• 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.

Previous Names: N/A
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, PLLC

N

ACO Governing Body:

First Name

Last Name

Title/Position

Voting Power

Membership Type

ACO Participant TIN Legal Business Name

Kenneth

Wilkins, Jr.

Medical Director

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.

Byrd

David

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.

Medical Director

Carrie Hagan

Compliance Officer

Kenneth W. Wilkins, Jr. M.D.

Quality Assurance/Improvement Officer

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 2018, $3,297,943
  • ⚬ 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 2018
  • » Proportion invested in infrastructure: 24.5%
  • » Proportion invested in redesigned care processes/resources: 10.2%
  • » Proportion of distribution to ACO participants: 65.3%
  • ⚬ 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

Quality Performance Results:

2018 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

87.92

86.14

ACO-2

CAHPS: How Well Your Providers Communicate

93.92

93.93

ACO-3

CAHPS: Patients' Rating of Provider

92.55

92.45

ACO-4

CAHPS: Access to Specialists

83.33

81.50

ACO-5

CAHPS: Health Promotion and Education

64.52

59.26

ACO-6

CAHPS: Shared Decision Making

65.38

61.94

ACO-7

CAHPS: Health Status/Functional Status

75.36

73.35

ACO-34

CAHPS: Stewardship of Patient Resources

29.93

26.26

ACO-8

Risk-Standardized, All Condition Readmission

14.76

14.98

ACO-35

Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)

18.74

18.59

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

29.41

37.01

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

73.83

76.75

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

52.96

59.00

ACO-43

Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))

1.62

1.98

ACO-11

Use of Certified EHR Technology

100.00

98.20

ACO-12

Medication Reconciliation Post-Discharge

87.97

85.91

ACO-13

Falls: Screening for Future Fall Risk

84.69

79.73

ACO-44

Use of Imaging Studies for Low Back Pain

83.33

64.36

ACO-14

Preventive Care and Screening: Influenza Immunization

86.81

72.71

ACO-15

Pneumonia Vaccination Status for Older Adults

90.73

75.97

ACO-16

Preventive Care & Screening: Body Mass Index (BMI) Screening & Follow Up

81.10

76.83

ACO-17

Preventive Care & Screening: Tobacco Use: Screening & Cessation Intervention

93.75

72.81

ACO-18

Preventive Care & Screening: Screening for Clinical Depression & Follow-up Plan

85.42

66.74

ACO-19

Colorectal Cancer Screening

86.33

68.27

ACO-20

Breast Cancer Screening

91.46

71.96

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

87.39

81.47

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

7.39

15.51

ACO-41

Diabetes: Eye Exam

68.14

52.42

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

90.68

73.10

ACO-30

Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

90.04

88.92

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.