• CCQC's Mission is to assist doctors in providing high quality and improved coordinated care for the patients they have been entrusted while reducing the growth in costs.

 

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

chagan@cchealthcare.com

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

N

ACO Governing Body:

Member

Member's Voting Power

Membership Type

ACO Participant TIN Legal Business Name/DBA, if Applicable

Last Name

First Name

Title/Position

Wilkins, Jr.

Kenneth W.

President and Chief Medical Officer

Voting

Member

Coastal Carolina Health Care, P.A.

Bounous, Jr.

E. Phillip

 

Voting

Member

Coastal Carolina Health Care, P.A.

DeGraw

Martin C.

 

Voting

Member

Coastal Carolina Health Care, P.A.

French

Kevin M.

 

Voting

Member

Coastal Carolina Health Care, P.A.

Gorman, Jr.

Richard F.

 

Voting

Member

Coastal Carolina Health Care, P.A.

Gibbs, M.D.

Wood

 

Voting

Member

Coastal Carolina Health Care, P.A.

Shields, M.D.

Wright

 

Voting

Member

Coastal Carolina Health Care, P.A.

Moore

Staley C.

 

Voting

Member

Coastal Carolina Health Care, P.A.

Casciello

Michael C.

 

Voting

Member

Coastal Carolina Health Care, P.A.

Overby

Joseph R.

 

Voting

Member

Coastal Carolina Health Care, P.A.

Lucas

Kent V.

 

Voting

Member

Coastal Carolina Health Care, P.A.

Lamsal, M.D.

Suman

 

Voting

Member

Coastal Carolina Health Care, P.A.

Smith

Stewart

Medicare Beneficiary Representative

Voting

Member

 

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:

Our ACO does not utilize the SNF 3-Day Rule Waiver.

Quality Performance Results:

2016 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.   

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.

Payment Rule Waivers

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