MSSP Waivers and Quality Measures

Medicare Pre-participation and/or Participation Waivers

MPCACO participates in the Medicare Shared Savings Program (MSSP) and as part of such participation takes advantage of the pre-participation and participation waivers afforded to it through the MSSP program. Specifically, MPCACO has utilized the MSSP pre-participation and/or participation waivers in connection with the following programs:

MPCACO has received MPCACO governing board approval that the various programs implemented by MPCACO, concerning its participation in the MSSP including, but not limited to, the savings distribution models it uses to distribute savings from the MSSP, meets the purposes of the MSSP and thus qualifies for participation waiver treatment under MSSP in the following specific instances:

1. Shared savings distributions with participating physicians (December 2014, December 2015 and October 2016)
2. Providing beneficiaries with supplies and services (July 2012 – present)
   Nurse Navigation Department of the MPCACO may distribute supplies such as blood pressure cuffs, medication containers, scales, etc. AND services such as cab vouchers, public transportation fees, fresh produce, etc. to MSSP beneficiaries.
3. Participators in the Baylor Scott and White Quality Alliance Aetna Whole Health Product (June 2015)

And the following specific instances where MPCACO has contracted with Methodist Health System to implement and oversee a project aimed at utilization of certain medical devices at Methodist Dallas Medical Center, Methodist Charlton Medical Center, Methodist Mansfield Medical Center and Methodist Richardson Medical Center:

1. Cardiac stent clinical integration project (April 5, 2013)
2. Spinal implant clinical integration project (April 23, 2014)
3. Hip-knee implants clinical integration project (April 23, 2014)
4. Electrophysiology (implantable cardiac devices) (August 27, 2014)
5. Endomecheanical Stapler Clinical Integration Project (March 26, 2015)
6. Hepatitis C Clinical Integration Agreement (January 2017)

And the Physician Key Leader Program, which MPCACO has contracted with Methodist Health System to implement and oversee, which provides key leaders on the Methodist Health System medical staff with education and training needed for such leaders to better guide the medical staff and MHS in their efforts to develop programs aimed at value based medical care and provider alignment. (July 23, 2014, August 27, 2015 and August 23, 2016)

And the Mayo Clinic Care Network Program, which MPCACO has contracted with Methodist Health System to implement and oversee, which provides physicians on the Methodist Health System medical staff with access to tools to assist in the delivery of care aimed at improving the quality of care available to patients of the Methodist Health System. (August 27, 2014)

And the Texas Accountable Care Provider Organization’s shared savings and shared risk programs which MPCACO participates in for purposes of developing and implementing population health programs and techniques that can be used to benefit patients of all types including patients who are beneficiaries of governmental health programs such as Medicare and Medicaid. (January 1, 2015)

Payment Rule Waivers

Our ACO does not utilize the Payment for Telehealth Services Waiver

Our ACO does not utilize the SNF 3-Day Rule Waiver

All programs described above were reviewed by and received MPCACO governing board approval and confirmation that such programs meet the purposes of the MSSP and thus qualify for participation waiver treatment under MSSP.

ACO Quality Measures

• Performance Year 1 – 3
• Performance Year 4 – 6

ACO Beneficiaries*

Information for Methodist Patient-Centered Accountable Care Organization (ACO) Patients

• Download Accountable Care Organizations and You: Frequently Asked Questions (FAQ) for People with Medicare
• Download What You Need to Know About the Methodist Patient-Centered ACO
• Download the Beneficiary Information Notice

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