ACO Participants ACO Participant in Joint Venture (Enter Y ...

ACO Name and Location

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

ACO Primary Contact Mary Ransome 971-254-5958 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:

Member

Last Name First Name Title/Position

James-

Lori

Nielsen

Corporate Member

Member's voting Power ?

Expressed as a percentage or

Number

Membership Type

ACO Participant Representative

Tseng

Ann

Corporate Member

ACO Participant Representative

Conklin Scott Brown

Jeff Garrett Gregory

President/Secretary Board Chair Provider Member

ACO Participant Representative

ACO Participant Representative

ACO Participant Representative

Lewis Knox

Marc Jody

Board Vice-Chair

RN Member

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 Adventist Health

Kamaljit Gernhart Byerly

Atwal Diana Laura

Hinojosa

Hector

Abbruzzese Evgenia

Gray, II

Timothy

Open Position

Provider Member

Treasurer

Provider Member

Community Fee For Service Medicare Member Community Member

Provider

ACO Participant Representative

ACO Participant Representative

ACO Participant Representative

ACO Participant Representative

ACO Participant Representative

Community Representative

Adventist Medical Center OHSU

Virginia Garcia Memorial Health Center

N/A

JCurve Consulting

Mt. View Medical Clinic

OHSU

Key ACO clinical and administrative leadership:

Jeffrey Conklin Dorane Brower Katrina McPherson Barbara Carey Katrina McPherson

Name

Position President ACO Executive Chief Medical Officer Compliance Officer Acting Quality Assurance/Improvement Officer

Associated committees and committee leadership:

Committee Name Finance & Plan Review Committee Clinical Value and 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 participated in Track A of the Shared Savings Program in the 2020 performance year. Therefore, 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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