MSSP public reporting ACO Name and Location:

North Shore-LIJ MSSP ACO, LLC d/b/a Northwell Health ACO
2000 Marcus Avenue
New Hyde Park, New York 11042

ACO Primary Contact:

Mr. Terry Lynam
Chief Public Relations Officer, Northwell Health
(516) 321-6702
tlynam@northwell.edu

Organizational Information: ACO Participants:

*Participants involved in a joint venture are identified by a * next to their names on the participant list.

ACO Participants in Joint Ventures Between ACO Professionals and Hospitals:

N/A

ACO Governing Body:

Key ACO Clinical and Administrative Leadership:

Executive Director

Amato Amarain

Medical Director

Sandy Balwan, MD, FACP

Compliance Officer

Aaron Lund, JD, LL.M

Quality Assurance/Improvement Officer

Lisa Sokoloff, RN, MS

Associated Committees and Committee Leadership:

Performance and Distribution Committee

Chairperson:

Mark Siegelheim, MD

Members:

Patrick Corcoran, MD
Steven Geier, MD
Mitchel Jacobs, MD
Joel Laxer, MD
Louis Potters, MD

Clinical Performance and Quality Committee

Chairperson:

Yashodhara Kirtane, MD

Members:

Patrick Burns, MD
Barry Cohen, MD
Sandy Balwan, M

Network Composition and Credentialing Committee

Chairperson:

Patrick Corcoran, MD

Members:

Barry Cohen, MD
Steven Geier, MD
Jaydeep Kadam, MD
Yashodhara Kirtane, MD
Mark Siegelheim, MD

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

• ACO professionals in group practice arrangements
• Networks of individual practices of ACO professionals
• Hospitals employing ACO professionals
• Partnerships or Joint Venture arrangements between hospitals and ACO professionals

Shared Savings and Losses:

Amount of Shared Savings/Losses

• First Agreement Period

• • Performance Year 2017, $0
  • Performance Year 2016, $0

Shared Savings Distribution

• First Agreement Period

• • Performance Year 2017
    • 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 2016

• • • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A

Payment Rule Waivers

• No, our ACO does not utilize the SNF 3-Day Rule Waiver.

2017 Quality Performance Results

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples and the ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes quality measure is not included in public reporting due to a non-material technical error.

• For 2017 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2017-Shared-Savings-Program-SSP-Accountable-Care-O/gk7c-vejx/data
• For 2016 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2016-Shared-Savings-Program-SSP-Accountable-Care-O/3jk5-q6dr/data

Note: In the Quality Performance Results file(s) above, search for “North Shore-LIJ MSSP ACO, LLC” or “Northwell Health ACO” to view the quality performance results. This ACO can also be found by using the ACO ID A22038 in the public use files on data.cms.gov.

Participation waiver disclosure

The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that may otherwise limited innovation by ACOs participating in the Medicare Shared Savings Program (“MSSP”). See Final Waivers in Connection With the Shared Savings Program, 79 Fed. Reg. 62356 (Oct. 17, 2014) (“Interim Final Rule”). Pursuant to the Interim Final Rule, North Shore-LIJ MSSP ACO, Inc. (the “ACO”) seeks waiver protection for the arrangement described below:

The ACO has entered into an agreement with Northwell Health to provide a broad range of necessary management services and operational personnel to support the ACO’s operations as an ACO in the MSSP. Under the arrangement, the ACO shall compensate Northwell Health from any shared savings payments for its provision of management services, including but not limited general day-to-day operational personnel and services, financial management and accounting services, and credentialing.

The ACO’s governing body, consistent with its obligations under 42 C.F.R. § 425.106(b)(3), has made and duly authorized a bona fide determination on August 23, 2016 that the arrangement is reasonably related to the purposes of the Medicare Shared Savings Program, including, specifically, promoting accountability for the quality, cost, and overall care for a Medicare population and aiding the ACO in managing and coordinating care for Medicare fee-for-service beneficiaries.

Posted: August 23, 2016

Resources

Quality Payment Program
Webinars and Events
Provider Information for New Medicare Cards
Beneficiary Video for New Medicare Cards
Northwell Health ACO Participation Poster (must be publicly displayed in ACO participant offices)
Beneficiary Information Notice