What is AnewCare?

AnewCare is an accountable care organization (ACO), which is a Medicare care coordination program of physicians, hospitals and other health care providers who share responsibility in providing patient-centered care. ACO members cooperate by sharing information, helping you receive the services you need when you need them.

AnewCare is not a health maintenance organization (HMO). You are not restricted to a provider network, and you are free to choose from any doctor who accepts Medicare. There are absolutely no costs to you. Physicians are care coordinators, responsible for providing you with improved health care options. There is no one prescribing what care and procedures you are eligible to receive. Your Medicare benefits will not change.

ACO Name and Location:

AnewCare Collaborative, LLC
509 Med Tech Parkway, Suite 100
Johnson City, TN 37604

ACO Primary Contact:

Paula Claytore
423-431-6147
paula.claytore@balladhealth.org

Organizational Information

ACO Participants:

ACO Participants ACO Participant in Joint Venture (Enter Y or N)
Abingdon Internal Medicine PC N
Abingdon Physician Partners N
Blue Ridge Medical Management Corporation N
Gray Family Clinic PLC N
May Clinic PLLC N
Medical Education Assistance Corporation University Physicians Practice N
Nolichuckey Management Services Inc N
Norton Community Physician Services LLC N
Samina Yousuf MD, PC N
Unaka Internal Medicine LLC N
Wellmont Cardiology Services N
Wellmont Medical Associates Inc N
William M Handy MD PC N
WPS Providers Inc N

ACO Governing Body:
Member Last Name  Member First Name Member Title/Position Member’s Voting Power Membership Type ACO Participant TIN Legal Business Name/DBA*
Combs, MD Stephen Chair/CMO 1 ACO Participant Blue Ridge Medical Management Corporation
Handy, MD William Vice Chair/Physician 1 ACO Participant William Mark Handy, MD PC
 Hackett, MD  Ryan  Physician  1  ACO Participant  Blue Ridge Medical Management Corporation
Holmes, MD Sheri Physician 1 ACO Participant Medical Education Assistance Corporation University Physicians Practice
Luff, MD Matt Physician 1 ACO Participant Wellmont Cardiology Services
Miller, MD Charles Physician 1 ACO Participant Unaka Internal Medicine, LLC
Newberry, MD Brian Physician 1 ACO Participant Norton Community Physician Services
Smith, MD BJ Physician 1 ACO Participant Integrated Health Transitions PLLC
Sutherland, MD Clint Physician 1 ACO Participant  Wellmont Medical Associates
Kilgore Steve SVP, Retail, Corporate Programs, & Business Development 1 ACO Participant Blue Ridge Medical Management Corporation
Rogers Allison AVP, Strategy & Value-Based Care Services 1 Health System Ballad Health
Spicer Lewis Retired 1 Medicare Beneficiary

*if applicable

Key ACO Clinical and Administrative Leadership:

  • ACO Executive: Paula Claytore
  • Medical Director: Shari Rajoo, MD
  • Compliance Officer: Dee Warrington
  • Quality Assurance/Improvement Officer: Joel Reagan

Associated Committees and Committee Leadership:

  • Clinical Committee: Megan Johnson, MD, Chair
  • Finance Committee: Chase Wilson, Chair
  • Governance Committee: Dee Warrington, Chair

Types of ACO Participants or Combinations of Participants that Formed the ACO:

  • ACO professionals in individual practices
  • ACO professionals in group practice arrangements

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Third Agreement Period
    • Performance Year 2020, $0
    • Performance Year 2019, $2,075,879
  • Second Agreement Period
    • Performance Year 2019: $2,075,879
    • Performance Year 2018: $3,324,805
    • Performance Year 2017: $1,632,905
    • Performance Year 2016: $2,664,222
  • First Agreement Period
    • Performance Year 2015, $7,114,296
    • Performance Year 2014, $3,485,421
    • Performance Year 2013, $6,896,579

Note: Our ACO participated in multiple performance years during Calendar Year 2019.  Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019. 

Shared Savings Distribution:

  • Third Agreement Period
    • Performance Year 2020: N/A
    • Performance Year 2019
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 30%
      • Proportion of distribution to ACO participants: 35%
  • Second Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 30%
      • Proportion of distribution to ACO participants: 35%
    • Performance Year 2018
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 30%
      • Proportion of distribution to ACO participants: 35%
    • Performance Year 2017
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 30%
      • Proportion of distribution to ACO participants: 35%
    • Performance Year 2016
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 30%
      • Proportion of distribution to ACO participants: 35%
  • First Agreement Period
    • Performance Year 2015
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 30%
      • Proportion of distribution to ACO participants: 35%
    • Performance Year 2014
      • Proportion invested in infrastructure: 16%
      • Proportion invested in redesigned care processes/resources: 68%
      • Proportion of distribution to ACO participants: 16%
    • Performance Year 2013
      • Proportion invested in infrastructure: 31%
      • Proportion invested in redesigned care processes/resources: 38%
      • Proportion of distribution to ACO participants: 31%

Note: Our ACO participated in multiple performance years during Calendar Year 2019.  Distribution of shard savings reported for Performance Year 2019 therefore represents the distribution of the net shard savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Quality Performance Results

2020 Quality Performance Results:

ACO # Measure Name Rate ACO Mean
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Condition 55.75 49.50
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.16 0.95
ACO-13 Falls: Screening for Future Fall Risk 94.62 84.97
ACO-14 Preventive Care and Screening: Influenza Immunization 78.07 76.03
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 60.53 81.67
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 39.92 71.46
ACO-19 Colorectal Cancer Screening 67.16 72.59
ACO-20 Breast Cancer Screening 72.09 74.05
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 84.72 83.37
ACO-40 Depression Remission at Twelve Months 20.45 13.99
ACO-27 Diabetes Mellitus Hemoglobin A1c Poor Control 12.06 14.07
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 66.67 75.04

For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.  The Centers for Medicare & Medicaid Services (CMS) waived the requirement for ACOs to field a CAHPS for ACOs to field a CAHPS for ACOs survey for PY2020 through the Physician Fee Schedule Final Rule for Calenar Year 2021.  Additionally, CMS reverted CO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-Day Rule Waiver: Yes
  • Waiver for Payment for Telehealth Services: Yes

 Last updated on March 29, 2021