Message from Patrick McManus, MD; Chair, Membership & Operations, Board of Managers

Seasons Greetings and a Happy New Year! As we draw to the close of 2018, Mary Washington Health Alliance has plenty to be cheerful about. As noted in the letter from Dr. Janus, we have had a very successful year, not only financially, but also in the maturation of our organization. We continued to expand our multiple programs, continued to expand the number of providers, as well as the number of covered lives that we are taking on.

With expansion, however, comes some increasing complexity in assessing quality in our organization and a constant reevaluation of our system of rewarding that quality and work. Our Membership and Operations committee has been diligently reevaluating our distribution formula on a continuous basis. The 2018 distribution is planned for $1.5 million. This should be distributed at our Annual Meeting in April, once the final claims have been settled from 2018.

The distribution has been comparable to our distribution formula in the past, with the main difference, however, that the primary care physicians who have been doing most of the due diligence to attain our shared savings will be given additional rewards. The distribution for specialists remains the same as in 2017. In addition, in the Next Generation ACO – an Advanced Alternative Payment Model (AAPM), all physicians who participate in the Medicare program will be given a 5% bonus based on their Medicare billings of 2018 to be distributed in the Spring of 2020.

The Membership and Operations committee remains hard at work again this year and the final distribution formula for 2019 has yet to be finalized.

In addition to the standard criteria of patient attribution, the committee has added the performance of AWV’s (Annual Wellness Visits) and HCC coding, as these both count heavily in our quality measures and the formula of shared savings of our Medicare population. The weighting of the criteria has yet to be determined and will be evaluated over the next several months.

We continue to celebrate the good news that we do have funds to distribute, and more importantly a healthy organization going into the new year.

Stay tuned. More to come!