The St. Louis Physician Alliance (SLPA) welcomes your questions regarding our clinically integrated network and ACO. Below is a list of the most commonly asked questions.
Who governs SLPA?
SLPA is governed by a 15-member Board of Managers, including 13 practicing physicians (6 of whom are elected by the membership for 2-year terms), one appointed USPI executive, and an appointed community representative. The SLPA Board chairman is a practicing physician elected by the Board Members. Since the terms of the physician board seats are staggered, an election for new physician board members is held annually each fall.
Is SLPA an Accountable Care Organization (ACO) working with Medicare?
In the summer of 2014, the SLPA Board of Managers approved the formation of a separate legal entity, SLPA ACO, LLC, to apply for the Medicare Shared Savings Program (MSSP). SLPA ACO, LLC submitted an application to the Centers for Medicare and Medicaid Services (CMS) for the program which allows Medicare to work with eligible Accountable Care Organizations (ACO) – which are health care providers (ie–primary care physicians, specialists, and hospitals) working together collaboratively to accept collective accountability for the quality and cost of care delivered to a defined patient population. SLPA ACO, LLC was awarded its intial three-year Medicare agreement with CMS for the MSSP effective January 1, 2015. SLPA ACO entered its second three-year contract effective January 1, 2018. SLPA continues the work of developing a clinically integrated network of providers who are committed to the goals of higher quality and lower overall cost of care, through effective collaboration, increased communication and data analysis.
Can any physician become a participant of SLPA?
The membership is closed at this time.
Is there a fee to participate in SLPA?
Yes, there is a one-time participation fee of $300 that is required for each physician. Facility (non-physician) providers pay a one-time $500 participation fee per tax ID.
Who are the owners?
The St. Louis Physician Alliance is a for profit organization with United Surgical Partners International (USPI) as the sole owner. SLPA ACO, LLC is a separate legal entity owned by St. Louis Physician Alliance. Tenet Healthcare is the owner of USPI.
I am a specialist. What are some of the advantages to joining SLPA?
The value added benefits of joining SLPA include participation in creating and excelling in the clinical integration world of tomorrow. By dedicating yourself to a common mission with like-minded providers, dedicated to the goals of improved quality and reduced cost through effective clinical integration, SLPA membership will create a firmly linked position in a care network.
I am a primary care physician. What are some of the advantages to joining SLPA?
Collaborating with like-minded independent physicians and coordinating care among patients is one of the advantages to joining the St. Louis Physician Alliance. As a member, you’ll have access to a group purchasing organization (GPO), discounted medical liability insurance, marketing through a listing in the SLPA website directory and opportunity to be featured in the SLPA website Spotlight Announcements, networking events, webinars and other educational opportunities.
Are there potential financial rewards to clinical integration?
In addition to the reduction of the MIPS reporting burden, participation in SLPA ACO has provided financial rewards through MSSP shared savings. For performance years 2015 through 2019, SLPA ACO saved CMS millions of dollars and received more than $16 million in shared savings from CMS.
What are the benefits of joining? The elevator speech that I can tell my partners/colleagues?
- Participation with a clinically integrated organization that shares information via a population health platform for contracts that offer shared savings, bundled payment, and/or other new payment methods;
- Participation in development of clinical best practice integration and evidence-based care paths; and
- Being identified with a brand supporting quality, reducing waste, and decreasing health care costs.
How do you bring new technology into this equation?
SLPA uses a sophisticated population health platform and analytic tools and works to integrate with practice EHRs to manage our ACO population and report the ACO quality measures on an annual basis.
Are there incentives/disincentives to keep patients within the SLPA network?
We believe that a participating provider wants to keep patients within the SLPA network to assure quality and better manage the costs for patient care. However, patients always have a choice in who they want to see.
What data is being monitored? What type of quality data will be collected and reported? Inpatient and Outpatient?
CMS requires ACOs to report on a standard set of pre-determined ACO quality measures annually. These include CAHPS measures, claims-based measures, and point-of-care documented measures. SLPA ACO works very closely with our PCP practices to ensure that the point-of-care documented measures are understood and collected for annual reporting purposes.
How will SLPA support care coordination? What are the care coordination requirements for the participant physician offices?
There are some best care examples in the community that have shown successful results, allowing health care practitioners to work at the top of their licenses. Care coordination is a key component of a successful ACO.
How do we manage participating providers who do not follow care paths and best care protocols?
All participating providers will expressly agree to follow best care practices and care paths. If some do not, the results will be reviewed by their peers on the Board. Following attempts at education or other performance improvement initiatives, non-compliant participants may be asked to leave the organization based on results of performance measurements of quality, cost, and best care practices.
Why have open panels for the network? Why not hand-pick physicians and certain specialties?
The idea was to be inclusive, with broad primary care and specialty panels. The SLPA Board monitors enrollment and recognizes that at a point in time the panel needed to close.
If your question is not covered on the list, please email us at SLPA@tenethealth.com