACO-27 Diabetes: Hemoglobin A1c Poor Control (>9%) 14.81 14.70
ACO-28 Controlling High Blood Pressure 83.75 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.
  • For Previous Years' Financial and Quality Performance Results, please visit data.cms.gov
  • This ACO can also be found by using the ACO ID A1066 in the public use files on data.cms.gov

Payment Rule Waivers

  • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR 425.612.

Preferred Network

Learn more about our preferred network.

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