Accountable Care Organization and Direct Contracting Entity- St. Luke’s Health Partners

What is St. Luke’s Health Partners Accountable Care Organization (SLHP ACO)?

A Next Generation Accountable Care Organization is a type of ACO program implemented through CMS's Center for Medicare and Medicaid Innovation (CMMI). ACOs are groups of doctors, hospitals, and other health care providers that come together to provide coordinated, high quality care to their Medicare Fee-for-Service beneficiaries. Coordinated care helps ensure beneficiaries, especially the chronically ill or those who are hospitalized, get the right care at the right time, and avoid unneeded duplication of services such as lab tests and x-rays. The Next Generation model offers different methodologies and financial arrangements with higher levels of risk and reward than current Medicare ACO initiatives.

Please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227 (TTY users should call 1-877-486-2048)) for questions or additional information about Next Generation Accountable Care Organizations.

What is St. Luke's Health Partners Direct Contracting Entity (SLHP DCE)?

The Global and Professional Direct Contracting (GPDC) Model is a program implemented through CMS's Center for Medicare and Medicaid Innovation (CMMI). Under GPDC, groups of doctors, hospitals, and other health care providers agree to come together to form a Direct Contracting Entity (DCE) to provide coordinated, high quality care to their Medicare Fee-for-Service beneficiaries. Coordinated care helps ensure beneficiaries, especially the chronically ill or those who are hospitalized, get the right care at the right time, and avoid unneeded duplication of services such as lab tests and x-rays. The GPDC model offers different methodologies and financial arrangements with higher levels of risk and reward than current Medicare initiatives.

Please visit https://innovation.cms.gov/innovation-models/gpdc-model or call 1-800-MEDICARE (1-800-633-4227 (TTY users should call 1-877-486-2048)) for questions or additional information about the Global and Professional Direct Contracting Model and Direct Contracting Entities.

Public Reporting Information

SLHP ACO, DCE
PO Box 1990
Boise, ID 83701
View our CMS Participation Agreement: SLHP ACO
SLHP ACO, DCE Primary Contact
Jonathan Schott, MD
SLHP Medical Director
208-381-1564
Composition of SLHP ACO, DCE:
Non-profit corporation that has agreements with hospitals and professionals.

Participating and Preferred Providers

Download Provider List: SLHP ACO
Download Provider List: SLHP DCE

Definitions for Participating and Preferred Provider Types

The Next Generation ACO and the Global and Professional Direct Contracting models features two categories of Medicare providers. The two primary categories are Participants and Preferred Providers.
- Participating Providers are the core group of providers that form the ACO and DCE. Participants are typically primary care physicians. They are bound to specific requirements under and are responsible for reporting quality and committing to beneficiary care improvement. They are used for beneficiary (patient) alignment.
- Preferred Providers are typically specialists/facilities/ancillary services which are defined as "in-network" and qualify for beneficiary enhancement and waivers. Preferred Providers contribute to ACO and DCE goals by extending and facilitating valuable care relationships. Preferred providers are not used for beneficiary alignment.

SLHP ACO and DCE Participating and Preferred Provider Joint Ventures

Currently, SLHP ACO and SLHP DCE are not pursuing joint ventures with Participants or Preferred Providers.

SLHP ACO and DCE Governing Body

Name	Title	Role	Member Type	Name of Employer
Christine Neuhoff	St. Luke's Health System VP, Legal Counsel	Chair	At-large: SLHP ACO, DCE Participant Director Designated Representative	St. Luke's Health System
Robert Ohlensehlen	Retired	Beneficiary Representative	At-large: Beneficiary Representative	Retired
Matt Wolff	St. Luke's Health Partners VP, Network Operations	President	President w/vote, SLHP ACO, DCE Participant Director, Designated Representative	St. Luke's Health Partners
Jeff Taylor	St. Luke's Health System Chief Financial Officer		At-large: SLHP ACO, DCE Participant Director, Designated Representative	St. Luke's Health System
Cynthia York	Division of Healthcare Policy, State of Idaho	Consumer Advocate	At-large: Consumer Advocate	Idaho Department of Health & Welfare
Aaron Brown, MD	St. Luke's Family Medicine Physician		At-large: SLHP ACO, DCE Participant Director	St. Luke's Clinic
Gary Fletcher	Retired St. Luke's Health System Executive		At-large	Retired
John Kaiser, MD	President, Southern Idaho Health Partners, LLC (Saltzer)		At-large: SLHP ACO, DCE Participant Director	Southern Idaho Health Partners
Robert Cavagnol, MD	St. Luke's Health System Executive Medical Director		At-large: SLHP ACO, DCE Participant Director	St. Luke's Health System
Daniel Reed, MD	Alliance Medical Group (Primary Health Medical Group)		At-large: SLHP ACO, DCE Participant Director	Alliance Medical Group
Jim Souza, MD	St. Luke's Health System Chief Medical Officer		At-large: SLHP ACO, DCE Participant Director,	St. Luke's Health System
Amy Gonzalez	St. Luke's Health Partners Director, Finance	Treasurer	At-large: SLHP ACO, DCE Participant Director, Designated Representative	St. Luke's Health Partners
Ben Keith	St. Luke's Health System Managing Counsel	Secretary	At-large: SLHP ACO, DCE Participant Director, Designated Representative	St. Luke's Health System

Key Clinical and Administrative Leadership

Jonathan Schott, MD, SLHP ACO Medical Director
Matt Wolff, President, St.Luke’s Health Partners, SLHP ACO, DCE President
Ben Gagnon, Compliance Director, St. Luke’s Health System
Steven Pitts, Chief Compliance Officer, St. Luke’s Health System

SLHP ACO Shared Savings and Losses

SLHP ACO received $22,930,169 in shared savings for performance year 2019.
SLHP ACO received $6,864,381 in shared savings for performance year 2018.
SLHP ACO received $6,420,247 in shared savings for performance year 2017.

Shared savings are distributed to participating and preferred providers according to the board-approved distribution methodology. (Download Chart)

Accountable Care Organization and Direct Contracting Entity