Bluestone Accountable Care Organization (ACO)
Bluestone Physician Services is participating in Bluestone ACO, an Accountable Care Organization. An ACO is a group of health care providers that work together to improve the quality and experience of care you receive. ACOs receive a portion of any savings that result from reducing costs and meeting quality requirements. Beneficiaries that are included in this population are those that have fee-for-service Medicare or Original Medicare.
What you need to know
- Medicare evaluates how well each ACO meets these goals every year. Those ACOs that do a good job can earn a financial bonus. ACOs that earn a bonus may use the payment to invest more in your care or share a portion directly with your providers. ACOs may owe a penalty if their care increases costs.
- Our participation in the Bluestone ACO doesn’t limit your choice of health care providers. Your Medicare benefits are not changing. You still have the right to visit any doctor, hospital or other provider that accepts Medicare at any time, just like you do now.
- To help us coordinate your health care better, Medicare shares information about your care with your providers. If you wish to decline this sharing of information call 1-800-MEDICARE (1-800-633-4227).
- Questions? Contact Bluestone at 877-599-1039 or BluestoneACO@BluestoneMD.com.
For more information on the CMS ACO Models, the following resources are available:
(800) MEDICARE (800-633-4227)
Toll Free: 877-599-1039
Compliance Hotline: 612-367-7975
|2022 Beneficiary Handouts|
|Medicare Beneficiary Handout||English||Spanish|
|Voluntary Alignment Notice||English||Spanish|
ACO Name and Location
270 Main St N
ACO Primary Contact
|ACO Participants||ACO Participant in Joint Venture|
|Bluestone Physician Services FL LLC||N|
|Bluestone Physician Services PA||N|
|Bluestone Physician Services Wisconsin SC||N|
ACO Governing Body:
|Member’s Voting Power (Expressed as a percentage or number)||Membership Type||ACO Participant Legal Business Name and D/B/A, if applicable|
|Hunkins||Nate||ACO Executive||31.66%||Participant Representative||Bluestone Physician Services PA|
|Nelsen||David||CFO||31.66%||Participant Representative||Bluestone Physician Services FL, LLC|
|Jarrett||Martha||Director of Care Management||31.66%||Participant Representative||Bluestone Physician Services WI, SC|
|Bergen||Brad||Beneficiary POA||5%||Beneficiary Representative|
|Keenan||Sarah||Chief Clinical Officer||0%||Other|
|Jarrett||Martha||Director of Care Management||0%||Other|
|Waks||Jessie||VP of Clinical Practice||0%||Other|
|Fuhrmannek-Kloubec||Andrea||VP of Corporate Compliance||0%||Other|
Key ACO Clinical and Administrative Leadership
|ACO Executive: Nate Hunkins||ACO Executive|
|Medical Director: Rajiv Patel, MD||Medical Director|
|Compliance Officer: Andrea Fuhrmannek-Kloubec||Compliance Officer|
|Quality Assurance/Improvement Officer: Nate Hunkins||Quality Assurance/Improvement Officer|
Associated Committees and Committee Leadership
Types of ACO Participants, or Combinations of Participants, that Formed the ACO:
Shared Savings and Losses
Amount of Shared Savings/Losses:
● First Agreement Period
|ACO Quality Measure Number||Measure Name||Rate||ACO Mean|
|001||Diabetes: Hemoglobin A1c (HbA1c) Poor Control2||17.27||33.57|
|134||Preventative Care and Screening: Screening for Depression and Follow-up Plan||75.52||39.11|
|236||Controlling High Blood Pressure||76.64||69.64|
|479||Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2||0.1514||0.1510|
|484||Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions ||43.60||30.97|
|CAHPS-1||Getting Timely Care, Appointments, and Information||73.61||83.69|
|CAHPS-2||How Well Providers Communicate||86.39||92.06|
|CAHPS-3||Patient’s Rating of Provider||75.66||77.00|
|CAHPS-4||Access to Specialists||58.13||62.68|
|CAHPS-5||Health Promotion and Education||56.62||60.97|
|CAHPS-6||Shared Decision Making||43.89||73.06|
|CAHPS-7||Health Status and Functional Status||72.67||85.46|
|CAHPS-9||Courteous and Helpful Office Staff||15.49||91.97|
|CAHPS-11||Stewardship of Patient Resources||15.49||25.62|
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers of Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO 38-Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19)- public health emergency (PHE) on these measures.
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: None
- ACO Participation Waiver: None