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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.

Resources

For more information on the CMS ACO Models, the following resources are available:

Medicare  Medicare.gov

(800) MEDICARE (800-633-4227)
24 hours a day/7 days a week.
TTY users should call (877) 486-2048

Bluestone ACO BluestoneACO@bluestonemd.com 

Toll Free: 877-599-1039

2022 Beneficiary Handouts
Medicare Beneficiary Handout English Spanish
Practice Notice English Spanish
Voluntary Alignment Notice English Spanish

ACO Name and Location
Bluestone ACO
9822 Tapestry Park Circle
Suite 208
Jacksonville, Florida 33246

ACO Primary Contact

Nate Hunkins
P: 612-916-4497
E: Nate.Hunkins@bluestonemd.com

Organizational Information

ACO Participants:

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

Last Name

Member

First Name

Member

Title/Position

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
Weinke Katie ACO COO 31.66% Participant Representative Bluestone Physician Services WI, SC
Bergen Brad Beneficiary POA 5% Beneficiary Representative
Stivland Todd Medical Director 0% Other
Keenan Sarah Chief Clinical Officer 0% Other
Jarrett Martha Director of Care Management 0% Other
Waks Jessie VP of Clinical Practice 0% Other
Daitz Mitchell Operational Consultant 0% Other
Levy Candice Compliance Officer 0% Other
Ryan Joanne Compliance Consultant 0% Other
Reuland Stacey Beneficiary POA 0% Other

 

Key ACO Clinical and Administrative Leadership

Nate Hunkins ACO Executive 
Todd Stivland Medical Director
Joanne Ryan Compliance Officer
Nate Hunkins Quality Assurance/Improvement Officer
 

Associated Committees and Committee Leadership

Committee Name Committee Leader Name and Position
Value Based Care Committee Nate Hunkins, ACO Executive
Executive & Finance Committee David Nelsen, CFO

Types of ACO Participants, or Combinations of Participants, that Formed the ACO:

  • Networks of Individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

● First Agreement Period

  • Performance Year 1 – 2020, $2,968,632.55
  • Performance Year 2 – 2021, $7,145,172.23

Shared Savings Distribution:

● First Agreement Period
o Performance Year 2020
▪ Proportion invested in infrastructure: 50%
▪ Proportion invested in redesigned care processes/resources: 50%
▪ Proportion of distribution to ACO participants: 0%

Performance Year 2021

  • Proportion invested in infrastructure: 47
  • Proportion invested in redesigned care processes/resources: 47%
  • Proportion of distribution to ACO participants: 6%

Quality Performance Results

2021 Quality Performance Results:

ACO Quality Measure Number Measure Name Rate ACO Mean
001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control2 22.20 37.48
134 Preventative Care and Screening: Screening for Depression and Follow-up Plan 73.09 51.07
236 Controlling High Blood Pressure 70.15 66.86
479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2 14% 15%
MCC1 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2 43.31 33.99
CAHPS-1 Getting Timely Care, Appointments, and Information 68.76 84.67
CAHPS-2 How Well Providers Communicate 79.30 93.56
CAHPS-3 Patient’s Rating of Provider 82.01 92.19
CAHPS-4 Access to Specialists 76.60 78.80
CAHPS-5 Health Promotion and Education 61.24 61.61
CAHPS-6 Shared Decision Making 53.89 60.89
CAHPS-7 Health Status and Functional Status 49.48 71.78
CAHPS-8 Care Coordination 74.80 85.66
CAHPS-9 Courteous and Helpful Office Staff 75.91 91.88
CAHPS-11 Stewardship of Patient Resources 18.39 24.71

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.

 

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