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 |
---|---|---|---|---|
Jim Giuffre | Retired President/CEO, Healthwise | Chair | At-large | Retired |
Robert Cavagnol, MD | President, St. Luke's Clinic | At-large: SLHP ACO, DCE Participant Director, Designated Representative |
St. Luke's Clinic | |
Dick Armstrong | Retired Director of IDHW | At-large | Retired | |
Ern Blackwelder | President & CEO Onsite Dental | At-large | Onsite Dental | |
April Dillion, DO | Physician, Primary Health Medical Group | At-large | Primary Health Medical Group | |
Brian Fortuin, MD | Physician, SLMV | At-large: SLHP ACO, DCE Participant Director | St. Luke's Magic Valley | |
Dee Jay Mailer | Retired CEO, Kamehameha Schools (Bishop Estate) | At-large | Retired | |
Laura McGeorge, MD | Medical Director, Primary Care Services, SLHS | At-large: SLHP ACO, DCE Participant Director | St. Luke's Clinic | |
Robert Ohlensehlen | Owner, A&O Associates, Twin Falls, ID | Beneficiary Representative | At-large: Beneficiary Representative | A&O Associates |
Randy Page, DO | Retired Physician | At-large | Retired | |
David Peterman, MD | Physician & CEO, Primary Health Medical Group | At-large | Primary Health Medical Group | |
Jeff Taylor | SVP, CFO SLHS | At-large: SLHP ACO, DCE Participant Director, Designated Representative | St. Luke's Health System | |
Casi Wyatt, DO | Infectious Disease Specialist, Sawtooth Epidemiology | At-large | Sawtooth Epidemiology | |
Cynthia York | Self-employed, Healthcare Delivery Consultant | Consumer Advocate | At-large: Consumer Advocate | Self-employed |
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 $25,679,914 in shared savings for performance year 2020.
- 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)
SLHP DCE Shared Savings and Losses
- TBD, Participation in this model to begin on January 1, 2022.
SLHP ACO Quality Performance Results
- Download the 2020 Quality Performance Results
- Download the 2019 Quality Performance Results
- Download the 2018 Quality Performance Results
- Download the 2017 Quality Performance Results
SLHP DCE Quality Performance Results
- TBD, Participation in this model to begin on January 1, 2022.