Tuality Health Plan Services Accountable Care Organization

ACO Name and Location

Tuality Health Plan Services P.O. Box 925 355 SE 8th Avenue Hillsboro, OR 97123

ACO Primary Contact

Dorane Brower 503-346-1744 THPSACO@ohsu.edu

Organizational Information ACO Participants:

ACO Participants

Adventist Health Primary Care - Clackamas Adventist Health Primary Care - Creekside Adventist Health Primary Care - Damascus Adventist Health Primary Care - Fishers Landing Adventist Health Primary Care - Gladstone Adventist Health Primary Care - Gresham Station Adventist Health Primary Care - Gresham Troutdale Adventist Health Primary Care - Parkrose Adventist Health Primary Care - Portland Adventist Health Primary Care - Sandy Adventist Health Tillamook Medical Group - Hoodland Anesthesia Associates Northwest LLC Care Partners Cascade Internal Medicine LLC Center For Dermatology And Laser Surgery PC Clackamas Dermatology PC Darrell Polster Deborah Garvey Dr. Kim-Chi Vu, MD, PC Ear, Nose And Throat Associates, LLC Grapevine Women's Health And Gynecology LLC Hicken Medical Clinic Hillsboro Cardiology, PC Hillsboro Clinic Hillsboro Eye Clinic PC Hillsboro Internal Medicine Hillsboro Orthopedic Group Inc. Hillsboro Pediatric Clinic LLC Kathryn Todd, MD Marion Lee Gardner, Jr., MD

ACO Participant in Joint Venture (Enter Y or N)

N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N

Medical Imaging Group Of Hillsboro

N

Mountain View Medical Center

N

North Plains Medical Clinic

N

Northwest Ear Institute PC

N

NW Allergy & Asthma Specialists, LLC

N

OHSU Orenco Station Medical Group

N

OHSU Tuality Primary Care Forest Grove

N

OHSU Tuality Primary Care North Plains

N

OHSU Tuality Primary Care South Hillsboro

N

Oregon Health & Science University

N

Reed Dermatology Northwest LLC

N

Ricardo Garza-Grande

N

Ronald L. Teed, M.D., P.C.

N

Senior Care Northwest

N

Somnique Health PC

N

Tanasbourne Pediatrics

N

Tuality Healthcare

N

Tuality Medical Group LLC

N

Tuality Physicians

N

University Professional Services

N

Virginia Garcia Memorial Health Center

N

Virginia Garcia Memorial Health Center Beaverton

N

Virginia Garcia Memorial Health Center Cornelius

N

Virginia Garcia Memorial Health Center Hillsboro

N

ACO governing Body:

Last Name

JamesNielsen

Member

First Name Title/Position

Lori

Corporate Member

Member's voting Power ?

Expressed as a percentage or

Number

11.1%

Membership Type

ACO Participant Representative

Hardman

Joe

Corporate Member 11.1%

ACO Participant Representative

Conklin Scott Brown

Jeff Garrett Greg

Corporate Member 11.1%

Board Chair

11.1%

Provider Member 11.1%

ACO Participant Representative ACO Participant Representative ACO Participant Representative

Lewis Jeddeloh Vacant

Marc BJ Vacant

Board Vice-Chair 11.1%

Medicare Beneficiary Corporate Member

11.1% 11.1%

ACO Participant Representative

ACO Participant Representative

ACO Participant Representative

ACO Participant

Legal Business Name/DBA, if Applicable Tuality Health Care Tuality Health Care OHSU

Hillsboro Eye Clinic Hillsboro Pediatric Clinic Hillsboro Clinic N/A

N/A

Vacant Peterson

Vacant Meredith

Secretary Treasurer

11.1% 0%

ACO Participant Representative ACO Participant Representative

N/A

Tuality Health Care

Key ACO clinical and administrative leadership:

Dorane Brower Katrina McPherson Shannon Kennedy Katrina McPherson

Name

Position ACO Executive Medical Director Compliance Office Acting Quality Assurance/Improvement Officer

Associated committees and committee leadership:

Committee Name Plan Review Committee Quality Committee

Committee Leader Name and Position Dana Nason, Chair Greg Brown, Chair

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

? ACO professional in group practice arrangements ? Hospitals employing ACO professionals ? RHCs ? FQHCs

Shared Savings and Losses

Amount of Shared Savings/Losses

? Not Applicable

Shared Savings Distribution

? Not Applicable

Quality Performance Results

Our ACO did not participate in Share Savings Program in the 2019 performance year, there this section is not applicable at this time.

Payment Rule Waivers

? Skill Nursing Facility (SNF) 3-day Rule Waiver: o No, our ACO does not use the SNF 3-Day Rule Waiver, pursuant to 42 CFR 425.612.

? Waiver for Payment for Telehealth Services: o Yes, our ACO clinicians do provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.

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