ACO Name and Location
Montana Health Plus
Previous Names: N/A
1805 Euclid Ave
Helena, MT 59601
ACO Primary Contact
| Primary Contact Name | Leslie Southworth |
| Primary Contact Phone Number | 406.594.3863 |
| Primary Contact Email Address | LSouthworth@mtpca.org |
Organizational Information
ACO Participants:
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
| Flathead Community Health Center Inc (Greater Valley Health Center) | N |
| Lincoln County Community Health Center, Inc. (Northwest Community Health Center) | N |
| Montana Migrant & Seasonal Farmworker Council, Inc | N |
| PureView Health Center | N |
| Butte Silver Bow Primary Health Care Clinic Inc (Southwest Montana Community Health Clinic) | N |
| Partnership Health Center Inc | N |
| Sapphire Community Health Inc, | N |
| Community Health Care Center Incorporated (Alluvion Health) | N |
| Glacier Community Health Center Inc, | N |
| Bullhook Community Health Center, Inc., | N |
| Yellowstone City County Health (RiverStone Health) | N |
| Bighorn Valley Health Center Incorporated (One Health) | N |
ACO Governing Body:
| Member | Member’s Voting Power – Expressed as a percentage or number | Membership Type | ACO Participant TIN Legal Business Name/DBA, if Applicable | ||
| Last Name | First Name | Title/ | |||
| Clemons | Maria | Chair | 7.14% | ACO Participant Representative | Lincoln County Community Health Center, Inc. (Northwest Community Health Center) |
| Murgel | Justin | Voting Member | 7.14% | ACO Participant Representative | PureView Health Center |
| Salazar | Lara | Voting Member | 7.14% | ACO Participant Representative | Partnership Health Center Inc |
| Forte | Jon | Voting Member | 7.14% | ACO Participant Representative | Yellowstone City County Health (RiverStone Health) |
| Cox | Tammy | Voting Member | 7.14% | ACO Participant Representative | Butte Silver Bow Primary Health Care Clinic Inc (Southwest Montana Community Health Center) |
| Seglem | Betsy | Voting Member | 7.14% | ACO Participant Representative | Glacier Community Health Center Inc, |
| Sterhan | Mary | Treasurer/ Secretary | 7.14% | ACO Participant Representative | Flathead Community Health Center Inc (Greater Valley Health Center) |
| Preston | William | Voting Member | 7.14% | ACO Participant Representative | Community Health Care Center Incorporated (Alluvion Health) |
| Townsend | Carol | Voting Member | 7.14% | ACO Participant Representative | Montana Migrant & Seasonal Farmworker Council, Inc. |
| Duncan | Kelly | Voting Member | 7.14% | ACO Participant Representative | Sapphire Community Health, Inc. |
| Hall | Kyndra | Voting Member | 7.14% | ACO Participant Representative | Bullhook Community Health Center, Inc. |
| Cooney | Lander | Voting Member | 7.14% | ACO Participant Representative | Bighorn Valley Health Center Incorporated (One Health) |
| Gonzalez | Dona | Medicare Beneficiary Board Member | 7.14% | Medicare Beneficiary Representative | N/A |
| Stergar | Cindy | Ex-Officio (non-voting) | 0% | Ex-Officio (non-voting) | Montana Primary Care Association |
Key ACO Clinical and Administrative Leadership:
| Leslie Southworth | ACO Executive |
| Shawna Yates, DO | Medical Director |
| Maria Clemons | Compliance Officer |
| Leslie Southworth | Quality Assurance/Improvement Officer |
Associated Committees and Committee Leadership:
| Committee Name | Committee Leader Name and Position |
| MSSP Operations Committee | Leslie Southworth (Chair) |
| Clinical Quality Committee | Shawna Yates, DO (Chair) |
| Fiscal Committee | Bree Sandoval (Chair) |
| Billing Workgroup | Tara Callaghan (Chair) |
Types of ACO participants, or combinations of participants, that formed the ACO:
- Federally Qualified Health Center (FQHC)
- Networks of individual practices of ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses
- Performance Year 2023, $1,845,514.83
- Performance Year 2024, N/A
- Performance Year 2025, N/A
- Performance Year 2026, N/A
- Performance Year 2027, N/A
Shared Savings Distribution
- First Agreement Period
- Performance Year 2023
- Proportion invested in infrastructure: 20%
- Proportion invested in redesigned care processes/resources: 20%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2024
- 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 2025
- 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 2026
- 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 2027
- 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 2023
Quality Performance Results
2023 Quality Performance Results:
Quality performance results are based on the CMS Web Interface collection type.
| Measure # | Measure Name | Collection Type | Reported Performance Rate | Current Year Mean Performance Rate (SSP ACOs) |
| Quality ID#: 001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [1] | CMS Web Interface | 9.24 | 9.84 |
| Quality ID#: 134 | Preventive Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 96.82 | 80.97 |
| Quality ID#: 236 | Controlling High Blood Pressure | CMS Web Interface | 64.36 | 77.80 |
| Quality ID#: 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 22.36 | 89.42 |
| Quality ID#: 110 | Preventive Care and Screening: Influenza Immunization | CMS Web Interface | 35.83 | 70.76 |
| Quality ID#: 226 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 81.67 | 79.29 |
| Quality ID#: 113 | Colorectal Cancer Screening | CMS Web Interface | 64.40 | 77.40 |
| Quality ID#: 112 | Breast Cancer Screening | CMS Web Interface | 65.49 | 80.36 |
| Quality ID#: 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 87.30 | 87.05 |
| Quality ID#: 370 | Depression Remission at Twelve Months | CMS Web Interface | 12.89 | 16.58 |
| Quality ID#: 321 | CAHPS for MIPS [2] | CMS Web Interface | 5.47 | 6.25 |
| Measure # 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [1] | CMS Web Interface | – | 0.1553 |
| Measure # 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] | CMS Web Interface | – | 35.39 |
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
- Payment for Telehealth Services: Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.