Skip to content

ACO Medicare

ACO Name and Location

Montana Health Plus
Previous Names: N/A
1805 Euclid Ave
Helena, MT 59601

ACO Primary Contact

Primary Contact NameLeslie Southworth
Primary Contact Phone Number406.594.3863
Primary Contact Email AddressLSouthworth@mtpca.org

Organizational Information

ACO Participants:
ACO ParticipantsACO 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, IncN
PureView Health CenterN
Butte Silver Bow Primary Health Care Clinic Inc (Southwest Montana Community Health Clinic)N
Community Health Partners, IncN
Partnership Health Center IncN
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:
MemberMember’s Voting Power – Expressed as a percentage or numberMembership TypeACO Participant TIN Legal Business Name/DBA, if Applicable
Last NameFirst Name

Title/
Position

ClemonsMariaChair7.14%ACO Participant RepresentativeLincoln County Community Health Center, Inc. (Northwest Community Health Center)
MurgelJustinVoting Member 7.14%ACO Participant RepresentativePureView Health Center
SalazarLaraVoting Member 7.14%ACO Participant RepresentativePartnership Health Center Inc
ForteJonVoting Member 7.14%ACO Participant RepresentativeYellowstone City County Health (RiverStone Health)
CoxTammyVoting Member 7.14%ACO Participant RepresentativeButte Silver Bow Primary Health Care Clinic Inc (Southwest Montana Community Health Center)
SeglemBetsyVoting Member 7.14%ACO Participant RepresentativeGlacier Community Health Center Inc,
SterhanMaryTreasurer/ Secretary 7.14%ACO Participant RepresentativeFlathead Community Health Center Inc (Greater Valley Health Center)
PrestonWilliamVoting Member 7.14%ACO Participant RepresentativeCommunity Health Care Center Incorporated (Alluvion Health)
TownsendCarolVoting Member 7.14%ACO Participant RepresentativeMontana Migrant & Seasonal Farmworker Council, Inc.
DuncanKellyVoting Member 7.14%ACO Participant RepresentativeSapphire Community Health, Inc.
HallKyndraVoting Member 7.14%ACO Participant RepresentativeBullhook Community Health Center, Inc.
MarkDavidVice Chair 7.14%ACO Participant RepresentativeBighorn Valley Health Center Incorporated (One Health)
CooneyLanderVoting Member 7.14%ACO Participant RepresentativeCommunity Health Partners, Inc.
GonzalezDonaMedicare Beneficiary Board Member 7.14%Medicare Beneficiary RepresentativeN/A
StergarCindyEx-Officio (non-voting)0%Ex-Officio (non-voting)Montana Primary Care Association
Key ACO Clinical and Administrative Leadership:
Leslie SouthworthACO Executive
Shawna Yates, DOMedical Director
Maria ClemonsCompliance Officer
Leslie SouthworthQuality Assurance/Improvement Officer
  
Associated Committees and Committee Leadership:
Committee NameCommittee Leader Name and Position
MSSP Operations CommitteeLeslie Southworth (Chair)
Clinical Quality CommitteeShawna Yates, DO (Chair)
Fiscal CommitteeBree Sandoval (Chair)
Billing WorkgroupTara 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, N/A
  • 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: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • 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

Quality Performance Results

Our ACO did not participate in the Shared Savings Program in Performance Year [2022]; therefore, this section is not applicable at this time.
2023 Quality Performance Results:
ACO#Measure NameRateACO Mean
ACO-8 [1]Risk Standardized, All Condition Readmission  
ACO-38 [1,2]Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions  
ACO-43 [3]Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))  
ACO-13Falls: Screening for Future Fall Risk  
ACO-14Preventive Care and Screening: Influenza Immunization  
ACO-17Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention  
ACO-18Preventive Care and Screening: Screening for Depression and Follow-up Plan  
ACO-19Colorectal Cancer Screening  
ACO-20Breast Cancer Screening  
ACO-42Statin Therapy for the Prevention and Treatment of Cardiovascular Disease  

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
• No, our ACO does not use the SNF 3-Day Rule Waiver.
• No, our ACO does not use the Waiver for Payment for Telehealth Services.