Existing ACO Members
Access to contracting, reporting and other information for ACO members.
New ACO Users
ACO members who need access to the secure ‘For ACO Members’ area.
Patient-Centered Care
Medicare ACOs (Accountable Care Organizations) are comprised of groups of doctors, hospitals and other health care providers who come together to provide coordinated, high-quality care at lower costs to Medicare patients. ACOs are patient-centered organizations where the patient and providers are partners in care decisions. This allows Medicare patients to have better control over their healthcare and providers to have better information about patients’ medical history and better relationships with the patients’ other providers. Medicare patients will see no change in Medicare benefits and keep their freedom to see any Medicare provider.
The Next Generation ACO Model is for ACOs that are experienced in coordinating care for populations of patients. The goal is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenses for Medicare fee-for-service patients.
The Next Generation ACO Model ensures that patients have access to and receive high-quality care. This Model will be evaluated on its ability to deliver better care for individuals, better health for populations at a lower cost. This is in accordance with the Department of Health and Human Services’ “Better, Smarter, Healthier” approach to improving our nation’s health care and setting clear, measurable goals. CMS will publicly report the performance of the Next Generation ACOs on its website.
Governance
Governing Body & Supporting Committees
ThedaCare ACO LLC and Next Generation ACO Model Board of Managers:
- Honnie Bermas, MD, Fox Valley Surgical Associates, Surgeon
- Brenton Meier, MD, ThedaCare Orthopedic Care, Orthopedic Care
- Stephen Dernlan, MD, Primary Care Associates of Appleton, Ltd., Internal Medicine
- Nathan Grunwald, MD, ThedaCare Physicians – Menasha, Family Practitioner
- Dave Jansen, ThedaCare VP Payer & Provider Strategies
- Mark Cockley, MD, Chief Clinical Officer & President of Clinically Integrated Network
- Philip Yazbak, MD, Neuroscience Group, Neurosurgeon
- Harsha Poola, MD, ThedaCare Cancer Care, Hematology & Oncology
- Sara Marquardt, ThedaCare VP Finance Operations Clinically Integrated Network
- Marvin Schneider, Consumer Advocate/ Medicare Beneficiary
- Eric Eberts, MD, Women’s Care of WI, OB Gynecology
Supporting Committees
- ThedaCare ACO Quality Committee
- ThedaCare ACO Strategy Business Committee
- ThedaCare ACO Insurance Committee
* Last updated: 01-04-21
The Next Generation Accountable Care Organization
An accountable care organization (ACO) is an organization of healthcare providers that agree to be accountable for the quality, cost and overall care of an assigned population of patients.
The Next Generation ACO Model was designed specifically for organizations that are already highly integrated with experience offering coordinated patient-centered care. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. Those participating in the Next Generation ACO model are working to transition from fee-for-service payments to payment for coordination of care and improved outcomes.
ThedaCare ACO does not have any joint ventures between or among the ACO and any of its Next Generation Participants.
- 2020 Next Generation ACO Model Participation Agreement Amendment to Section VIII and Appendix B Amendment No. 2
- 2020 Next Generation ACO Model Participation Agreement Amendment No. 3
- 2020 Next Generation ACO Model Participation Agreement Amendment to Sections VIII.C and XIV.C of the Agreement, Appendix B, Appendix L Amendment No. 1
- 2019 Next Generation ACO Participation Agreement with Appendices
- 2019 Next Generation ACO Model Participation Agreement Amendments
* Last updated: 02/24/21
Shared Savings and Losses
Aggregate Amount of Shared Savings/Losses
- Performance year 1: $1,348,292.00
- Performance year 2: $2,762,143.00
- Performance year 3: $1,278,693.00
- Performance year 4: $935,996.00
Shared Savings Distribution
- Reinvest in infrastructure to support quality patient care: 100%
- Distribution to ACO participants: 0%
- Primary Care Professionals: 0%
- Specialists: 0%
- Hospitals: 0%
- Quality Measure Performance Year 1 2016 (For Performance Year 1 (2016), Next Generation ACOs are required to be able to report on 33 quality measures. ThedaCare ACO scored 100% by completely and accurately reporting on all of the quality measures for the 2016 performance year.)
- Quality Measure Performance Year 2 2017
- Quality Measure Performance Year 3 2018
- Quality Measure Performance Year 4 2019
* Last Updated: 01-28-21
Corporate Compliance
ThedaCare ACO’s Corporate Compliance Program, Plan, and Policies are consistent with that of ThedaCare, Inc.
ThedaCare ACO’s (TC-ACO) corporate compliance program is in effect for all TC-ACO entities and governs all TC-ACO suppliers/providers. This review is provided to ensure you understand the laws and regulations which impact your job.
Simply stated, corporate compliance means, “doing the right thing”. TC-ACO suppliers/providers should follow all federal, state, local and industry regulations. Examples include tax filings, payroll practices, coding and billing practices, employee benefits and confidential information. These practices support the TC-ACO values of honesty, integrity and trust.
Facts about our corporate compliance program:
- ThedaCare ACO leadership and the TC-ACO Quality Committee provide oversight management to this program.
- TC-ACO reviews problems as they are discovered and implements solutions.
Reporting corporate compliance concerns:
- Speak to your manager directly
- Report your concerns confidentially
- ThedaCare Corporate Compliance Policy
- Breach of Protected Health Information
Your reports of corporate compliance concerns will be promptly investigated by TC-ACO’s Corporate Compliance Officer who will take appropriate action.
Compliance Officer
Robert Reed
ThedaCare Corporate Compliance Officer
ThedaCare ACO LLC
Robert.reed@thedacare.org
Phone: (920) 454-4186
* Revised: 06-05-20
Participating Provider Groups
Complete List of ThedaCare ACO Participating Providers
- ThedaCare Medical Center – Berlin *
- ThedaCare Medical Center – New London *
- ThedaCare Medical Center – Shawano *
- ThedaCare Medical Center – Waupaca *
- ThedaCare Medical Center – Wild Rose *
- ThedaCare Regional Medical Center – Appleton *
- ThedaCare Regional Medical Center – Neenah *
- Allergy and Asthma Associates SC *
- Appleton Emergency Services SC *
- Appleton Plastic Surgery Center SC *
- Association of Hospital Anesthesiologists SC *
- Catalpa Health *
- C. Thomas DeRoche DPC LLC *
- Corey Wesner, DPM SC *
- Digestive Healthcare Specialists SC *
- Ear Nose & Throat Specialists of Wisconsin, SC *
- Ear Nose & Throat Surgical Associates *
- Evolve LLC *
- Family Care of the Fox Cities SC *
- Farrar and Associates Mental Health SC
- Fox Cities Eye Clinic SC *
- Fox Valley Dermatology SC *
- Fox Valley Emergency Medicine SC *
- Fox Valley Nephrology Partners SC *
- Fox Valley Pathologists SC *
- Fox Valley Perinatology SC *
- Fox Valley Plastic Surgery SC *
- Fox Valley Pulmonary Medicine SC *
- Fox Valley Surgical Associates Ltd *
- Greenville Foot & Ankle Center LLC *
- Hand to Shoulder Center of Wisconsin *
- Integrative Pain Management SC *
- Kagen Dermatology Clinic SC *
- Kaukauna Clinic SC *
- Mary McDonald MD SC *
- Neal Diabetic Foot & Ankle Center *
- Neuroscience Group of NE WI *
- NEW Dermatology Group *
- Northeast Wisconsin Foot & Ankle Associates SC *
- Northeast Wisconsin Retina Associates SC *
- North Shore Foot & Ankle *
- Ophthalmic Surgery of Wisconsin LTD *
- Osteopathic Medicine & Physical Therapy Group of NE WI SC *
- Perinatal Consulting Group LLC *
- Pinnacle Cataract & Laser Institute *
- Primary Care Associates of Appleton LTD *
- Radiation Oncology Specialists *
- Radiology Associates of Appleton *
- Radiology Associates of the Fox Valley *
- Renard Foot Specialist at North Shore *
- Sherman Counseling Management LLC *
- Surgical Associates of the Neenah SC *
- ThedaCare Inc. *
- The Center for Aesthetics and Plastic Surgery
- The Kagen Allergy Clinic SC *
- Torhorst Foot and Ankle Clinic SC *
- Valley Eye Associates *
- Wisconsin Institute of Urology SC *
- Wisconsin Institute of Plastic Surgery SC*
- Women’s Care of Wisconsin SC *
- Women’s Health Specialists SC *
* Next Generation ACO Model Participant
* Last updated 03-23-21
Contact Us
Location and Primary Contact:
ThedaCare ACO LLC, a Next Generation ACO Model Participant
- Corporate: 1 Neenah Center, Neenah, WI 54956
- Office: 3 Neenah Center, Neenah, WI 54956
- Hours of Operation: Monday – Friday from 8:00am – 4:30pm CST
- Contact: David Krueger, MD, Medical Director
- ACO Administration: (920) 454-4242
Clinical and Administrative Leaders:
- David Krueger, MD: ThedaCare ACO, Medical Director
- Jennifer Glasheen, Director ThedaCare Payer Contracting & Provider Relations
**If you have any questions about the Next Generation ACO Model you may contact Medicare at (800) 633-4227 (1-800-MEDICARE)
* Last update: 6/22/20