Essential Care ACO

Essential Care ACO

An Accountable Care Organization (ACO) committed to improving patient outcomes through elevated value-based care.

An Accountable Care Organization (ACO) committed to improving patient outcomes through elevated value-based care.

ACO Name and Location
ACO Name and Location

Wellvana Essential Care, LLC
20 Burton Hills Blvd
Nashville, TN 37215

ACO Primary Contact
ACO Primary Contact

Stephanie Bartels
Phone: (615) 410-9744
Email: mssp@wellvana.com

Organizational Information

Organizational Information

ACO Participants

ACO Participant in Joint Venture

RAGHAV LLC

N

DESERT ANGELS MEDICAL CLINIC PLC

N

MEDICAL COLLEAGUES OF TEXAS LLP

N

SYED V AHMED MD PA

N

MA MEDICAL CARE PLLC

N

ZHENGNAN YIN, MD, PLLC

N

RAJA ABUSHARR MD PA

N

SHADY CANYON MEDICAL GROUP

N

OPEN CITIES HEALTH CENTER INC

N

NEIGHBORHOOD HEALTHSOURCE

N

CEDAR RIVERSIDE PEOPLES CENTER

N

FUQUA FAMILY PRACTICE AND URGENT CARE PA

N

RICHARD C. LOCK, M.D., P.A.

N

KOTA JAGDISH REDDY MD PA

N

LEENA CHACKO MD PA

N

GREGG C. CASTILLO, MD, PA

N

ORLANDO FONSECA, MD, PLLC

N

SHUBHA P SHETTY MD PA

N

ALEXANDRIA MEDICAL ASSOCIATION PA

N

SIRI PRIYAM LLC

N

ALAN M SANDERS MD

N

ALAN W EDWARDS MD PC

N

BEACH MEDICAL PLLC

N

CARL I. MITCHELL, MD, PA

N

CHRIS BURLING MD PA

N

DAVID A RAMOS MD PA

N

KHAN & MUJEEB URGENT CARE GROUP

N

ZAWAIDEH MEDICAL CENTER PC

N

ERIC WATSON

N

George D Sagrera, MD

N

OSAFO HEALTH CARE CLINIC INC

N

CRESCENT MEDICAL INC

N

VALLEY PRIMARY CARE PHYSICIANS LLC

N

BURTON MEDICAL GROUP LLC

N

PROVIDENCE FAMILY PRACTICE LLC

N

KELLUM PHYSICIAN PARTNERS PA

N

HEALTH CARE SOLUTIONS PA

N

UNITED FAMILY PRACTICE HEALTH CENTER

N

ACO Governing Body:

ACO Governing Body:

Member First Name

Member Last Name

Member Title/Position

Member’s Voting Power

Membership Type

ACO Participant Legal Business Name

Shantipriya

Siripurapu

Board Member

19.00%

ACO Participant

Siri Priyam LLC

Kamran

Khan

Board Member

19.00%

ACO Participant

Khan & Mujeeb Urgent Care Group, PLLC

James

Henderson

Board Member

19.00%

ACO Participant

Providence Family Practice, LLC

Zhengnan

Yin

Board Member

19.00%

ACO Participant

Zhengnan Yin MD

Mark

Montoney, MD

Board Chair

10%

Voting Member

Wellvana

Stephanie

Bartels

Secretary

10%

Voting Member

Wellvana

Cynthia

Uzoh

Board Member

4%

Medicare Beneficiary

N/A

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

Key ACO Clinical and Administrative Leadership:

ACO Executive: Liz Canis

ACO Executive: Liz Canis

Medical Director: Mark Montoney, M.D.

Medical Director: Mark Montoney, M.D.

Compliance Officer: Kyle Creager

Compliance Officer: Kyle Creager

Quality Assurance/Improvement Officer: Rajul Gandhi

Quality Assurance/Improvement Officer: Rajul Gandhi

Associated Committees and Committee Leadership:

Associated Committees and Committee Leadership:

Committee Name

Committee Leader Name and Position

Health Equity Committee

Dr. Mark Montoney, Chair

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

• Networks of individual practices of ACO professionals

Shared Savings and Losses:

Shared Savings and Losses:

Shared Savings and Losses:

Shared Savings and Losses:

Amount of Shared Savings/Losses: TBD

Amount of Shared Savings/Losses: TBD

Shared Savings Distribution: TBD

Shared Savings Distribution: TBD

Quality Performance Results

Quality Performance Results

Quality Performance Results

Quality Performance Results

2023 Quality Performance Results:

Our ACO did not participate in the Shared Savings Program in Performance Year 2023; therefore, this section is not applicable at this time.

Payment Rule Waivers

Payment Rule Waivers

Payment Rule Waivers

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-Day Rule Waiver: N/A

  • Waiver for Payment for Telehealth Services: N/A

Advance Investment Payments (AIP)

Advance Investment Payments (AIP)

Spend Plan:

Payment Use

General Spend Category

General Spend Subcategory

Projected Spending 2024

Actual Spending 2024

Projected Spending 2025

Actual Spending 2025

Projected Spending 2026

Actual Spending 2026

Projected Spending 2027

Actual Spending 2027

Projected Spending 2028

Actual Spending 2028

Care Coordinator

Increased Staffing

Case Manager

$116,206

$0

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Clinical RN

Increased Staffing

Case Manager

$224,712

$0

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Wiseman - CM System

Health Information Technology

Case Management System

$6,300

$0

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Social Worker

Increased Staffing

Licensed Clinical Social Worker

$35,071

$0

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Pharmacist and Pharma Tech

Increased Staffing

Physician

$17,800

$0

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Quality Educator

Increased Staffing

Other

$14,667

$0

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Field Management

Increased Staffing

Other

$57,300

$74,886

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Clinical Documentation

Increased Staffing

Other

–

$270,151

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Patient Scheduling Specialist

Increased Staffing

Other

–

$121,087

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Patient Scheduling Software

Health Care Infrastructure

Other

–

$3,155

$0

N/A

$0

N/A

$0

N/A

$0

N/A

ADTs

Health Care Infrastructure

Health information exchange and health information network participation

–

$67,046

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Patient Outreach Team

Increased Staffing

Other

–

$60,339

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Patient Outreach Software

Health Care Infrastructure

Other

–

$30,848

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Data Analytics

Increased Staffing

Other

–

$263,627

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Remote Access Technologies

Health Care Infrastructure

Remote Access Technologies

–

$46,103

$0

N/A

$0

N/A

$0

N/A

$0

N/A

IT Support

Health Care Infrastructure

Other

–

$129,137

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Data Analytics

Health Care Infrastructure

Other

–

$41,417

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Pop Health Tools

Health Care Infrastructure

Case Management System

–

$81,557

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Field Management Software

Health Care Infrastructure

Other

–

$5,292

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Electronic Quality Reporting

Health Care Infrastructure

Electronic Quality Reporting

–

$57,000

$0

N/A

$0

N/A

$0

N/A

$0

N/A

Subtotals

$472,056

$1,251,643

$0

$0

$0

$0

$0

$0

$0

$0

Spend Plan Summary:

Projected Total Advance Investment Payments

$1,251,643

Actual Spending

$1,251,643

Future Projected Spending

$0

Remaining Funding to Allocate

$0

Remaining Funding to Allocate

$1,251,643

Our ACO has established a separate designated account for the deposit and expenditure of all advance investment payments in accordance with 42 CFR 425.630(e)(4).

Fraud and Abuse Waivers

Fraud and Abuse Waivers

Fraud and Abuse Waivers

Fraud and Abuse Waivers

  • ACO Pre-Participation Waiver: N/A

  • ACO Participation Waiver: N/A

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