ACO Name & Location
Emergent ACO, LLC
2323 N. John B Dennis Hwy
Kingsport, TN 37660
ACO Primary Contact
Primary Contact Name: Scott R. Fowler, J.D., M.D.
Primary Contact Phone: 423-857-2091
Primary Contact Email: scott.fowler@myhmg.com
Organizational Information
ACO Participants:
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
|---|---|
| Holston Medical Group, PC | Y |
| HealthStar Physicians, PC | Y |
| Iredell Physician Network, LLC | Y |
| RDMG Associates, PA | Y |
| Raleigh Durham Medical Group, PA | Y |
| Samina Yousuf, MD, PC | Y |
| Lieb Family Practice Inc | Y |
| Optimed Hospitalists | Y |
| Medical Care, PLLC | Y |
| Family Practice Associates of Taos | Y |
| La Familia Primary Care PC | Y |
| Schreiber Family Medicine LLC | Y |
| South Central Colfax County Special Hospital District | Y |
| Taos Medical Group PA | Y |
| Taos Whole Health Integrative Care LLC | Y |
| LifeCare Family Medicine of Bellevue, PC | Y |
ACO Governing Body:
PY 2025
| Member | Member's Voting Power – Expressed as a Percentage or Number |
Membership Type | ACO Participant Legal Business Name/DBA, if Applicable |
||
|---|---|---|---|---|---|
| Last Name | First Name | Title/Position | |||
| Fowler, J.D., M.D. | Scott | Director/President | 6.25% | ACO Participant Representative | Holston Medical Group, PC |
| Hager, M.D. | Shelton | Director | 6.25% | ACO Participant Representative | Holston Medical Group, PC |
| Moye | David | Director | 6.25% | ACO Participant Representative | RDMG Associates, PA |
| Wenzlik, M.D. | Adam | Director | 6.25% | ACO Participant Representative | RDMG Associates, PA |
| Delay, M.D. | Eric | Director | 6.25% | ACO Participant Representative | HealthStar Physicians, PC |
| McNabney, M.D. | David | Director | 6.25% | ACO Participant Representative | HealthStar Physicians, PC |
| Tondo, M.D. | Lewis | Director | 6.25% | ACO Participant Representative | Iredell Physician Network, LLC |
| Green | John | Director | 6.25% | ACO Participant Representative | Iredell Physician Network, LLC |
| Ajjan, M.D. | Madhi | Director | 6.25% | ACO Participant Representative | Optimed Hospitalists |
| Ibanez, PA | Alicia | Director | 6.25% | ACO Participant Representative | Optimed Hospitalists |
| Hopland, M.D. | Kenneth | Director | 6.25% | ACO Participant Representative | Medical Care, PLLC |
| Hopland | Steve | Director | 6.25% | ACO Participant Representative | Medical Care, PLLC |
| Kauffman, M.D. | Michael | Director | 6.25% | ACO Participant Representative | Taos Medical Group, PA |
| Friedman, M.D. | Neal | Director | 6.25% | Medicare Beneficiary Representative | Medicare Beneficiary Representative |
| Blanken | Vickey | Director | 6.25% | Community Stakeholder | Highlands Physicians, Inc. |
| Sizemore | Samantha | Director | 6.25% | Other | OnePartner Health Solutions, LLC |
Key ACO Clinical & Administrative Leadership:
| ACO Executive: | Scott R. Fowler, J.D., M.D. |
| Medical Director: | Shelton L. Hager, M.D. |
| Compliance Officer: | Cheryl Stanski, M.D. |
| Quality Assurance/Improvement Officer: | Samantha Sizemore, COO |
Associated Committees & Committee Leadership:
| Committee Name | Committee Leader Name and Position |
|---|---|
| Clinical Transformation Committee | Shelton Hager, M.D. - Committee Chair |
| Operations, Quality, Clinical Process, and Population Health Improvement Committee | Samantha Sizemore, COO - Committee Chair |
| Beneficiary Engagement Committee | Samantha Sizemore, COO - Committee Chair |
| Communications & Marketing Committee | Samantha Sizemore, COO - Committee Chair |
| Technology & Data Analytics Committee | Byron Sayler - Committee Chair |
| Contracting & Finance Committee | Shawna Armstrong, Treasurer - Committee Chair |
| Compliance Committee | Cheryl Stanski, M.D. - Committee Chair |
Types of ACO Participants, or Combinations of Participants, that Formed the ACO:
- Networks of individual practices of ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses
- Fifth Agreement Period
- Performance Year 2023 - January 1, 2023 - December 31, 2023, $13,329,960.66
- Fourth Agreement Period
- Performance Year 2022 - January 1, 2022 - December 31, 2022, $10,221,401.17
- Third Agreement Period
- Performance Year 2021 - January 1, 2021 – December 31, 2021, $8,290,400.71
- Second Agreement Period
- Performance Year 2020 - January 1, 2020 – December 31, 2020, $8,679,219.81
- First Agreement Period
- Performance Year 2019 A - July 1, 2019 – December 31, 2019, $3,289,869.51
Note: Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019, therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
Shared Savings Distribution
-
Fifth Agreement Period
- Performance Year 2023 - January 1, 2023 - December 31, 2023
- Proportion invested in infrastructure: 0%
- Proportion invested in redesigned care processes/resources: 25%
- Proportion of distribution to ACO participants: 75%
- Performance Year 2023 - January 1, 2023 - December 31, 2023
-
Fourth Agreement Period
- Performance Year 2022 - January 1, 2022 - December 31, 2022
- Proportion invested in infrastructure: 0%
- Proportion invested in redesigned care processes/resources: 20%
- Proportion of distribution to ACO participants: 80%
- Performance Year 2022 - January 1, 2022 - December 31, 2022
-
Third Agreement Period
- Performance Year 2021 – January 1, 2021 – December 31, 2021
- Proportion invested in infrastructure: 0%
- Proportion invested in redesigned care processes/resources: 20%
- Proportion of distribution to ACO participants: 80%
- Performance Year 2021 – January 1, 2021 – December 31, 2021
- Performance Year 2020 - January 1, 2020 – December 31, 2020
- Proportion invested in infrastructure: 0%
- Proportion invested in redesigned care processes/resources: 20%
- Proportion of distribution to ACO participants: 80%
- Performance Year 2019A – July 1, 2019 – December 31, 2019
- Proportion invested in infrastructure: 0%
- Proportion invested in redesigned care processes/resources: 0%
- Proportion of distribution to ACO participants: 100%
Note: Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019, therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
2023 Quality Performance Results:
| ACO Quality Measure Number |
Measure Name | Rate | ACO Mean |
|---|---|---|---|
| 001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [1] | 9.15 | 9.84 |
| 134 | Preventive Care and Screening: Screening for Depression and Follow-up Plan | 91.56 | 80.97 |
| 236 | Controlling High Blood Pressure | 87.28 | 77.80 |
| 318 | Falls: Screening for Future Fall Risk | 95.75 | 89.42 |
| 110 | Preventive Care and Screening: Influenza Immunization | 96.59 | 70.76 |
| 226 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100.00 | 79.29 |
| 113 | Colorectal Cancer Screening | 81.51 | 77.14 |
| 112 | Breast Cancer Screening | 85.14 | 80.36 |
| 438 | Statin Theraphy for the Prvention and Treatment of Cardiovascular Disease | 81.34 | 87.05 |
| 370 | Depression Remission at Twelve Months | 11.11 | 16.58 |
| 321 | CAHPS for MIPS | 6.95 | 6.25 |
| 479 | Hospital Wide 30 Day, All-Cause Readmission HWR Rate for MIPS Groups | 0.1572 | 0.1553 |
| 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] | - | 35.89 |
| CAPHS Number | Measure Name | Rate | ACO Mean |
|---|---|---|---|
| CAHPS-1 | Getting Timely Care, Appointments, and Information | 82.20 | 83.68 |
| CAHPS-2 | How Well Providers Communicate | 94.25 | 93.69 |
| CAHPS-3 | Patient’s Rating of Provider | 92.67 | 92.14 |
| CAHPS-4 | Access to Specialists | 76.32 | 75.97 |
| CAHPS-5 | Health Promotion and Education | 62.18 | 63.93 |
| CAHPS-6 | Shared Decision Making | 64.22 | 61.60 |
| CAHPS-7 | Health Status and Functional Status | 75.36 | 74.12 |
| CAHPS-8 | Care Coordination | 86.68 | 85.77 |
| CAHPS-9 | Courteous and Helpful Office Staff | 93.00 | 92.31 |
| CAHPS-11 | Stewardship of Patient Resources | 31.10 | 26.69 |
Please also note that per CMS policy, you should not publicly share or report cell sizes <11 or any combination of information that would allow cell sizes of <11 to be calculated.
Payment Rule Waivers
- Waiver for Payment for Telehealth Services:
- Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.
- Fraud and Abuse Waivers
- ACO Pre-Participation Waiver:
The following information describes each arrangement for which our ACO seeks protection under the ACO
Pre-Participation Waiver, including any material amendment or modification to a disclosed arrangement.- Parties to the arrangement: Emergent ACO, LLC and Quest Diagnostics, Inc.
- Date of arrangement: 03/16/2018
- Items, services, goods, or facility provided: Services
- No Amendments
- Summary of Arrangement Conducted Under the Medicare ACO Pre-Participation Waiver
- ACO Participation Waiver:
The following information describes each arrangement for which our ACO seeks protection under the ACO
Participation Waiver, including any material amendment or modification to a disclosed arrangement.- Parties to the arrangement: Emergent ACO, LLC and Quest Diagnostics, Inc.
- Date of arrangement: 02/01/2019
- Items, services, goods, or facility provided: Services
- No Amendments
- Summary of Arrangement Conducted Under the Medicare ACO Participation Waiver
- ACO Pre-Participation Waiver:
Last updated on November 27, 2024