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Realizing Success 2017–2018 Value-Based Care Report
The statements contained in this document are solely those
of the authors and do not necessarily reflect the views or
policies of the Centers for Medicare and Medicaid Services
(CMS). The authors assume responsibility for the accuracy and
completeness of the information contained in this document.
1
Introduction ................................................................................................................. 3
Our Goal: To Advance the Triple Aim ...................................................................... 5
UnityPoint Accountable Care Value-Based Contracts ........................................... 6
Care Coordination/Population Health ..................................................................... 8
Annual Wellness Visits .............................................................................................10
Falls Prevention and Screening ...............................................................................12
AMGA Adult Immunization Collaborative ............................................................13
2018 Regional Care Delivery Enhancements .......................................................14
Analytics Support .....................................................................................................18
Post-Acute Care Network Development ...............................................................20
Providing Excellent Patient Care at Home ............................................................23
Payment Models/Funds Flow ..................................................................................26
Financial Performance Summary ............................................................................27
Quality Data ..............................................................................................................28
Governance Groups .................................................................................................30
Quality & Clinical Integration Council (QCIC)
Finance & Network Development Council (FNDC)
Board of Managers
Advisory Team
Looking Ahead ..........................................................................................................35
Network Participants ................................................................................................36
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UnityPoint Accountable Care, L.C. (UAC) is pleased to share the 2018 value report with our participants and preferred providers. UnityPoint Accountable Care is a strategic platform to convene key stakeholders to develop innovative and data-driven solutions that can be systematically deployed to deliver exceptional care, experience and financial value for patients and providers. Our work is helping our network providers prosper in an ever-changing healthcare environment.
In the past year, healthcare policy and regulatory activities have resulted in the most sweeping changes in care delivery since the passage of the Affordable Care Act. We remain committed to the journey from volume to value, continuing to take on difficult challenges in meeting the needs of our network and our patients.
This “can do” attitude positioned UAC to be a successful participant in the Next Generation Accountable Care Organization (ACO) Model for performance year 2017, resulting in an overall quality score exceeding 93 percent and shared savings of $11,478,688.
The 2018 story begins with our success in contract performance efforts, which sets the stage for our ongoing focus on “right time, right place, and right care” for our patients.
2019 will generate unique challenges as we navigate through payors’ increased demand for risk-taking contracts, managing high performance through the network, bringing new tools to use across the networks and regions, and charting our path to pre-payment and full risk-sharing arrangements.
Introduction
Dr. Kyle ChristiasonMedical Director UnityPoint Accountable Care, L.C. Leadership Dyad
Sue ThompsonCEO UnityPoint Accountable Care, L.C.
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Healthcare can be chaotic, unpredictable and challenging. It is constantly changing.
However, our purpose in delivering healthcare does remain constant: our patients.
UnityPoint Accountable Care is a convening platform for all of us to collectively own
the health of the communities in which we serve and live.
Whether it be the hospital, clinic or home health; an independent physician or one
who is employed by a health system; or a specialist or a primary care provider,
UnityPoint Accountable Care empowers all of us to deliver on the Triple Aim: “the
right care, in the right place, at the right time.”
Through engagement, mutual support and accountability, and the use of
data-informed tools, we are striving to become one of the nation’s most clinically
integrated healthcare networks.
– Susan Thompson, CEO, UnityPoint Accountable Care, L.C.
– Kyle Christiason, M.D., Medical Director/UnityPoint Accountable Care, L.C. Leadership Dyad
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Our Goal: To Advance the Triple AimUnityPoint Accountable Care grew significantly in 2018. Our focus was maintaining our
well-functioning narrow network. We also improved our performance and increased our
appropriate use of Waivers for our Next Generation ACO Model beneficiaries.
In 2018, 32 provider groups and 1,987 providers joined our network, as well as 10 skilled
nursing facilities (SNFs). In our service areas, we increased availability for many specialists
and behavioral health providers. Our success is due to our strong regional partnerships
and dedication to expanding care access options for our members and patients.
Our new tertiary and quaternary care partner, University of Iowa Health Care (UIHC),
allows us to provide a necessary full continuum of specialty care options for our network.
This addition provides improved care coordination, a greater scope of network specialty
services and improved opportunities to monitor quality and control costs.
• Better health care for
individual patients.
• Better value and more
affordable cost of care for all.
• Better health for our communities.
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UnityPoint Accountable Care Value-Based ContractsValue-Based Contracts
unitypoint.org/UAC
UnityPoint Health Self-Insured Employee Health Plan
HealthPartners UnityPoint Health Medicare Advantage
CMS Next Generation ACO Model
Aetna ACO
Blue Cross and Blue Shield of Illinois ACO
HealthPartners Total Cost of Care
Wellmark Blue Cross and Blue Shield of Iowa
UnitedHealthcare ACO
Medica Health Plans
Minnesota
MADISON
DUBUQUE
CEDAR RAPIDS
IOWA CITY
QUAD CITIES
WATERLOOFORT DODGE
CENTRAL IOWA
SIOUX CITY
SouthDakota
Nebraska
QUINCY
PEORIA
Iowa
Illinois
Wisconsin
Map_900_UAC VBPA 01/19Effective January 1, 2019
6
UnityPoint Accountable Care Value-Based Contracts
Adding UIHC, a provider with
approximately 20,000 covered lives
located in a unique geography such as
Iowa City, required us to form a new,
distinct regional structure that also
incorporates the region’s post-acute
care and community agencies. Regional
Organized System of Care (OSC)
oversight promotes performance
consistent with our current Next
Generation ACO Model measurement
processes, communication cadence and
support functions.
In the Dubuque region, we expanded
our relationship with Grand River Medical
Group PC, an independent consortium
of physicians and providers. With this
addition to our network, approximately
6,000 more Medicare beneficiaries will
benefit from care coordination and
additional services provided through our
Next Generation ACO Model participation
agreement.
We also grew our relationship with
Walmart, where our network is a benefit
plan option for employees. The Walmart
UAC network plan is available in 50 stores
across Iowa and Illinois. An additional
three stores will be added in 2019. We
value this partnership with Walmart,
working to provide the best care possible
for their employees and families.
As UnityPoint Health continues to grow,
our provider network will continue to
work with our regions to provide a reliable
and robust provider network. Much of
our growth in 2018 centered around the
new UnityPoint Health relationships in
Grinnell, Keokuk, Marshalltown and Iowa
City, as well as in UAC commercial and
government contracts.
In 2018, UAC and Aetna began
collaborating to offer a member-focused,
doctor-driven health care product in
the marketplace. There are currently
8,600 Aetna patients in our value-based
arrangements. We also partnered with
Medica to offer a narrow network product
on the Iowa Insurance Exchange featuring
UnityPoint Health and our network
providers. Beginning in 2019, UAC will
offer a new value-based agreement
allowing network providers to continue to
serve over 21,000 members in Medica’s
Inspire product.
7
Care Coordination/Population HealthThis past year, the focus of the UnityPoint
Accountable Care clinical care team
was improving the health of the patients
we serve in our various value-based
arrangements. To achieve this goal, we
provided patient and provider education
and provider practice support in key
areas that aligned with our contractual
imperatives. Provider practice support
included the dissemination and adoption
of evidence-based protocols and care
guides that were evaluated and approved
by the Quality and Clinical Integration
Council (QCIC). We aligned closely with
UnityPoint Health providers to maximize
our impact and create focus across
our large network. Important areas of
focus in 2018 included Annual Wellness
Visits (AWVs) for our Medicare patients,
screenings and interventions with patients
at risk for falls, and increasing completion
rates for patient pneumococcal and
influenza vaccinations.
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Annual Wellness VisitsTo further explore the benefits of AWVs,
data from 2017 was analyzed comparing
those patients who received an AWV
to those who did not. We discovered
that UAC patients who had an AWV
had fewer emergency department (ED)
visits, fewer hospital admissions, fewer
computerized tomography (CT) scans, a
lower per-member per-month cost and a
higher chance of being screened for fall
risk. Despite these benefits, fewer than
25 percent of UAC Next Generation ACO
Model beneficiaries had this focused
time with their provider in 2016.
To respond to this, the UAC clinical team
developed a care Playbook to educate
practices and providers about the
AWV. This Playbook included practical
information on patient care, billing and
deployment. The clinical team also
worked with our marketing team to
create an easy-to-understand infographic
demonstrating the benefits of the AWV
for both the patient and the provider.
This Playbook was made widely available
in our regions. UAC also partnered with
UnityPoint Clinic (UPC) and regional
population health leaders to educate
providers about the quality benefits of
the AWV. UAC physicians helped guide
clinical workflows and standardize the
Health Risk Assessment as part of this
initiative. AWV completion was included
as a metric in our Funds Flow model to
reward providers for focusing on AWVs.
The result of these efforts has been a
drastic improvement in the number of
our patients who received this valuable
benefit. At the mid-point of 2018, 26
percent of patients had already received
an AWV, exceeding the total number of
AWV visits in 2016.
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Annual Wellness Visit BenefitsPersonalized Prevention Plan of Service (PPPS)
Helps Both• Identify any important gaps in care• Identify need for referral to additional health resources
Helps Medicare Patient
• Focus is on preventative care and overall state of health
• Develop a full preventative care plan in partnership with provider
• Better understand risk factors and treatment options
• Discuss topics - home safety - how to take medications - implementation of
advance directives - strength of family
support system - detect and prevent disease
• Coordinate care across health care providers
002127-1 5/17 CS
Helps Provider/Care Team
• Strengthens the patient-provider relationship and contributes to improved patient experience
• Complements information needed for national National Committee for Quality Assurance and Healthcare E�ectiveness Data and Information Set quality metrics
• Helps with chart maintenance
• Helps improve hierarchical condition categoryscoring accuracy
• Health Risk Assessment (HRA) completed ahead of time helps guide discussion
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Falls Prevention and ScreeningFalls screening is an important part
of the Annual Wellness Visit as well
as other ambulatory patient visits.
Screening is important because of the
sheer number of patients we care for
that do experience falls, and because
of the significant adverse impact a fall
can have on the health of a patient.
UnityPoint Health has 22,000 annual
patient encounters related to falls for
our over-65 population, and more than
four percent of our Medicare patients
have a severe fall each year.
Falls screening is an important function
of our clinical teams in the ambulatory
setting, and we currently screen about
70 to 80 percent of our population for
risk of falls. However, our UAC clinical
team identified an opportunity to
improve the reliability with which we
apply interventions to those patients
who do screen positive. The clinical
team led a multidisciplinary group of
ACO participants in the development
of an evidence-based protocol to
stratify the risk of the patient based
on the falls risk screening and make
recommendations for the most
appropriate interventions. Interventions
included patient education, physical
therapy referral, home safety evaluation,
pharmacy medication review and
connection to community resources.
UAC medical directors are now leading
work to “hardwire” this protocol into
UnityPoint Health and other network
partner clinic workflows to facilitate
appropriate interventions based on
patient risk.
AMGA Adult Immunization Collaborative UAC participated in the American
Medical Group Association (AMGA) Adult
Immunization Collaborative from April
2017 to April 2018. This best-practice
learning collaborative focused on
increasing the rate of pneumococcal and
influenza vaccinations and reducing the
clinical burden of vaccine-preventable
illnesses. Initial work through the
collaborative was done at two pilot
clinics in the Quad Cities Region.
Interventions included identifying a
physician champion, evaluating data
for care gaps, and providing focused
patient and provider education. With
these changes, both clinics saw significant
increases in immunizations for influenza
and pneumonia for both the over-65 and
at-risk patient populations.
Lessons learned from this collaborative
are now being disseminated throughout
our network. Additionally, we continued
to reinforce the importance of
immunization by including immunization
metrics in our Funds Flow model for
shared savings disbursement. By focusing
on education and creating incentives
through our financial model, we aligned
efforts to improve the vaccination rates for
our patients.
“Being part of the AMGA Adult Immunization Collaborative was very beneficial to our clinic. All our clinicians and staff were involved; it was truly a group effort, from our patient service representatives to our nurses and physicians. The pilot program provided us with the education and resources necessary to improve our pneumonia vaccination rates, with good tools to track our vaccination rates and create opportunity reports. And educational materials such as posters and buttons helped us educate our patients about why vaccinations are important.”
— Himabindu Alla, MD, UnityPoint Clinic — Family Medicine Moline
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2018 Regional Care Delivery Enhancements
Cedar RapidsThe Cedar Rapids regional network initiated cross-continuum work
focusing on multiple chronic disease management. Patients with
multiple chronic diseases have a high clinical burden and higher
utilization of high-cost services. In addition, 29 percent of these
individuals can have a co-morbid behavioral health condition.
Through improved medical management and integrated care
management, Cedar Rapids is working to enhance patient-
centered medical care coordination and communication across
the different settings of care as well as between physicians. This
communication allows for increased shared decision-making
for patients and families with physicians, improved medication
coordination (reconciliation) and management and heightened
care standardization for these patients helping avoid contradictory
advice, medications, etc. The initial disease cohort is individuals
in the Next Generation ACO Model population who have chronic
obstructive pulmonary disease (COPD), heart failure and diabetes.
Central IowaThe Central Iowa region has actively engaged SNF providers in
quality improvement and cost-saving initiatives. The Central Iowa
team works to reduce readmissions, reduce inpatient and SNF
length of stay and improve care and outcomes for our patients.
The region began this collaborative work in 2015 and since then
has seen SNF length of stay reduced by 18.6 percent to an average
length of stay of 19.2 days while maintaining readmission rates.
The Central Iowa team has collaborated on several clinical
initiatives, including blood transfusion best practice, congestive
heart failure and no/low sodium diets, fall prevention and other
areas of interest. They proactively address barriers to timely
discharge and work to prevent readmission to the hospital.
DubuqueDubuque took another step this year to further the Triple Aim
with its SNF partners. To help keep care in place, Dubuque
staff established a wound care outreach program to provide
comprehensive wound care services, enhanced clinical
outcomes, improved patient experience and lower costs for
SNFs and for patients. In collaboration with their Wound and
Hyperbaric Center, nurse practitioners provided weekly rounding,
staff education and specialty wound care at the bedside. The
goal is to improve community health resulting in reduced
readmissions, enhanced care coordination and transitions and
improved patient quality of care.
Fort Dodge The Fort Dodge region focused on implementing COPD best
practices and included their post-acute partners in the work.
Improvement was realized in confirmed COPD diagnosis and
spirometer metrics. The region also engaged internal UnityPoint
Health clinicians in collaboration with SNFs, home health and
public health agency partners to impact their immunization
performance for flu and pneumonia. The region also created
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specialized integrated health programming for behavioral health
patients, including placement of behavioral health staff in the ED
and having health and wellness classes at their Community Mental
Health Center. These classes included pre-diabetic education,
smoking cessation, nutrition exercise wellness recovery (NEW-R),
and whole health action management (WHAM).
PeoriaPeoria continued to strengthen their “one team” model focused
on fostering enhanced communication and collaboration
amongst inpatient, clinic and home care population health teams.
Consistent use of hand-off tools among their care teams across
sites of care resulted in improved communication. The region also
focused on improving the experience for patients who required an
SNF stay. The ability to schedule in Epic was implemented in our
preferred SNFs to ensure capture of all patients admitted, focusing
on Next Generation ACO Model and Medicare Penalty diagnoses,
decreased SNF length of stay and increased in-network utilization
of ACO preferred partners for skilled care.
Quad CitiesThe Quad Cities regional team engaged two regional clinics in the
AMGA Foundation Collaborative during 2017-2018 to serve as
improvement catalysts for increasing pneumococcal and influenza
vaccination rates. Both clinics realized gains in vaccination
rates with the most significant improvements seen in rates of
pneumococcal vaccinations for high-risk and at-risk populations.
The clinics improved the pneumococcal vaccine metric associated
for patients 65 and older by one percent. For high risk and at-risk
patients under age 65, the clinics improved the pneumococcal
15
vaccine metric by twelve percent and the influenza performance
metric by eleven percent. An important key to improvement
was provider and staff education on the most recent guidelines
with standardized workflows designed to capture the patient’s
immunization status at every visit. The Quad Cities teams credited
strong provider support and persistence in communicating the
importance of vaccination for patients and peers alike for the
successful improvements.
QuincyQuincy Medical Group patients were offered transitional care visits
following their hospitalization. During 2018, nurse care managers
conducted over 200 post-discharge home visits with eligible Next
Generation ACO Model patients who approved of the home
visits. Under the Waiver, UAC providers can deliver this innovative
service to eligible patients who do not qualify for traditional home
care services to help remove barriers they may encounter that can
lead to re-hospitalization. During the visits, care managers perform
a thorough social and clinical assessment and partner with the
patient’s primary care provider and social services agencies to
help better meet patient needs. Early review of performance data
shows the promise for better patient outcomes and the ability to
keep patients at home longer.
Sioux CityThe Sioux City region leveraged data and technology to decrease
hospital readmission rates for its patients. Through diligent review,
it was noted that UnityPoint Clinic locations with access to the
patient’s Epic hospital record were experiencing lower readmission
rates than independent clinics who did not have access. The
team looked for ways to replicate data processes partnering with
the independent clinics. The OSC Director worked to connect
nine independent clinics, ensuring their health coaches and care
coordinators had access to EpicCare Link so they could review
the Transitions of Care report. This enabled the care team to learn
about the inpatient stay and to address transition opportunities
that the hospital staff had identified during the inpatient stay
before calling or seeing the patient at their clinic.
WaterlooIn the Waterloo region, the regional analyst designed and
tested a prototype for provider-level performance reports and
beneficiary care gap reports. The new reporting package was used
in a quarterly review to keep network providers informed about
their projected outcomes for 2018. The provider reports show
the individual provider compared to peers using color coding,
green-yellow-red, to easily identify gaps. The “Beneficiary Matrix”
report provides a listing of all beneficiaries for the performance
year, with population health gaps by Funds Flow model metrics
and Next Generation ACO Model metrics (examples: colorectal
cancer screening, Emergency Department utilization, number
of hospitalizations, patient risk, etc.). The matrix can be used
in conjunction with AWVs to address gaps in care and identify
process improvement opportunities within a practice. In 2018,
vaccination metrics were most positively affected by this process.
These tools have strengthened relationships with independent
providers by giving them actionable data and helped promote
conversations around coordinated, proactive approaches to care.
16
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Analytics Support The UAC analytics team (Analytics)
supports the ACO in achieving its goals
by using data to uncover opportunities,
monitor performance and build the
necessary reporting infrastructure to
allow the network to drive results. Some
examples of analytics products used
today include:
• Optum™ One
• ACO dashboard
• Opportunity assessments
• Post-Acute Care scorecard (PAC)
• Opportunity Summary Report (OSR)
• Contract-level Funds Flow
• ACO quality measures
• Clinical priority analysis
• Performance simulation and projection
Analytics regularly examines their existing
portfolio for enhancement opportunities.
Recently, Analytics applied feedback
from the regions and network to enhance
the Post-Acute Care scorecard. Analytics
gathered a cross-functional team during
2018 to work on these improvements and
will launch the new product, PAC 2.0, in
early 2019. Users will notice an improved,
streamlined interface, customizable and
presentable dashboards and improved
data availability.
Analytics also looks for opportunities to
add capabilities and solutions that assist
in understanding and positively impacting
contract performance. In 2018, Analytics
created an advanced simulation model
to project contract and shared savings
performance. The updated methodology
generates a probability range of likely
outcomes considering contract terms
and performance drivers. This gives
UAC a clearer picture of likely outcomes,
financial risks and the factors driving
contract performance, as well as savings
opportunities that are not easily seen at
the summary level.
Our sophisticated shared savings modeling used outcome distribution for more than 10,000 scenarios based on various factors affecting performance.
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© 2017 UnityPoint Health Proprietary and Confidential
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Post-Acute Care Network DevelopmentThe UAC SNFs also continued to grow as UnityPoint Health
expanded into new markets. Our regions required additional
facility options to maintain network adequacy. The number of
SNFs expanded from 85 in 2017 to 93 in 2018, plus six additional
SNFs to be added in 2019, bringing our new total to 99 facilities.
Due to network growth, both Johnston and Lee Counties now
have SNFs that are part of our post-acute care network.
In our SNF partnerships, length of stay (LOS) continued to
improve. We have seen reduced LOS throughout 2018, moving
from an average of 21 days at the end of 2017 to 19 days through
August of 2018. We also focused on hospital readmission rates,
which remained flat at 14 percent between 2017 and August of
2018. These are excellent outcomes that have been achieved by
the continued hard work taking place in each of our regions and
with strong support from the post-acute care subcommittee.
The Doyle AwardIn March 2018, UAC proudly accepted the 2017 Doyle Award from
MCG Health. The award recognized our work for development
of a high-performing post-acute care SNF network that reduced
patient length of stay without any increase in rehospitalization.
20
21
22
Providing Excellent Patient Care at HomeA key tenant of UAC is providing the “right care in the right place at the right time.” Patients often prefer to receive their care in their own
house. To meet this need, we have developed new programming to provide safe and robust care at home.
Post-discharge home visit Waiver Implementation of Waivers was another
important area of network focus and
growth in 2018. Utilization of the
post-discharge home visit Waiver was
the highest in Quincy, IL with patients of
Quincy Medical Group. It also gained
traction in Central Iowa and the Quad
Cities, aided by leadership from Chris
Butters, Manager of Post-Acute Services
for UnityPoint Health. Post-discharge
home visit utilization increased in 2018
not only because of our geographic
expansion to additional regions but
also changes from CMS, with the Waiver
specifications changing from two allowed
visits in 30 days to nine allowed visits in 90
days. In addition to Post-discharge home
visit Waiver use, SNF 3-Day Rule Waiver
utilization increased 22 percent across the
network with more than 600 Waivers used
through September 2018. The utilization
of these Waivers helps providers to care
for patients in the most appropriate
setting to best meet the needs of the
patient, often avoiding an unnecessary
hospital admission or readmission.
In all, 293 post-discharge home visits
were completed in 2018. The majority
occurred in the Quincy market (65
percent), with good activity in Central
Iowa (34 percent) and a start in the Quad
Cities (one percent). Most patients were
seen in an acute care setting before the
post-discharge home visit was completed,
and most patients were identified for
a post-discharge home visit after they
returned home. The services most often
provided were medication management
and review of post-discharge instructions;
the patient needs most often identified
during the visits were medication issues
and barriers to transport/mobility.
UAC also conducted a 134-person study
to examine patients with either an ED
visit or inpatient stay who had received
a post-discharge home visit compared
with a control group of patients who had
not. The study found that patients who
received a post-discharge home visit
had fewer rehospitalizations and/or ED
utilizations compared to a control group.
23
New Hospital to Home ServicesThe UnityPoint Health ambulatory
enterprise introduced a 2018 strategic
priority to improve and expand
population health interventions
through a home-based care program
with a “one-stop” approach. The
overall home-based care program will
incorporate 1) Hospital to Home to
treat patients with selected low-acuity
conditions in their home instead of
an acute care hospital, 2) a home
visit component for patients who are
unable to complete a clinic visit and 3) a
telemonitoring component for patients
who can benefit from early detection
of a change in clinical status. Successful
implementation of this overall program
has the potential to significantly reduce
the total cost of care per beneficiary
and stimulate expansion of capitated
and value-based arrangements with
government and commercial payers.
Use of the new Hospital to Home Waiver
supports care delivery transformation
by developing a home-based care
alternative option to traditional
facility-based hospital-level care. Hospital
to Home is a provider-level care delivery
model. A typical Hospital to Home
episode is three to five days, with a daily
provider visit and twice daily nursing visits.
Additional ancillary licensed staff home
visits are ordered as needed for therapy
or social work services.
Our first Hospital to Home Next
Generation ACO Model patient was
admitted at the end of September 2018
and a total of eleven patients received
Hospital to Home care by the end of the
year. We anticipate our Hospital to Home
program will serve a minimum of ten
Next Generation ACO Model patients per
month in 2019.
UAC initially implemented the initial six
diagnoses recommended by the Johns
Hopkins Hospital to Home model criteria:
COPD, heart failure, pneumonia, urinary
tract infection, cellulitis and dehydration.
The primary diagnosis served thus far is
COPD. At the end of 2018, UAC received
approval from the Ambulatory Care
Transformation Clinical Service Group to
add two additional diagnoses for 2019:
deep vein thrombosis and pulmonary
embolism.
Initial patient experience measurement
in the last quarter of 2018 was positive,
with a healthy response rate and patient
comments that indicate they see high
value in the new service. A recent survey
comment was, “We were so thankful not
to have to negotiate the hospital and
were able to have the problem resolved
at home."
24
CMS Benefit Enhancement Review Demonstrates our Compliance CommitmentDuring 2017, CMS conducted a
targeted review of the UAC Benefit
Enhancement (BE) deployment and the
utilization of the BEs by our participants
and preferred providers. The BEs under
review included the SNF 3-Day Rule
Waiver, telehealth expansion and the
post-discharge home visit. The routine
CMS monitoring review was conducted
to ensure UAC compliance with our
CMS participation agreement and
to identify areas of non-compliance.
Over the course of the review, UAC
provided extensive documentation
to demonstrate compliance with the
BE requirements outlined in the CMS
participation agreement.
Of the 22 requirements reviewed, UAC
met all requirements, with no findings or
recommendations. Given the complexity
of the BEs and the documentation
required to demonstrate compliance,
the results of this audit were celebrated
as a significant accomplishment for our
team and indicative of our continued
focus on successful deployment of
CMS-sponsored initiatives and our
commitment to compliance. 25
Payment Models/Funds Flow The UAC Funds Flow model is an
incentive-based payment system to
reward providers who achieve high
performance for key quality/utilization
targets. UAC utilizes its Funds Flow model
to drive the network toward an improved
quality of care, better patient experiences
and a reduction in per capita costs. As
our Funds Flow model ends its second
operating year, it has proven to be an
effective tool to distribute shared savings
and incentive funds. Positive benefits from
our model include:
• Increased provider engagement to
help drive performance for many
value-based, risk bearing contracts
(commercial and governmental).
• Increased recognition/understanding
of the UAC value proposition, including
eligibility for the Advanced Alternative
Payment Model (AAPM) and five percent
incentive for Next Generation ACO
Model participant providers. Additionally,
providers now have a greater awareness
of the value of exemption from reporting
in the Merit-based Incentive Payment
System (MIPS).
• More focused assistance to regional
analysts as they prioritize efforts related
to the Funds Flow measures and
opportunities shared in the regional
Opportunity Summary Reports.
• Increased transparency in reporting
provider performance.
• Use of a more effective tool for
calculating how downside risk is shared
across the network.
In 2018, our Funds Flow model
allowed us to begin to leverage a
population-based payment (PBP)
approach for Next Generation ACO
Model providers. After consideration,
UAC requested CMS to withhold three
percent of Next Generation ACO Model
participant revenues attached to the
contract’s aligned lives. Withheld funds
are sent to UAC which first reserves them
to cover any contract losses. If contract
savings are achieved, the withheld
funds are instead distributed to reward
providers for high performance against
key quality and utilization measures within
the defined hospital, physician, SNF and
home care pools.
Continuous improvement processes will
help mature our Funds Flow model by
refining quality and utilization measures
and optimizing risk/reward levels. In
addition, UAC leadership continues to
explore expansion of the Funds Flow to
our other value-based contracts.
$2,500
$3,000
$3,500
$4,000
Bronze (274)
Performance Levels/Number of Providers
AverageSharedSavings
Per Provider
Silver (883) Gold (1,328) Platinum (711)
26
Financial Performance Summary In 2017, UAC achieved more than $15.8
million in shared savings from the Next
Generation ACO Model and United
Healthcare (UHC) value-based contracts
(VBCs). Our total shared savings decreased
in 2017 from 2016 due primarily to the
absence of a Wellmark VBC.
UAC success in the Next Generation ACO
Model was due in part to a reduction of
the average SNF length of stay from 23.9
days in 2016 to 21.9 days in 2017.
UAC quality performance was strong
for our commercial VBCs, where we are
routinely compared against regional
and national benchmarks, and our own
baseline performance, to demonstrate
improvement. UAC success in the
UHC VBC benefitted from a statistically
significant reduction in ED utilization.
We performed particularly well in
preventative care metrics (i.e., breast
cancer screening and pediatric well child
visits) and consistently improved our
target performance.
Looking ahead, in our commercial VBCs,
savings opportunities exist for reducing
potentially avoidable acute admissions
and ED visits. Savings opportunities exist
for the Next Generation ACO Model by
continuing to leverage network home
care services in place of an SNF stay when
clinically feasible.
Contract 2012 2013 2014 2015 2016 2017 Total
Government $304,268 $707,039 $10,527,767 $11,478,688 $23,017,762
Commercial $6,504,815 $6,186,980 $1,177,783 $7,407,781 $18,200,280 $4,321,533 $43,799,171
Total $6,504,815 $6,186,980 $1,482,051 $8,114,819 $28,728,047 $15,800,221 $66,816,933
2017 Value-Based Contract Performance Summary
Commercial UACContracts
Government UACContracts
2012 2013 2014 2015 2016 2017 TOTAL0
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
70,000,000
80,000,000
27
Measure Number
Measure Name P4P or
P4R*
2017 UAC Next
Generation ACO Model
2016 UAC Next
Generation ACO Model
2017 Mean Performance Rate
(all Next Generation ACO Model organizations)
ACO-1 CAHPS: Getting Timely Care, Appointments and Information P 84.27 85.25 81.29
ACO-2 CAHPS: How Well Your Providers Communicate P 92.46 92.93 93.20
ACO-3 CAHPS: Patients’ Rating of Provider P 91.88 92.61 92.41
ACO-4 CAHPS: Access to Specialists P 84.42 85.34 82.83
ACO-5 CAHPS: Health Promotion and Education P 61.66 59.17 62.51
ACO-6 CAHPS: Shared Decision-Making P 70.75 75.67 74.98
ACO-7 CAHPS: Health Status/Functional Status R 74.19 76.48 73.37
ACO-34 CAHPS: Stewardship of Patient Resources P 22.80 26.11 24.54
Measure Number
Measure Name P4P or
P4R*
2017 UAC Next
Generation ACO Model
2016 UAC Next
Generation ACO Model
2017 Mean Performance Rate
(all Next Generation ACO Model organizations)
ACO-8 Risk Standardized, All Condition Readmission R 14.57 13.92 15.18
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission Measure (SNFRM)
R 18.42 17.46 18.66
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes R 37.55 51.63 37.90
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure R 78.33 74.46 80.35
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions
R 60.82 60.79 62.08
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator #91)
R 1.87 N/A 1.73
ACO-44 Use of Imaging Studies for Low Back Pain R 69.06 N/A 68.01%
ACO-12 Medication Reconciliation Post Discharge R 37.42 N/A 63.87%
ACO-13 Falls: Screening for Fall Risk P 91.47 74.05 74.09%
Quality Data Patient/Caregiver Experience
Care Coordination and Patient Safety
28
Measure Number
Measure Name P4P or
P4R*
2017 UAC Next
Generation ACO Model
2016 UAC Next
Generation ACO Model
2017 Mean Performance Rate
(all Next Generation ACO Model organizations)
ACO-14 Influenza Immunization P 80.08 69.85 74.14%
ACO-15 Pneumococcal Vaccination P 85.12 76.86 76.65%
ACO-16 Adult Weight Screening and Follow-up (BMI) P 76.45 90.43 64.16%
ACO-17 Tobacco Use Assessment and Cessation Intervention P 98.51 93.41 90.16%
ACO-18 Depression Screening P 91.49 84.67 59.12%
ACO-19 Colorectal Cancer Screening R 71.37 74.64 69.70%
ACO-20 Mammography Screening R 80.47 72.89 72.55%
Measure Number
Measure Name P4P or
P4R*
2017 UAC Next
Generation ACO Model
2016 UAC Next
Generation ACO Model
2017 Mean Performance Rate
(all Next Generation ACO Model organizations)
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
R 81.07 85.50 80.94%
ACO-40 Depression Remission at Twelve Months R 0.00 0.00 6.11%
Diabetes C Diabetes Composite (All or Nothing Scoring) P 60.00 57.19 44.91%
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control … R 10.26 11.64 16.60%
ACO-41 Diabetes: Eye Exam R 63.48 62.33 51.17%
ACO-28 Hypertension: Controlling High Blood Pressure P 85.68 80.51 74.19%
ACO-30 IVD: Use of Aspirin or Another Antithrombotic P 95.76 90.2 86.80%
Preventive Health
At-Risk Population
*P4P means Pay for Performance. P4R means Pay for Reporting.
Color Key:
Less than 50th percentile
50th percentile or better
70th percentile or better
90th percentile or better
29
Governance GroupsUnityPoint Accountable Care (UAC) is
a physician-led, physician-governed,
integrated network of primary and
specialty care providers dedicated to
providing better health for communities,
better health care experiences for
individuals, and more affordable care
for all. The Board of Managers and
governance councils are made up of a
majority of physicians, with physician
representatives from each of UAC’s ten
geographic regions.
30
2019 Quality and Clinical Integration Council (QCIC)
Dr. Leah Johnson, Chair Physician – Family Medicine and CEO/Residency Director, Siouxland Medical Education Foundation [email protected](712) 294-5000Sioux City Region
Dr. Himabindu AllaPhysician—Family Medicine, UnityPoint [email protected](309) 762-9869Quad Cities Region
Dr. Janet AndrewsPhysician – OB/GYN, University of Iowa Health [email protected](319) 353-7486Iowa City Region
Peg Bradke, MA, BSNVice President, Post-Acute Care,UnityPoint Health – St. Luke’s [email protected](319) 369-7269Cedar Rapids Region
Dr. Ron IversonPhysician – Endocrinology and MetabolismDubuque Internal Medicine, P.C. [email protected](563) 557-9111Dubuque Region
Dr. Greg JohnsonPhysician – GeriatricsUnityPoint Clinic and Medical Director of Care Transformation (Peoria) [email protected](309) 672-4908Peoria Region
Dr. Christina Taylor Physician – Internal MedicineThe Iowa [email protected](515) 875-9192Central Iowa Region
Dr. Katelyn ThompsonPhysician – PsychiatryUnityPoint Health Berryhill [email protected](515) 574-9004Fort Dodge Region
Dr. Clete YoungerPhysician – Family MedicineUnityPoint [email protected](319) 889-2201Cedar Rapids Region
Dr. Ravi MallavarapuPhysician – GastroenterologyCedar Valley Medical Specialists [email protected](515) 234-5990Waterloo Region
Dr. Ramesh RamanPhysician – EndocrinologyEndocrine Associates of the Quad [email protected](309) 788-0014Quad Cities/Muscatine Region
Dr. Adam RoisePhysician, Family Medicine and Medical Director Northeast Iowa Family [email protected](319) 272-2112Waterloo Region
Dr. Jay Rosenberger Physician – Internal MedicineUnityPoint Clinic [email protected] 515) 241-8221Central Iowa Region
Dr. Richard Schlepphorst Physician – Pediatrics and Chief Medical OfficerQuincy Medical [email protected](217) 222-6550Quincy Region
Dr. Matt StetterPhysician – Family MedicineMorton Family Medicine [email protected] (309) 263-9124Peoria Region
PAC Subcommittee Michele Friedman, ARNP / Skilled Nursing Facility / Waterloo IA (Chair)Lori Cooling, MSN, CCM, RN / Case Management / Rock Island IL (Co-Chair)Julia Jenkins, DO / Family Medicine / Des Moines, IA (UnityPoint Health Sponsor)April Barnhill, RT (R) / Director Clinic Operations / Des Moines, IAPeg Bradke, MA, RN / VP Post- Acute Services / Cedar Rapids IALaura Hacker, RN, CCM - PA / Skilled Care Transitions / Peoria ILSarah Hasken / Regional OSC Director / Dubuque IALisa Jansen, ARNP / Nuero/Rehab / Des Moines, IAAmanda Motto, DO / Family Medicine / Davenport IAMilda Mullesch, MSN, RN / VP Accountable Care / Waterloo IAJoni Ogden, MAHS, BSW / Director Post-Acute Care Strategies / Sioux City, IAAmish Patel, MD / Senior Health / Peoria ILDianne Schultz, MSN, RN UPAH / Director Care at Home / Des Moines, IA
31
Dr. Mark Belz — ChairPhysician – NephrologyIowa Kidney Physicians, PC [email protected] (515) 241-5710 Central Iowa Region
Dr. Deepak AhujaPhysician - Internal MedicineUnityPoint Health—Trinity [email protected](309) 779-2904Quad Cities/Muscatine Region
Dr. Larry Burr Radiologist Radiology Consultants of Iowa, [email protected] (319) 533-6830 Cedar Rapids Region
Dr. Elizabeth Day Physician – Pulmonologist Critical Care Chief Medical Information Officer UnityPoint Health – Fort Dodge [email protected] (515) 574-8408Fort Dodge Region
Dr. Nathan DurickRadiologistAdvanced Radiology, [email protected] (309) 762-1072Quad Cities/Muscatine Region
Bradley HawsAssociate Vice President for Financeand Chief Financial OfficerUniversity of Iowa Health [email protected] (319) 384-2844Iowa City Region
Dr. Kalyana Sundaram Physician – CardiologyCedar Valley Medical [email protected](319) 236-1911 Waterloo Region
Dr. Douglas Van DaelePhysician – OtolaryngologyUniversity of Iowa Health [email protected] City Region
Dr. Lincoln Wallace Physician – Family Medicine, UnityPoint Clinic Medical Director, Trinity Pioneer ACO [email protected] (515) 564-6800 Fort Dodge Region
Patty Williamson Chief Financial Officer Quincy Medical Group [email protected] (217) 222-6550 ext. 3304 Quincy Region
Dr. Greg JohnsonPhysician—Geriatrics and Medical Director of Care TransformationUnityPoint Health – [email protected](309) 672-4908Peoria Region
Scott KallemeynExecutive DirectorSurgery Center Cedar Rapids [email protected](319) 558-4801Cedar Rapids Region
Chad Markham Vice President, Clinics & Network Development UnityPoint Health – Sioux City [email protected] (712) 279-3646 Sioux City Region
Dr. Michael Piplani Chief Medical Officer – Physician Siouxland Community Health Center [email protected] (712) 224-1818 Sioux City Region
Dr. Mark Purtle Vice President, Medical Affairs UnityPoint Health – Des Moines [email protected] (515) 241-5100 Central Iowa Region
Rob Quin Vice President and Chief Financial Officer UnityPoint Health - Peoria [email protected] (309) 672-4893 Peoria Region
2019 Finance & Network Development Council (FNDC)
32
2019 Board of ManagersThe UnityPoint Accountable Care (UAC)
Board of Managers is committed to achieving
the Triple Aim. The Board is responsible for
approving the annual operation and capital
budgets and for oversight and approval of our
population health strategy. The Board receives
reports and recommendations from the Quality
and Clinical Integration Council and the Finance
and Network Development Council, as well as
UAC and UnityPoint Health staff, to help fulfill its
responsibilities.
Consistent with the UAC vision of physician-led
governance, Board of Managers seats include
nine physicians (five independent and four
employed) and six non-physicians, including at
least one Medicare beneficiary and consumer
advocate, as required by government
regulations. There are currently open positions
for independent physicians to serve on the UAC
Board of Managers.
Dr. Mark Belz, Board Chair Physician – NephrologyIowa Kidney Physicians, PC [email protected] (515) 241-5710 Central Iowa Region
Michael DewerffPresident and Chief Executive OfficerUnityPoint Health – Fort [email protected](515) 574-6603Fort Dodge Region
Dennis DukePresident – Robert Young CenterUnityPoint Health – Trinity Quad [email protected](309) 779-2023Waterloo Region
Dr. Gregory JohnsonPhysician— Geriatric MedicineUnityPoint Health – [email protected](309) 672-4908Peoria Region
Dr. Leah JohnsonPhysician – Family Medicine and CEO/Residency Director, Siouxland Medical Education Foundation [email protected](712) 294-5000Sioux City Region
Dr. Francis “Rocky” Kane Physician – Family Medicine Family Care Partners of the Quad Cities, [email protected](563) 344-7400 Quad Cities/Muscatine Region
Dr. Vinay Kantamneni Physician – Nephrology Cedar Valley Medical Specialist vinay. [email protected] (319) 833-5940 Waterloo Region
Richard Michael Beneficiary Representative/ Consumer Advocate [email protected] (515) 573-3641 All Regions
Dr. Richard Schlepphorst Physician – Chief Medical Officer Quincy Medical [email protected](217)-222-6550, Ext 3403Quincy Region
Dr. Doug TimboePhysician – Family Medicine UnityPoint [email protected] (515) 224-9666 Central Iowa Region
Dr. Dave WilliamsPresident and Chief Executive OfficerUnityPoint Clinic, UnityPoint at [email protected](515) 471-9281All Regions
33
34
Looking Ahead
Join us on our journey to improving the way health care is delivered to our communities.
To learn more about UnityPoint Accountable Care, L.C., visit unitypoint.org/ACO or email us at [email protected]
In 2019, UAC will focus our Next Generation ACO Model development
on specific clinical opportunities, including falls, benefit enhancement
Waivers (such as increasing our post-discharge home visits), palliative
care and advanced care planning opportunities.
To enhance care for our employees in the UnityPoint Health Self-Insured
Health Plan (SIHP), UAC will be focused on new tools and processes
in integrated care management, pharmacy delivery and providing
alternatives to ED utilization for non-emergent conditions.
Our clinical team will be instituting a new care management assessment
at the practice level. This assessment will assist us in determining staff
resources and additional tools needed in our network for optimal
performance.
We will continue to expand our processes and systems for care delivery
and improve our performance for quality, cost and patient experience.
Working in conjunction with UnityPoint at Home, we will increase
our emphasis on Hospital to Home programs. Our Next Generation
ACO Model participation underpins our ability to offer innovations to
beneficiaries such as care management visits, post-discharge home visits
and other population heath improvements.
To realize the full promise of our value-based contracts, we will continue
to increase our risk management infrastructure needs, including adding
analytic tools and incorporating a new “Patient Ping” alert system to
allow our network to see admissions, discharges and transfers when a
patient presents to a hospital or skilled nursing facility.
And we will expand our contract offerings as we accelerate on our path
toward pre-payment and full risk.
Our collaborative journey continues — but the future is getting closer all
the time.
35
CEDAR RAPIDSAbbe Center for Community Mental HealthAllergy Partners of Cedar RapidsAmana Family PracticeAssociates for Behavioral HealthcareCedar Centre Psychiatric GroupCedar Rapids OB Gyn Specialists PCCedar Valley PathologistsCounseling and Health Center, LLPDermatology Clinic of IowaDr. Fitzgerald & AssociatesEast Central Iowa Acute CareEastern Iowa Foot SpecialistsEastern Iowa Health CenterEye Associates of Iowa CityEye Associates of Iowa, PCFamily Medicine Specialists, PCFamily Psychology AssociatesFoot & Ankle Specialists of IowaForefront DermatologyHawkeye Anesthesia, PLCIowa Eye CareIowa Eye CenterIowa Foot & Ankle ClinicIowa Valley Eye Care, PLCKingus, Robert T. OD, PCLinn County AnesthesiologistsLinn County Eye Care, PLCMarengo Memorial Hospital and clinicsMartin, Michael G. ODMathew, Stanley, MD, PLLCMedical Laboratories of Eastern Iowa, LCMt. Vernon Eye Clinic, PLCOB-GYN Associates, PC
Physicians’ Clinic of IowaRadiology Consultants of Iowa, PLCRegional Medical Center | ClinicsStapley, Denise LMHC, PLCUnityPoint Health - Cedar RapidsVanderZee, John MD, PCVirginia Gay Hospital clinicsWehr, MelissaWollner, John, MD
CENTRAL IOWAAlbrecht Foot and AnkleAllergy | Asthma Associates, PCAmes Eye ClinicAnkeny Eye CareAshworth Vision Clinic, PCAssociated Anesthesiologists, PCAssociated OphthalmologistsAssociates in Kidney CareBlank Health ProvidersBoone County Comprehensive Specialty CareBoone County Family MedicineBroadlawns Medical CenterBrooklyn Medical ClinicCampbell Neuropsychological Services, PCCampidilli, Patti LLCCapstone Behavioral HealthcareCentral States MedicineChild and Family Eyecare, PCChild Psychiatry AssociatesChildren and Families of Iowa Childress, Emily KClinical Psychology, PLCCompass Clinical Associates
Counseling Associates of Central Iowa PCCounseling for Growth and ChangeDawson, Bruce PsydDermatology, PCDes Moines AnesthesiologistsDes Moines Eye CareDes Moines Eye SurgeonsDes Moines Internal MedDes Moines Orthopaedic SurgeonsDes Moines Pastoral Counseling CenterDes Moines Pediatric and Adolescent ClinicDes Moines University Osteopathic Medical CenterDomino Eye CareDucharme DermatologyElite Eye Care, PCEye Care AssociatesEyecare Associates of Southwest IowaEyerly Ball Community Mental Health ServicesFamily Medicine, LLPFamily Vision Center Gallagher, James MDGanske, Greg MDGeneral Surgery Physician, PCGreater Des Moines DermatologyGreater Regional Medical CenterGreene County Medical CenterGrinnell Regional Medical CenterGuthrie County HospitalHuxley Physical TherapyHuxley Vision ClinicIowa Arthritis and Osteoporosis CenterIowa Diabetes and Endocrinology CenterIowa Digestive Disease Center, PCIowa Ear Center
Providers
UAC Network Participants
36
Iowa ENT Center, INCIowa Head & Neck, PCIowa Kidney PhysiciansIowa Pathology Associates, PCIowa Radiology, PCIowa Retina ConsultantsIowa Surgery Center, PCKenya Rocha - Mosaic Family Counseling CenterKoch Facial and Plastic SurgeryKoenen, Jeffrey L. OD PCLifeworksLucas County Health Center Medical ClinicMadrid Family PracticeMcFarland ClinicMedical Oncology and Hematology AssociatesMetro Anesthesia and Pain ManagementMid Iowa FertilityNevada Vision ClinicNew Life Family Medicine, PCNewton Clinic PCNewton Family Eye Care, PCOrchard PlaceOsceola Vision CenterPediatric and Adult Allergy, PCPediatric CardiologyPella Regional Health CenterPhysicians Eye ClinicPine Rest Christian Mental Health ServicesPorto, Dennis P, MDPrairie WellnessProfessional Vision CareR.H. Sharp, OD, PCRegional Laboratory Consultants, PCRiver Valley Therapy Clinic, LLC
Sharp, Robert H. OD PCSnodgrass Family Eyecare, PLLCStory County Hospital and ClinicsSurgical Associates, LLP GrinnellThe Iowa ClinicTotal Family Eye CareUgulini Pals, Amy J LMHC, LLCUCS HealthcareUnityPoint Health - Des MoinesValley Eye Clinic Vision SourceWaggoner Pediatrics of Central IowaWest Des Moines Children’s ClinicWillow Grove Therapy GroupWolfe Eye ClinicWomen’s Care Clinic, PLCYounker Rehabilitation Therapy Services, LLC
DUBUQUEAdvanced Wellness Center, PC Asbury Counseling and Evaluation Services, LLCFilitti Counseling ServicesHeil, ElizabethHillcrest Family ServicesHorizon Mental Health ManagementLester-Howland,Lynn ODTri-State IPACornerstone Family Practice Dubuque ENTDubuque Neurology & Sleep MedicineDubuque Obstetrics and GynecologyDubuque Orthopedic SurgeonsDubuque PodiatryDubuque RheumatologyDubuque Surgery
Fuerste Eye ClinicGrand River Medical Group, PC High Point Family MedicineLancaster Family Medical CenterMaloney, Karen MDMaquoketa Family ClinicMedical Associates of MaquoketaMemorial Hospital of Lafayette County Primary CareMercy Radiologists of DubuqueMidwest Medical CenterMississippi Valley AnesthesiologyOphthalmology PCPlastic Surgery AestheticsPlatteville PodiatryPostville Medical ClinicRadiation Oncology of IowaSchuck, Steven DPMTri-State Family PracticeTristate Vein CenterWagoner Family Foot ClinicWestside OrthopaedicsUnityPoint Health - FinleyWeber Counseling Services
37
FORT DODGEAdvanced Family Medicine, PCBuena Vista Regional Medical CenterCenters for Allergy, Asthma and Immune Disorders, PCCleveland, KayeDaniel J. Reedy, ODDelucca, Leopold, MDFort Dodge Oral Surgery & Maxillofacial Surgery, PCGenesis Mental Health Associates, LLCHumboldt County Memorial HospitalIowa ENT & Sinus Surgery CenterLoring HospitalLutheran Family ServiceMedical Arts EyeCare, PLCMy Skin ClinicsNorthwest Iowa AnesthesiaNorthwest Iowa Bone Joint & Sports SurgeonsNorthwest Iowa Ear, Nose and ThroatNorthwest Iowa Surgeons, PCNorthwest Iowa Urologists, PCPocahontas Community HospitalRock Vision Clinic, PCStewart Memorial Hospital ClinicsTimi Jordison Psychological ServicesUnityPoint Health – Berryhill CenterUnityPoint Health – Fort DodgeUrology AssociatesVision Care ClinicWebster County Health DeptWellendorf ENT, PCWest Central PathologyWestern Iowa Surgery, IncWood Vision Clinic, Inc
MADISON, WIMeriter Medical GroupUnityPoint Health - Meriter
MULTIPLE REGIONSUnityPoint Clinic
PEORIA, ILAdvanced Physicians Health Care, SCAffiliated Urology Specialists, LtdAffinity Women’s Health Care, SCAlignlife North PeoriaAllergy & Asthma of IllinoisAntioch Group IncAssociated Anesthesiologists, SCAssociates in Mental Health, SCBaylor, Mark C, MDBochantin OB/GYN Services LtdCarter Chiropractic Office Catherine Kilborn LCSWCentral IL Diabetes, Thyroid & Metabolism InstituteCentral Illinois Dermatology, SCCentral Illinois Radiation Oncology Physicians, LtdCouri Center for Gynecology and Integrative Women’s HealthEaster Seals Central IllinoisEastside Wellness ChiropracticEmergency Physicians Staffing Solutions, LLCEndocrine & Diabetes, S.C.Facial Plastic & Laser Surgery CenterGayon High Performance Chiropractic & RehabGlen Manor Counseling, LTDHeartland Health ServicesHuman Service Center
ICPR Family PracticeIllinois CancerCare, PCIllinois Eye CenterIllinois Gastroenterology InstituteIllinois Retina InstituteJalovec, Lynne M MDJody Kelly, M.D. & Associates, LLCJohn R. Day & Associates, LtdJoseph and Hishon ChiropracticJoy Miller & AssociatesKhoury, Tracie, DCKidney HealthcareKurt M. Pepperell, DCMa, Lindsey, MD SCMethodist Medical GroupMidwest Orthopaedic Center, SCMidwest Urological Group, LtdMillennium Pain Center, LLCNatural Balance Wellness CenterOgburn Counseling ServicesOlt, Tamara, SC, IncPekin HospitalPeoria Area Women’s HospitalistPeoria ChiropracticPeoria Ear, Nose & Throat Group, SCPeoria Surgical Group, LtdPeoria Tazewell PathologyPro HealthProctor Medical GroupProctor First CareProfessional Therapy Services, IncPsychology Specialists LtdRenal Care Associates
Providers
UAC Network Participants (continued)
38
Resource Management Services, Inc.Retina Consultants of Central IllinoisSchierbeck, Debra Senara Health and Healing CenterShay and AssociatesSoderstrom DermatologySpecialists in Medical Imaging, SCSunnyland ChiropracticSwingler, James MDTeverbaugh Croland and Mueller Ob/Gyn and Associates, SCThe Bleeding & Clotting Disorders InstituteTuttle ChiropracticUnityPoint Health – Methodist │ProctorUniversity of Illinois Medical Service Plan at PeoriaWashington ChiropracticWomen’s Health Institute
QUAD CITIESAde, David MDAde, Thomas MDAdvanced Foot and Ankle AssociatesAdvanced Imaging Center, LLCAdvanced Radiology, SCAhmad, Anis MDAllergy & Asthma Associates of the Mississippi Valley PLLCArthritis Care Center, PCBettendorf Pediatric & Family PracticeBurlington Family Eye CareCardiac Surgery Associates, SCCardiovascular Medicine, PCCaring Dermatology CenterCastro, Reynaldo MDCenter for Alcohol and Drug Services, Inc
Children’s Therapy Center of the Quad CitiesChizek Family Eye CareContemporary Obstetrics and Gynecology Women’s Care Center, LLCDan L. Stadelman, ODDavenport Surgical Group, PCDigestive Disease SpecialistsDiscover ChiropracticDodson, Kevin C., D.P.M.Eastern Iowa DermatologyEastern Iowa Gastroenterology, PLCEndocrine Associates of the Quad CitiesENT Professional ServicesEye Associates of Iowa CityEye Surgeons Associates, PCFamily Eye and Contact Lens Center Franklin PediatricsFried, Richard G. DCGastroenterology Associates, PCGastrointestinal Clinic of the Quad CitiesGovindaiah, Sujatha, MD, SCGreat River Medical GroupHammond Henry HospitalHartman Pediatrics LLCHeartland Clinic, LLCHematology & Oncology CareHybrid Medical GroupIowa Foot & Ankle Specialists, PLLCIowa Plastic SurgeryJohnson Eyecare, PCJohnson, Gordon, DO, PCKidney Care Quad Cities, LLCLaparoscopic Surgical Specialties
Lass, ReneeMahadevia Sleep ConsultantsMarla, Rammohan MDMarriage and Family Counseling ServiceMedical Arts Associates, LtdMetro Infectious Disease Consultants, LLCMetropolitan Medical LabOB Hospitalists GroupORA Orthopedics, PCOrthopaedic Specialists, PCPanozzo, kerry MD PCPediatric Group AssociatesPlastic Surgery Associates, LLPPlastic Surgery Center, PCPsychology Health GroupPurighalla Neuroscience & Spine Institute, LLCQC Medical Group and Weight Loss ClinicQuad Cities Audiology Consultants, PCQuad Cities Foot and Ankle Associates, PCQuad Cities Mental HealthQuad Cities Nephrology Associates, PLCQuad Cities Pathologists, LLCQuad Cities PediatricsQuad Cities Retina ConsultantsQuad City Family PhysiciansQuint-Cities Radiation Oncology, LTDRheumatology Associates, PCSales, James MDSmith, Kevin D. DPMStone Ridge Medical GroupThe Center for Neurosciences, LLCUnityPoint Health - MuscatineUnityPoint Health - Quad Cities
39
Providers
UAC Network Participants (continued)
UnityPoint Health - The Robert Young Center for Community Mental HealthUrological Associates, PCVascular Surgery Associates, PCVirdi Eye ClinicWaterford Family MedicineWestern Illinois Anesthesiologists LLCWomen’s Care Specialists, PCZmuda-Swanson, Elizabeth
QUINCY, ILQuincy Medical Group
SIOUX CITY20/20 Vision WearAnesthesia Consultants, PCAssociates for Psychological and Therapy ServicesAssociates of Psychiatric ServicesBottger Anesthesia ServicesBruening Eye SpecialistsCherokee Regional Medical CenterCNOS, PCDean & Associates, PCDermatology Associates of Siouxland, PCDigestive and Liver DisordersDrs. Spronk, VanderGriend & RadkeEar, Nose and Throat Consultants, PLCFamily Eye and Vision Care Family Health Care of SiouxlandFloyd Valley Hospital Family Medicine ClinicFoot and Ankle Clinic, PCHanno Therapy ServicesHartje, James A, MDHines Psychotherapy Services
Horn Memorial HospitalJackson Recovery CentersJohn Kiernan, OD Jones Eye ClinicJune E. Nylen Cancer CenterMental Health Associates, LLCMidlands Clinic, PCOrange City Area Health SystemParkview Psychological ServicesPathology Medical Services of Siouxland, PCPlains Area Mental Health IncPrairie PediatricsRenal Associates, PCRenewing the MindRoat, James W, MDRumberger, Daniel J PsyDSioux City Allergy & Asthma AssociatesSiouxland Adult MedicineSiouxland Community Health CenterSiouxland Cytology Consultants, LLCSiouxland GastroenterologySiouxland Hospitalists PLLCSiouxland Medical Education FoundationSiouxland Mental Health CenterSiouxland OB/GYN, PCSiouxland Podiatry Associates, PCSiouxland Urology Associates, PCSiouxland Women’s Healthcare, PCSt. Luke’s Health ResourcesTri-State Specialists, LLPUnityPoint Health - St. Luke’s Sioux CityVision Care ClinicWadzinski Eye ClinicWagner Ear, Nose & Throat
WATERLOOAllen Memorial HospitalBlack Hawk Grundy Mental Health Center, IncCedar Valley Medical SpecialistsCedar Valley Podiatry, PCCedar Valley Neuropsychology ServicesCenter AssociatesCornerstone Family Therapy, LLCCommunity Memorial Hospital Medical Clinic-SumnerDr. Anthony Bailey Family Foot Health Care, PLCFiat Family MedicineGrace C Mae Advocate CenterGrundy County Memorial HospitalHintz, Brent m MDKontos, Annie M, PCMarshalltown Eye CareMarshalltown Vision, PCMoonstone WellnessNE IA Medical Education FoundationNortheast Iowa PodiatryPathways Behavioral Services IncPeoples Community Health ClinicPerformance Rehab, LLCPhysical Medicine and Rehabilitation Associates of NE Iowa, IncPremier Dermatology LtdPsychiatric Associates of Northeast Iowa, PCSmith, Matthew J, MDTaylor Physical Therapy AssociatesTotal Health of Iowa, IncUnityPoint Health-MarshalltownWaverly Health CenterWood Vision Clinic, Inc
40
Facilities/Services CEDAR RAPIDSClarence Nursing HomeEastern Iowa Sleep Center, LLCJones Regional Medical CenterRegional Medical CenterMarengo Memorial HospitalMedical Laboratories of Eastern Iowa, LCRadiology Consultants of Iowa, PLCS.T.L. Care Company Living Center East and Living Center WestThe Outpatient Surgery Center of Cedar RapidsVirginia Gay Hospital, Inc.UnityPoint Health - Cedar Rapids St. Luke’s Hospital
CENTRAL IOWABoone County HospitalBrio of Johnston, A Wesley Active Life Community, LLCBroadlawns Medical CenterCalvin CommunityClarke County HospitalEdgewater, A Wesley Active Life Community, LLCFountain WestGreater Regional Medical CenterGreene County Medical CenterGrinnell Regional Medical CenterGuthrie County HospitalHearthstone, A Ministry of WesleyLife, LLCIowa Digestive Disease CenterIowa Endoscopy Center, IncIowa Jewish Senior Life CenterIowa Pathology Associates, PC Iowa Radiology, PCKennybrookLakeview Surgery Center, LLCLucas County Health Center
Norwalk Nursing and Rehabilitation CenterNorthridge Village On With Life, IncOrthopaedic Outpatient Surgery CenterParkridge SpecialtyPella Regional Health CenterPrairie Vista VillagePresbyterian Homes Mill Pond, IncRegional Laboratory Consultants, PC Select Specialty Hospital – Des MoinesSpurgeon ManorStory County Hospital and ClinicsSunny ViewSurgery Center of Des MoinesThe Bridges at Ankeny The Iowa Clinic Endoscopy CenterUnityPoint Health - Des MoinesBlank Children’s HospitalIowa Lutheran HospitalIowa Methodist Medical CenterJohn Stoddard Cancer CenterMethodist West HospitalUrbandale Health Care CenterValley View VillageWesley Community Services, IncWesley Retirement Services, IncWest Des Moines Ambulatory Surgical CenterWest Lakes Medical Equipment LLCWolfe Surgery Center
DUBUQUEClayton County VNADubuque Endoscopy Center, LCEnnoble Skilled Nursing & Rehabilitation CenterFinley Hartig Homecare
Hawkeye Care CenterHospice of DubuqueManor Care of Dubuque IA, LLCMidwest Medical CenterMill Valley Care CenterStonehill Franciscan ServicesUnited Clinical Laboratories, IncUnityPoint Health – Finley Hospital
FORT DODGEBuena Vista Regional Medical CenterBlackHawk Lifecare CentersFort Dodge Health and RehabilitationFriendship HavenGood Samaritan Society – MasonGrandview Health Care CenterHumboldt County Memorial HospitalLaurens Care CenterLoring HospitalMarian HomeMethodist Manor Retirement CommunityPark View Rehabilitation CenterPleasant View HomePocahontas Community HospitalPocahontas ManorQHC Humboldt North, LLCQHC Humboldt South, LLCRotary Ann Nursing HomeStewart Memorial HospitalSunny Knoll Care CentreTwilight AcresUnityPoint Health – Berryhill CenterUnityPoint Health – Trinity Regional Medical Center
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UAC Network Participants (continued)
Facilities/Services IOWA CITYCrestview Specialty CareIowa City Rehab and Health Care CenterLantern Park Specialty CareRiver Hills VillageSolon Retirement VillageWindmill Manor
MADISON, WIUnityPoint Health – Meriter Hospital
MULTIPLE REGIONSUnityPoint at HomeUnityPoint Hospice
PEORIA, ILCentral Illinois Endoscopy Center, LLCComplete Home Respiratory CareComprehensive Prosthetics & OrthoticsEdgepark Medical SuppliesFarmington Country Manor Generations at Peoria, LLCGenerations at Riverview, LLCHeritage of ChillicotheLutheran Hillside VillageManor Court of PeoriaPekin ManorSnyder VillageSpecialists in Medical Imaging, SCUnityPoint Health – Methodist │ProctorUnityPoint Health – Pekin
QUAD CITIESAdvanced Imaging Center, LLCAdvanced Radiology, SCFriendship Manor, Inc
Geneseo VillageHammond Henry HospitalHeartland Health Care Center -MolineKahl Home for the Aged and InfirmLutheran Homes SocietyManor Care Health Services-Utica RidgeMetro MRIMetropolitan Medical LabMississippi Valley MRIMississippi Valley Sleep Disorder CenterMississippi Valley Surgery CenterQuad City Ambulatory Surgery Center, LLCRegional Surgi CenterRosewood Care Center of MolineSpring Park Surgery CenterThe Center for Neurosciences, LLCUnityPoint Health – Trinity Trinity BettendorfTrinity Moline Trinity Muscatine Trinity Rock Island The Robert Young Center for Community Mental HealthValley LaboratoriesValley View Anesthesia
QUINCY, ILBarry Community Care CenterGood Samaritan Home of QuincyLewis County Nursing Home DistrictNorth Adams HomeSt. Vincent’s HomeSunset HomeUnityPoint Health - Keokuk
SIOUX CITYAccura Healthcare of Cherokee, LLC Cherokee Regional Medical CenterCJ Elmwood PartnersFloyd Valley HospitalHospice of SiouxlandHorn Memorial HospitalJackson Recovery CentersJP senior Health CareJune E. Nylen Cancer CenterOrange City Area Health SystemPierce Street Same Day Surgery LCRegency Square Care CenterSunrise Retirement CommunityTouchstone Health Care CommunityUnityPoint Health – St. Luke’s Hospital
WATERLOOBartels Lutheran Retirement CommunityBuchanan County Health CenterCare Initiatives Northcrest Specialty CareCare Initiatives Pinnacle Specialty CareCare Initiatives Ravenwood Specialty CareCedar Valley HospiceCedar Valley Sleep Center LLCCommunity Memorial HospitalGrandview Heights Inc.Grundy County Memorial Hospital Hawkeye Care Center MarshalltownManor Care of Waterloo IA, LLCMartin Health Center, IncNewAldaya LifescapesPathways Behavioral Services IncSouthridge Specialty Care UnityPoint Health – Allen HospitalWaverly Health Center
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