Accountable Care Organization

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