Accountable Care Organization

ACO Name and Location                               

ThedaCare ACO, LLC

1 Neenah Center, Neenah, WI 54956 (Corporate)

3 Neenah Center, Neenah, WI 54956 (Office)

ACO Primary Contact

Jennifer Glasheen

(920) 454-4212

Jennifer.Glasheen@thedacare.org

Organizational Information

ACO Participants:

ACO Participants	ACO Participant in Joint Venture
Allergy and Asthma Associates SC	N
Appleton Emergency Services SC	N
Appleton Plastic Surgery Center SC	N
Association of Hospital Anesthesiologists SC	N
C. Thomas DeRoche DPM LLC	N
Corey W Wesner, DPM SC	N
Digestive Healthcare Specialists SC	N
Ear Nose & Throat Specialists of Wisconsin SC	N
Ear Nose & Throat Surgical Associates SC	N
Family Care of the Fox Cities SC	N
Farrar and Associates Mental Health SC	N
Fox Cities Eye Clinic SC	N
Fox Valley Dermatology SC	N
Fox Valley Emergency Medicine SC	N
Fox Valley Nephrology Partners SC	N
Fox Valley Pathologists SC	N
Fox Valley Perinatology SC	N
Fox Valley Plastic Surgery SC	N
Fox Valley Pulmonary Medicine SC	N
Fox Valley Surgical Associates LTD	N
Greenville Foot & Ankle Center LLC	N
Hand to Shoulder Center of Wisconsin LTD	N
Integrative Pain Management SC	N
Kagen Dermatology Clinic SC	N
Kaukauna Clinic SC	N
Mary McDonald MD SC	N
Neal Diabetic Foot & Ankle Center LLC	N
Neuroscience Group of NE WI SC	N
Northeast Wisconsin Foot & Ankle Associates SC	N
Northeast Wisconsin Retina Associates SC	N
North Shore Foot & Ankle SC	N
Optivision Eye Care LLP	N
Pain Relief 1 LLC	N
Primary Care Associates of Appleton LTD	N
Radiology Associates of Appleton SC	N
Radiology Associates of the Fox Valley SC	N
Refresh Evolve LLC	N
Renard Foot and Ankle LLC	N
Sherman Counseling Management LLC	N
Surgical Associates of Neenah SC	N
ThedaCare Inc.	N
ThedaCare Regional Medical Center-Appleton Inc	N
ThedaCare Medical Center-Berlin Inc	N
ThedaCare Regional Medical Center-Neenah Inc	N
ThedaCare Medical Center-New London Inc	N
ThedaCare Medical Center-Shawano Inc	N
ThedaCare Medical Center-Waupaca Inc	N
ThedaCare Medical Center-Wild Rose Inc	N
The Center for Aesthetics and Plastic Surgery SC	N
The Kagen Allergy Clinic SC	N
Torhorst Foot and Ankle Clinic SC	N
Valley Eye Associates	N
Wisconsin Institute of Urology SC	N
Wisconsin Institute of Plastic Surgery SC	N
Women’s Care of Wisconsin SC	N
Women’s Health Specialists SC	N

ACO Governing Body:

Member Last Name	Member First Name	Member Title/Position	Member’s Voting Power (Expressed as a percentage or number)	Membership Type	ACO Participant Legal Business Name and D/B/A, if applicable
Bermas	Honnie	MD	9.1%	ACO participant representative	Fox Valley Surgical Associates LTD
Fisher	Cynthia	DO	9.1%	ACO participant representative	ThedaCare Inc.
Werner	Michael	MD	9.1%	ACO participant representative	Primary Care Associates of Appleton LTD
Grunwald	Nathan	MD	9.1%	ACO participant representative	ThedaCare Inc.
Cockley	Mark	MD	9.1%	ACO participant representative	ThedaCare Inc.
Poola	Harsha	MD	9.1%	ACO participant representative	ThedaCare Inc.
Marquardt	Sara	VP	9.1%	ACO participant representative	ThedaCare Inc.
McDonald	Jeannette	Medicare Beneficiary	9.1%	Medicare beneficiary representative	N/A
Eberts	Eric	MD	9.1%	ACO participant representative	Women’s Care of Wisconsin SC
Lang	Tanner	MD	9.1%	ACO participant representative	Association of Hospital Anesthesiologists SC
Elmer	Montgomery	MD	9.1%	ACO participant representative	ThedaCare Inc.

Key ACO Clinical and Administrative Leadership:

ACO Executive: Jennifer Glasheen

Medical Director: Montgomery Elmer, MD

Compliance Officer: Robert Reed

Quality Assurance/Improvement Officer: Shelah Bechtel

Associated Committees and Committee Leadership:

Committee Name	Committee Leader Name and Position
ThedaCare ACO Quality Committee	Mark Cockley, MD, Chief Clinical Officer
ThedaCare Strategy Business Committee	Jennifer Glasheen, Director, Payer Contracting & Provider Relations

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

• Networks of individual practices of ACO professionals
• Hospitals employing ACO professionals
• CAHs that bill under Method II
• RHCs
  

Shared Savings and Losses

Amount of Shared Savings/Losses:

• Second Agreement Period
  • N/A
• First Agreement Period
  • N/A

Shared Savings Distribution:

• Second Agreement Period
  • N/A
• First Agreement Period
  • N/A

Quality Performance Results

Our ACO did not participate in the Shared Savings Program in the 2021 performance year, therefore this section is not applicable at this time.

Payment Rule Waivers

• Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
  • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.

• Waiver for Payment for Telehealth Services:
  • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.