ACO Name and Location:

Physician Quality Partners
2131 South 17th Street
Wilmington, North Carolina 28401

ACO Primary Contact:

Lydia Newman, MPP
Lydia.Newman@nhrmc.org
(910) 667-7640

Organizational Information:

ACO Participants

ACO participants in joint ventures between ACO professionals and hospitals:

No participants are involved in a joint venture between ACO professionals and hospitals.

ACO Governing Body

  • Dr. Janalynn F. Beste, Voting Member and Chair, ACO Participant Representative, Coastal Family Medicine
  • Dr. Philip Brown, Voting Member, ACO Participant Representative, New Hanover Regional Medical Center
  • Mr. Andre Boyd, Voting Member, ACO Participant Representative, New Hanover Regional Medical Center
  • Dr. Andre J. Leonard, Voting Member, ACO Participant Representative, Intracoastal Internal Medicine
  • Dr. Charmaine A. Lewis, Voting Member, ACO Participant Representative, New Hanover Regional Hospitalists - NHRMC Physician Group
  • Dr. William T. Smith, Voting Member, ACO Participant Representative, Cape Fear Heart Associates - NHRMC Physician Group
  • Mr. David B. Sims Jr., Voting Member, Medicare Beneficiary Representative 

Key ACO Clinical and Administrative Leadership

  • ACO Executive: Ms. Lydia Newman
  • Medical Director: Dr. Amy Messier
  • Compliance Official: Ms. Lydia Newman
  • Quality Assurance/Improvement Officer: Ms. Diana Amedy

Associated committees and committee leadership:

  • Operating Committee: Charin L. Hanlon, Chair
  • Compliance Committee: Lydia Newman, Chair
  • Utilization Subcommittee: Amy Messier, Chair 
  • Quality Improvement Subcommittee: Diana Amedy, Chair 

Types of ACO participants, or combinations of participants, that formed the ACO:

  • A hospital employing ACO professionals
  • Partnerships or joint venture arrangements between hospitals and ACO professionals 

Shared Savings and Losses

Amount of Shared Savings/Losses

  • To be completed at the conclusion of the performance year. 

Shared Savings Distribution

  • To be completed at the conclusion of the performance year. 

Payment Rule Waivers

  • No, our ACO does not utilize the SNF 3-Day Rule Waiver. 

Quality Performance Results

  • To be completed at the conclusion of the performance year

Physician Quality Partners, LLC
ACO Participation Waiver Documentation for Hospital Quality and Efficiency Program (HQEP)

Parties Involved: Physician Quality Partners (PQP), New Hanover Regional Medical Center (NHRMC), Moore Orthopaedics PA, Carolina Sports Medicine and Ortho Specialists PA, Cape Fear Sports Medicine PA, Bowling Jack W Jr MD, Ortho Wilmington PA, Emerge Ortho

Additional orthopedic practices and providers may be added to this program as deemed appropriate and necessary, by PQP and NHRMC.

Start Date: September 22, 2015                                                    End Date: Ongoing

Description/Purpose of the Arrangement:

PQP has developed a program, in conjunction with NHRMC to provide quality based incentive payments to certain members of the NHRMC medical staff in the orthopedic service lines. Under this arrangement, NHRMC has entered into a contract whereby NHRMC will provide funding to PQP in return for the ACO administering the quality program, overseeing performance, and distributing compensation to providers who meet specified quality benchmarks. These benchmarks are approved by the PQP Board of Managers to ensure high quality care of individuals undergoing surgery, or follow-up care from the orthopedic service line. The PQP Board of Managers will review the goals and effectiveness of the program periodically to determine whether the quality goals should be adjusted, to help ensure the program meets the intended purpose of increasing the quality of care provided to individuals receiving orthopedic services while avoiding unnecessary costs associated with events like readmission, post-surgical blood clots, and other usually preventable concerns.

All compensation provided under HQEP is related to the ability of the individual provider to meet the stated quality goals. Payments are not made based on number of services provided or referral to NHRMC. Moreover, providers participating in HQEP are in no way guaranteed or provided any preference in assigning or referring patients.

Items, Services and/or goods included:

Compensation under HQEP is provided in the form of a bonus payment. Some quality goals are measured and paid on a quarterly basis, while others are longer term goals and paid out annually. These payments are made irrespective of whether or not the ACO is able to achieve shared savings under the Medicare Shared Savings Program.

All compensation provided under the HQEP is based on fair market value as to the services provided and does not take into account the volume or value of referrals or other business generated by any provider. Compensation will be actively monitored and adjusted on at least an annual basis, and is reviewed by a third party to ensure appropriate fair market value rates are used. Moreover, providers participating in HQEP are in no way guaranteed or provided any preference in assigning or referring patients.

Relation to Purposes of the Medicare Shared Savings Program

In order for this program to move forward, the PQP Board of Managers must make and duly authorize a bona fide determination, consistent with each member’s duty under 42 CFR 425.106(b)(3), that the arrangement is reasonably related to one of the stated purposes of the Shared Savings Program. Please select at least one of the following and then describe how this program is reasonably related to that purpose:

☒Promoting accountability for the quality, cost and overall care for a Medicare patient population as described in the Shared Savings Program: The HQEP is intended to provide a financial incentive to members of the NHRMC medical staff under the orthopedic service line based on their ability to increase the quality of care provided to individual while lowering costs by avoiding care associated with events such as readmission, post-surgical blood clots, and other usually preventable concerns. This compensation is intended to incentivize additional accountability for the quality and cost of care for individuals receiving services under the orthopedic service line.

☐Managing and Coordinating care for Medicare Fee-For-Service beneficiaries through an ACO, or

☐Encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare beneficiaries.



Authorization by Governing Body

Method of Authorization (select one):                                                                                                                                              Date: September 22, 2015

__ Unanimous Written Consent

_x_ Governing Body Vote documented accordingly a resolution adopted by the Board of Managers during the September 22, 2015 meeting 

Physician Quality Partners, LLC
ACO Participation Waiver Documentation for Hospital Quality and Efficiency Program (HQEP)

As discussed, and noted, when initially implementing the ACO’s Participation Waiver for the Hospital Quality and Efficiency Program (HQEP) waiver, Physician Quality Partners, LLC (PQP) has decided to expand the Hospital Quality and Efficiency Program (HQEP) to include additional areas of practice. All other elements of the program remain unchanged though additional benchmarks will be created as appropriate for the neurosurgical practices being added.

Parties Being Added to the HQEP: Atlantic Neurosurgical and Spine Specialists, PA, Coastal Neurosurgical Associates, PA, Port City Neurosurgery and Spine, PA

Start Date: January 1, 2017                                                                         End Date: Ongoing



Authorization by Governing Body

Method of Authorization (select one):                                                                                                                                           Date: January 4, 2017

__ Unanimous Written Consent

_x_ Governing Body Vote documented accordingly a resolution adopted by the Board of Managers during the January 4, 2017 meeting