ACO Name and Location
Coastal Plains Network, LLC
Previous Names: N/A
800 W.H. Smith Blvd
PO Box 6028
Greenville, NC 27835
ACO Primary Contact
Primary Contact Name: Ronald Gaskins
Primary Contact Phone Number: 252-816-0899
Primary Contact Email Address: Ronald.gaskins@vidanthealth.com
Organizational Information
ACO participants:
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
|---|---|
| Outer Banks Professional Services, LLC | Y |
| Vidant Medical Group, LLC | N |
| Roanoke Chowan Community Health Center, Inc. | N |
| East Carolina Health-Beaufort, Inc. (DBA Vidant Beaufort Hospital, Washington) | N |
| Pitt County Memorial Hospital, Inc. (DBA Vidant Medical Center, Greenville) | N |
| Halifax Regional Medical Center, Inc. | N |
| Roanoke Valley Health Services, Inc. | N |
| East Carolina Health (DBA Vidant Roanoke-Chowan Hospital, Ahoskie) | N |
| East Carolina Health-Bertie (DBA Vidant Bertie Hospital, Windsor) | N |
| East Carolina Health-Heritage, Inc. (DBA Vidant Edgecombe Hospital, Tarboro) | N |
| East Carolina Health-Chowan, Inc. (DBA Vidant Chowan Hospital, Edenton) | N |
| The Outer Banks Hospital, Inc. | Y |
| East Carolina University (DBA East Carolina University Physician Plan) | N |
| Duplin General Hospital Inc. (DBA Vidant Duplin Hospital, Kenansville) | N |
| Rural Health Group, Inc. | N |
| VECU Medical Group Inc | N |
| ECU Physicians Diagnostic Pathology Services (DBA East Carolina University Physician Plan) | N |
ACO governing body:
| Member | |||||
| Last Name | First Name | Title/Position | Voting Power | Type | Legal Name/DBA |
| Foltz, D.O | Jason | Voting Member | 1 | ACO Participant Representative | East Carolina University Physician Plan |
| Pye, M.D | Joseph | Voting Member | 1 | ACO Participant Representative | Vidant Medical Group |
| Firnhaber, MD | Jonathon | Voting Member | 1 | ACO Participant Representative | East Carolina University Physician Plan |
| Blair, MD | Mott | Voting Member | 1 | ACO Participant Representative | Vidant Duplin Hospital, Kenansville |
| Peters, MD | Brookes | Voting Member | 1 | ACO Participant Representative | Vidant Edgecombe Hospital, Tarboro |
| Avery, M.D | Scott | Voting Member | 1 | Community Member | N/A |
| Galloway | David | Voting Member | 1 | Medicare Beneficiary Representative | N/A |
| Powell, MD | Steve | Voting Member | 1 | ACO Participant Representative | East Carolina University Physician Plan |
| Armistead, MD | Niti | Voting Member | 1 | ACO Participant Representative | Vidant Medical Center, Greenville |
| Richardson, M.D | Claudia | Voting Member | 1 | ACO Participant Representative | Roanoke Chowan Community Health Center, Inc. |
| Long-Gee | Yvonne | Voting Member | 1 | ACO Participant Representative | Rural Health Group, Inc. |
| Mose | Tiffany | Voting Member | 1 | ACO Participant Representative | Halifax Regional Medical Center, Inc. / Roanoke Valley Health Services, Inc. |
Key ACO Clinical and administrative leadership:
| Ronald Gaskins | ACO Executive |
| Mott Blair, MD | Medical Director |
| Gail Brown | Compliance Officer |
| Sherri Bryant | Quality Assurance/Improvement Officer |
Associated committees and committee leadership:
| Committee Name | Committee Leader Name and Position |
|---|---|
| Executive Committee | Niti Armistead, MD (Chair) |
| Quality Improvement & Performance Committee | Joseph Pye, MD (Chair) |
| Finance & Contracting Committee | Mott Blair, MD (Chair) |
| Compliance & Credentials Committee | Claudia Richardson, MD (Chair) |
Types of ACO participants, or combinations of participants, that formed the ACO:
| Critical Access Hospital (CAH) billing under Method II |
| Hospital employing ACO professionals |
| Partnerships or joint venture arrangements between hospitals and ACO professionals |
| Federally Qualified Health Centers |
| Rural Health Center |
Shared Savings and Losses
Amount of Shared Savings/Losses
- Second Agreement Period
- Performance Year 2018, $0
- First Agreement Period
- Performance Year 2017, $3,916,671
- Performance Year 2016, $0
- Performance Year 2015, $3,279,327
Shared Savings Distribution
- Second Agreement Period
- Performance Year 2018
- Proportion invested in infrastruture: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2018
- First Agreement Period
- Performance Year 2017
- Proportion invested in infrastructure: 40%
- Proportion invested in redesigned care processes/resources: 0
- Proportion of distribution to ACO participants: 60%
- Performance Year 2016
- Proportion invested in infrastruture: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2015
- Proportion invested in infrastruture: 10%
- Proportion invested in redesigned care processes/resources: N/0
- Proportion of distribution to ACO participants: 90%
- Performance Year 2017
Quality Performance Results
2018 Quality Performance Results:
| ACO# | Measure Name | Rate | ACO Mean |
| ACO-1 | CAHPS: Getting Timely Care, Appointments, and Information | 81.29 | 86.14 |
| ACO-2 | CAHPS: How Well Your Providers Communicate | 91.72 | 93.93 |
| ACO-3 | CAHPS: Patients’ Rating of Provider | 90.05 | 92.45 |
| ACO-4 | CAHPS: Access to Specialists | 79.91 | 81.50 |
| ACO-5 | CAHPS: Health Promotion and Education | 60.64 | 59.26 |
| ACO-6 | CAHPS: Shared Decision Making | 63.13 | 61.94 |
| ACO-7 | CAHPS: Health Status/Functional Status | 75.53 | 73.35 |
| ACO-34 | CAHPS: Stewardship of Patient Resources | 27.85 | 26.26 |
| ACO-8 | Risk Standardized, All Condition Readmission | 15.46 | 14.98 |
| ACO-35 | Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) | 19.96 | 18.59 |
| ACO-36 | All-Cause Unplanned Admissions for Patients with Diabetes | 39.40 | 37.01 |
| ACO-37 | All-Cause Unplanned Admissions for Patients with Heart Failure | 79.73 | 76.75 |
| ACO-38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 62.66 | 59.00 |
| ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91) | 1.70 | 1.98 |
| ACO-11 | Use of Certified EHR Technology | 100.00 | 98.20 |
| ACO-12 | Medication Reconciliation Post-Discharge | 57.88 | 85.91 |
| ACO-13 | Falls: Screening for Future Fall Risk | 87.69 | 79.73 |
| ACO-44 | Use of Imaging Studies for Low Back Pain | 60.63 | 64.36 |
| ACO-14 | Preventive Care and Screening: Influenza Immunization | 73.71 | 72.71 |
| ACO-15 | Pneumonia Vaccination Status for Older Adults | 71.32 | 75.97 |
| ACO-16 | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up | 81.60 | 76.83 |
| ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 80.39 | 72.81 |
| ACO-18 | Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan | 83.08 | 66.74 |
| ACO-19 | Colorectal Cancer Screening | 65.75 | 68.27 |
| ACO-20 | Breast Cancer Screening | 78.52 | 71.96 |
| ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 80.07 | 81.47 |
| ACO-27 | Diabetes Mellitus: Hemoglobin A1c Poor Control | 17.91 | 15.51 |
| ACO-41 | Diabetes: Eye Exam | 46.27 | 52.42 |
| ACO-28 | Hypertension (HTN): Controlling High Blood Pressure | 65.57 | 73.10 |
| ACO-30 | Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet | 93.26 | 88.92 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
Quality Performance Results
- For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov
Note: In the Quality Performance Results file(s) above, search for “Coastal Plains Network, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A2684 in the public use files on data.cms.gov.
Payment Rule Waivers
- Skilled Nursing Facility (SNF) 3-day Rule Waiver: No, our ACO does not use the SNF 3-Day Rule Waiver, pursuant to 42 CFR 425.612.
- Waiver for Payment for Telehealth Services: No, our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.
Public Disclosure Statement
- East Carolina University Administration Waiver
- Coastal Plains Network Participant Travel Expense Waiver
Disclosure
Ethics and Compliance Hotline:
It is Coastal Plains Network expectation that all employees, contractors, CIN participants, and CIN providers/suppliers should be able to communicate their concerns freely to the Compliance Officer and/or the Compliance and Credentials Committee. To encourage reporting, the Coastal Plains Network, LLC will utilize the Vidant Health toll-free Corporate Ethics and Compliance Hotline at 888-777-2617 to which employees can report issues anonymously. Issues reported through this method must contain enough information for the Coastal Plains Network, LLC to conduct a thorough investigation of the alleged issues. Coastal Plains Network, LLC will treat any such reported concerns confidentially to the maximum extent consistent with the fair and rigorous enforcement of the Compliance Program.