• 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.

Byrd

David E.

 

Voting

Member

Coastal Carolina Health Care, P.A.

Maybee

David B.

 

Voting

Member

Coastal Carolina Health Care, P.A.

Fujimagari

Michael M.

 

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.

Willi

Marc C.

 

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 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 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

81.38

80.51

ACO-2

CAHPS: How Well Your Providers Communicate

92.37

93.01

ACO-3

CAHPS: Patients' Rating of Provider

92.63

92.25

ACO-4

CAHPS: Access to Specialists

82.21

83.49

ACO-5

CAHPS: Health Promotion and Education

66.64

60.32

ACO-6

CAHPS: Shared Decision Making

74.65

75.40

ACO-7

CAHPS: Health Status/Functional Status

74.12

72.30

ACO-34

CAHPS: Stewardship of Patient Resources

38.65

26.97

ACO-8

Risk-Standardized, All Condition Readmission

13.96

14.70

ACO-35

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

17.43

18.17

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

38.64

53.20

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

55.06

75.23

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

44.80

59.81

ACO-9

Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)

4.91

9.27

ACO-10

Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 )

12.21

14.53

ACO-11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

100.00

82.72

ACO-39

Documentation of Current Medications in the Medical Record

99.91

87.54

ACO-13

Falls: Screening for Future Fall Risk

85.71

64.04

ACO-14

Preventive Care and Screening: Influenza Immunization

89.69

68.32

ACO-15

Pneumonia Vaccination Status for Older Adults

90.10

69.21

ACO-16

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

85.71

74.45

ACO-17

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

98.04

90.98

ACO-18

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

82.09

53.63

ACO-19

Colorectal Cancer Screening

90.80

61.52

ACO-20

Breast Cancer Screening

93.14

67.61

ACO-21

Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented

90.10

76.79

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

87.84

77.72

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

7.24

18.24

ACO-41

Diabetes: Eye Exam  

82.07

44.94

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

82.80

70.69

ACO-30

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

94.92

85.05

ACO-31

Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

100.00

88.67

ACO-33

Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)

95.52

79.67

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.