Accountable Care Organization

Accountable Care Organization

Accountable Care Organization

The Louisiana Primary Care Accountable Care Organization, LLC (LPCACO) was founded by 22 Federally Qualified Health Centers and the Louisiana Primary Care Association in order to enter the Medicare Shared Savings Program (MSSP) for the 2017 program year.  LPCACO was selected as one of 99 new Shared Savings Program ACOs, providing Medicare beneficiaries with access to high-quality, coordinated care across the United States.  Beginning January 1, 2017, a total of 480 Shared Savings Program ACOs are serving over 9 million assigned beneficiaries.

NEWS: LPCACO Names New Director of Managed Care and Network Development (4/12/2022)

What is an Accountable Care Organization (ACO)?

Doctors, hospitals, and health care providers establish ACOs to work together to provide higher-quality coordinated care to their patients, while helping to slow the growth of health care costs.  LPCACO is one of 480 ACOs participating in the Shared Savings Program, as of January 1, 2017.  Beneficiaries seeing health care providers in ACOs always have the freedom to choose doctors inside or outside of the ACO.  ACOs have the opportunity to receive a portion of the Medicare savings generated from lowering the growth in health care costs as long as they also meet standards for high quality care.

Since ACOs first began participating in the Shared Savings Program in early 2012, thousands of health care providers have signed on to participate in the program, working together to provide better care to Medicare beneficiaries.

For the Shared Savings Program Fact Sheet and a list of the new and renewing ACOs announced, visit the Shared Savings Program News and Updates webpage.

LPCACO Logo

Louisiana Primary Care
Accountable Care Organization, LLC

503 Colonial Drive Baton Rouge, Louisiana 70806

ACO Primary Contact:
Nakeisha R. Cleveland, Director of Managed Care and Network Development
225-927-7662, ext. 209
ncleveland@lpca.net

ACO Participants

Participant NameIn Joint Venture
St. Thomas Community Health Center, IncYes
MQVN Community Development CorporationYes
Winn Community Health Center, Inc.Yes
Priority Health CareYes
Marillac Community Health CentersYes
Baton Rouge Primary Care Collaborative IncYes
Jefferson Community Health Care Centers, IncYes
Start CorporationYes
Southwest Louisiana Primary Health Care Center, Inc.Yes
Iberia Comprehensive Community Health Center, IncYes
Outpatient Medical Center, IncYes
Catahoula Parish Hospital District No 2Yes
SWLA Center for Health ServicesYes
No/Aids Task ForceYes
Excelth, IncYes
Southeast Community Health SystemsYes
St. Gabriel Health Clinic, IncYes
Primary Health Services CenterYes
Capital City Family Health Center, IncYes
Primary Care Providers for a Healthy Feliciana, IncYes
Innis Community Health Center, IncYes
Teche Action Board, IncYes
Morehouse Community Medical Centers, IncYes
Odyessey House Inc LouisianaYes
HIV/Aids Alliance for Region Two, IncYes
Tensas Community Health Center, IncYes
David Raines Community Health Center, IncYes

ACO Governing Body

MemberTitle/PositionVoting PowerMembership TypeACO Participant Legal Business Name/DBA(if applicable)
Michael GriffinDr/Chairman1ACO Participant RepresentativeMarillac Community Health Centers
Deano ThorntonMr/Voting Member1ACO Participant RepresentativeWinn Community Health Center, Inc.
Shondra WilliamsDr/Secretary/Treasurer1ACO Participant RepresentativeJefferson Community Health Care Centers, Inc.
William BrentMr/Vice Chairman1ACO Participant RepresentativeIberia Comprehensive Community Health Center, Inc.
Roderick CampbellMr/Voting Member1ACO Participant RepresentativeMarillac Community Health Centers
Gerrelda DavisMs/Voting Member1Community Stakeholder RepresentativeN/A
Dodie LaMottMs/Voting Member1ACO Participant RepresentativeSouthwest LA Primary Health Care Center
Marshall Wayne SmithMr/Voting Member1Medicare BeneficiaryN/A
Gary WiltzDr/Voting Member1ACO Participant RepresentativeWinn Community Health Center, Inc.

Key ACO Clinical & Administrative Leadership

Gerrelda Davis
ACO Executive

Gary Wiltz
Medical Director

Harry Thompson
Compliance Officer

Shannon Robertson
Quality Assurance/Improvement Officer

Associated Committees & Committee Leadership

Shondra Williams, Chair
Operations Committee

William Brent, Chair
Finance Committee

Gary Wiltz, Chair
Clinical Committee

Michael Griffin, Chair
IT/Data Committee

Types of ACO participants, or combinations of participants, that formed the ACO:
Federally Qualified Health Center (FQHC)

Shared Savings & Losses

Amount of Shared Savings/Losses:
  • Second Agreement Period
    • Performance Year 2020, $4,975,037.75
    • Performance Year 2019, $2,904,613.51
  • First Agreement Period
    • Performance Year 2018, $0
    • Performance Year 2017, $0
Shared Savings Distribution:

Second Agreement Period

  • Performance Year 2020
    • Proportion invested in infrastructure: 21%
    • Proportion invested in redesigned care processes/resources: 40%
    • Proportion of distribution to ACO participants: 39%
  • Performance Year 2019
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: 40%
    • Proportion of distribution to ACO participants: 60%

First Agreement Period

  • Performance Year 2018
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A
  • Performance Year 2017
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A

Quality Performance Results: 2020

ACO Quality Measure NumberMeasure NameRateACO Mean
ACO-43 (3)Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))1.110.95
ACO-13Falls: Screening for Future Fall Risk68.6984.97
ACO-14Preventive Care and Screening: Influenza Immunization59.9276.03
ACO-17Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention75.9581.67
ACO-18Preventive Care and Screening: Screening for Depression and Follow-up Plan84.7871.46
ACO-19Colorectal Cancer Screening61.7472.59
ACO-20Breast Cancer Screening67.9674.05
ACO-42Statin Therapy for the Prevention and Treatment of Cardiovascular Disease86.2583.37
ACO-40Depression Remission at Twelve Months26.7613.99
ACO-27Diabetes: Hemoglobin A1c Poor Control (>9%)21.7814.70
ACO-28Controlling High Blood Pressure56.9072.87

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.

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

  • Not Available