ACO Name and Location:
Coastal Carolina Quality Care, Inc.
1020 Medical Park Avenue
New Bern, North Carolina 28562
ACO Primary Contact:
Primary Contact Name |
Carrie Hagan |
Primary Contact Phone Number |
252-633-4111 |
Primary Contact Email Address |
Organizational Information:
ACO Participants:
ACO Participants |
ACO Participant in Joint Venture (Enter Y or N) |
Coastal Carolina Health Care, P.A. |
N |
Eastern Carolina Womens Center, P.A. |
N |
Crystal Coast Pain Management Center, PLLC |
N |
ACO Governing Body:
First Name |
Last Name |
Title/Position |
Voting Power |
Membership Type |
ACO Participant TIN Legal Business Name |
Kenneth |
Wilkins, Jr. |
President and Chief Medical Officer |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
E. Phillip |
Bounous, Jr. |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Martin |
DeGraw |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Kevin |
French |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Richard |
Gorman |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Wood |
Gibbs |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Wright |
Shields |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Staley |
Moore |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Michael |
Casciello |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Joseph |
Overby |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Kent |
Lucas |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Suman |
Lamsal |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Ronald |
Lather |
Member |
6.66% |
ACO Participant Representative |
Coastal Carolina Health Care, P.A. |
Stewart |
Smith |
Member |
6.66% |
Medicare Beneficiary Representative |
N/A |
Kirk |
Harum |
Member |
6.66% |
ACO Participant Representative |
Crystal Coast Pain Management Center, PLLC |
Key ACO Clinical and Administrative Leadership:
Stephen Nuckolls |
ACO Executive |
Kenneth W. Wilkins, Jr., M.D. |
President and Chief Medical Officer |
Carrie Hagan |
Compliance Officer |
Kenneth W. Wilkins, Jr. M.D. |
Quality Assurance/Improvement Chair |
Associated Committees and Committee Leadership:
Committee Name |
Committee Leader Name and Position |
Quality Assurance and Improvement Committee |
Kenneth W. Wilkins, Jr., M.D. Chairman |
Types of ACO participants, or combinations
of participants, that formed the ACO:
ACO professionals in a group practice arrangement
Shared Savings and Losses
Amount of Shared Savings/Losses
- Second Agreement Period
- ⚬ Performance Year 2017, $3,370,629
- ⚬ Performance Year 2016, $2,236,944
- First Agreement Period
- ⚬ Performance Year 2015, $0
- ⚬ Performance Year 2014, $0
- ⚬ Performance Year 2013, $0
Shared Savings Distribution
- Second Agreement Period
- ⚬ Performance Year 2017
- » Proportion invested in infrastructure: 29%
- » Proportion invested in redesigned care processes/resources: 20%
- » Proportion of distribution to ACO participants: 51%
- ⚬ Performance Year 2016
- » Proportion invested in infrastructure: 20%
- » Proportion invested in redesigned care processes/resources: 80%
- » Proportion of distribution to ACO participants: 0%
- First Agreement Period
- ⚬ Performance Year 2015
- » 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 2014
- » 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 2013
- » 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.
Quality Performance Results:
2017 Quality Performance Results:
ACO# |
Measure Name |
Rate |
ACO Mean |
ACO-1 |
CAHPS: Getting Timely Care, Appointments, and Information |
80.53 |
80.60 |
ACO-2 |
CAHPS: How Well Your Providers Communicate |
93.21 |
93.13 |
ACO-3 |
CAHPS: Patients' Rating of Provider |
93.44 |
92.31 |
ACO-4 |
CAHPS: Access to Specialists |
84.88 |
83.32 |
ACO-5 |
CAHPS: Health Promotion and Education |
65.84 |
62.30 |
ACO-6 |
CAHPS: Shared Decision Making |
72.95 |
75.85 |
ACO-7 |
CAHPS: Health Status/Functional Status |
73.19 |
73.05 |
ACO-34 |
CAHPS: Stewardship of Patient Resources |
28.62 |
25.68 |
ACO-8 |
Risk-Standardized, All Condition Readmission |
13.93 |
15.01 |
ACO-35 |
Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) |
17.91 |
18.46 |
ACO-36 |
All-Cause Unplanned Admissions for Patients with Diabetes |
39.90 |
53.95 |
ACO-37 |
All-Cause Unplanned Admissions for Patients with Heart Failure |
65.05 |
79.16 |
ACO-38 |
All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions |
47.71 |
61.74 |
ACO-43 |
Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) |
1.35 |
1.93 |
ACO-11 |
Use of Certified EHR Technology |
100.00 |
98.48 |
ACO-12 |
Medication Reconciliation |
78.93 |
75.32 |
ACO-13 |
Falls: Screening for Future Fall Risk |
86.44 |
74.38 |
ACO-44 |
Imaging Studies for Low Back Pain |
48.00 |
67.32 |
ACO-14 |
Preventive Care and Screening: Influenza Immunization |
88.36 |
72.52 |
ACO-15 |
Pneumonia Vaccination Status for Older Adults |
93.79 |
72.92 |
ACO-16 |
Preventive Care & Screening: Body Mass Index (BMI) Screening & Follow Up |
90.21 |
70.69 |
ACO-17 |
Preventive Care & Screening: Tobacco Use: Screening & Cessation Intervention |
98.53 |
90.48 |
ACO-18 |
Preventive Care & Screening: Screening for Clinical Depression & Follow-up Plan |
85.35 |
61.98 |
ACO-19 |
Colorectal Cancer Screening |
87.09 |
64.58 |
ACO-20 |
Breast Cancer Screening |
92.00 |
70.05 |
ACO-42 |
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease |
87.76 |
79.89 |
ACO-27 |
Diabetes Mellitus: Hemoglobin A1c Poor Control |
7.85 |
16.74 |
ACO-41 |
Diabetes: Eye Exam |
80.63 |
50.37 |
ACO-28 |
Hypertension (HTN): Controlling High Blood Pressure |
84.09 |
71.47 |
ACO-30 |
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic |
96.23 |
86.86 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.
- 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
- For 2015 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/x8va-z7cu/data
- For 2014 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/ucce-hhpu/data
- For 2013 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/yuq5-65xt/data
Note: In the Quality Performance Results file(s) above, search for “Coastal Carolina Quality Care, Inc.” to view the quality performance results. This ACO can also be found by using the ACO ID A76034 in the public use files on data.cms.gov.