What is the CoxHealth Next Generation Accountable Care Organization? 

A Next Generation Accountable Care Organization (ACO) is a type of ACO model implemented through the Centers for Medicare and Medicaid Services’s (CMS's) Innovation Center. 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.

Preferred Facilities

• Quailcreek Skilled Nursing LLC
• N&R of Springfield East LLC (Glendale Gardens)
  
• Sunterra Springfield OC, LLC
• N & R of Branson LLC (Shepherd of the Hills)

ACO Participants & Preferred Provider Joint Ventures 

There are no joint ventures between or among the ACO and its Participants and/or Preferred Providers.

Key Clinical & Administrative Leadership

ACO Governing Body

• Bryan Finke, MD, CoxHealth
• Tim Jones, DO, CoxHealth
  
• Julia Flax, MD, CoxHealth
• Shawn Usery, MD, CoxHealth
  
• Frank Romero, MD, CoxHealth
• Norm Mechlin, MD, CoxHealth
  
• Piper Schulte, Springfield Neurological Institute, LLC
• Jake McWay, CoxHealth
• David Raney, CoxHealth
• Max Buetow, CoxHealth
• Robert Ferguson, CoxHealth
• Jerry Jared, Community Member

Shared Savings & Losses

• The proportion of shared savings invested in infrastructure, redesigned care processes and other resources necessary to improve outcomes and reduce Medicare costs for beneficiaries 
• The proportion of shared savings to be invested in infrastructure depends on the amount of shared savings received. Currently, the distribution policy covers operating expenses for the ACO including participant incentives for engagement and coordination of care before any shared savings are distributed to providers.  
• The proportion of shared savings distributed to Next Generation Participants and Preferred Providers
• After covering the costs noted above, any remaining shared savings are split between CoxHealth Accountable Care and Participating Providers at a rate of 60% and 40%, respectively.  Preferred Providers do not share in savings or loss associated with the Next Generation ACO.

Quality Performance Results