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
|2021 Beneficiary Handouts|
|Medicare Beneficiary Handout||English||Spanish|
|Voluntary Alignment Notice||English||Spanish|
ACO Name and Location
9822 Tapestry Park Circle
Jacksonville, Florida 33246
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|
|Koehler||Tim||Chairman/Chief Executive Officer||23.75%||Participant Representative||Bluestone Physician Services PA|
|Keenan||Sarah||Co-Chairman/COO||23.75%||Participant Representative||Bluestone Physician Services WI, SC|
|Stivland||Todd||Medical Director||23.75%||Participant Representative||Bluestone Physician Services PA|
|Nelsen||David||CFO||23.75%||Participant Representative||Bluestone Physician Services FL, LLC|
|Hunkins||Nate||Quality Assurance/Improvement Officer||0%||Other|
|Levy||Candice||Senior VP of Clinical Services||0%||Other|
|Bergen||Brad||Beneficiary POA||2.5%||Beneficiary Representative|
|Reuland||Stacey||Beneficiary POA||2.5%||Beneficiary Representative|
Key ACO Clinical and Administrative Leadership
|Tim Koehler||ACO Executive|
|Todd Stivland||Medical Director|
|Joanne Ryan||Compliance 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|
|ACO-43||Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))||0.84||0.95|
|ACO-13||Falls: Screening for Future Fall Risk||76.98||84.97|
|ACO-14||Preventive Care and Screening: Influenza Immunization||57.60||76.03|
|ACO-17||Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention||95.45||81.67|
|ACO-18||Preventive Care and Screening: Screening for Depression and Follow-up Plan||47.98||71.46|
|ACO-19||Colorectal Cancer Screening||15.94||72.59|
|ACO-20||Breast Cancer Screening||2.84||74.05|
|ACO-42||Statin Therapy for the Prevention and Treatment of Cardiovascular Disease||67.07||83.37|
|ACO-27||Diabetes Mellitus: Hemoglobin A1c Poor Control||29.41||14.70|
|ACO-28||Hypertension (HTN): Controlling High Blood Pressure||69.94||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. 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.
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.