ACO Information

CHESS NextGen

CHESS NextGen, LLC (CHESS NextGen) represents a group of health care providers who have come together to provide coordinated high quality care to the Medicare beneficiaries they serve. Coordinated care helps ensure Medicare beneficiaries get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors.

CHESS NextGen is administered by Cornerstone Health Enablement Strategic Solutions, LLC (CHESS) (www.chesshealthsolutions.com), a physician-led company owned by North Carolina Baptist Hospital, Cornerstone Health Care, and Laboratory Corporation of America.

CHESS NextGen Participants include the physicians and their teams from Cornerstone Health Care, Wake Forest University Health Sciences, and Catawba Valley Medical Group. A number of Preferred Providers and skilled nursing facility affiliates also will help coordinate care as part of the program. Through the program, Participating Providers are focused on improving access to care, enhancing clinical quality and controlling costs.

In December 2015, CHESS NextGen chose to participate in the Centers for Medicare & Medicaid Services (CMS) accountable care organization (ACO) model called the Next Generation ACO Model (Next Generation ACO), advancing the Administration’s health care system goals and building on experience from the Pioneer ACO Model and the Medicare Shared Savings Program. Through this model, CMS has partnered with CHESS NextGen and other ACOs that are experienced in coordinating care for populations of patients and whose provider groups are ready to assume higher levels of financial risk and reward.

The Next Generation ACO Model is one of many innovative payment and care delivery models created under the Affordable Care Act, and is an important step toward advancing models of care that reward value over volume in care delivery.

CHESS provides the following information regarding its participation as a Medicare Next Generation ACO.

Accountable Care Organization Public Reporting Guidance

General and Organization Information

CHESS NextGen, LLC
1701 Westchester Drive, Suite 850
High Point, NC 27262
Hours: 9 am – 5 pm Monday through Friday

ACO Primary Contacts

Michael J. Berwanger, ACO Executive
CHESSACO_Executive@chesshealthsolutions.com
(336) 802-2661

Melissa Pollock, CMS Liaison
CHESSACO@chesshealthsolutions.com
(336) 802-2661

Composition of ACO

CHESS NextGen, LLC represents a provider-led partnership between physicians in the following organizations, organized to improve health care throughout the region.

Next Generation ACO Participants and Preferred Providers
See a full list of our Participating and Preferred Providers here.

ACO Participants in Joint Ventures between ACO Professionals and Hospitals
None

CHESS NextGen Governing Body

Yates Lackey
Voting Member, ACO Participant, Wake Forest University Health Sciences

Rich Lord, MD
Voting Member, ACO Participant, Wake Forest University Health Sciences

Bradley Clark
Voting Member, ACO Participant, Wake Forest University Health Sciences

Scott Polster, MD
Voting Member, ACO Participant, Catawba Valley Medical Group

Kimberly Crews
Voting Member, ACO Participant, Catawba Valley Medical Group

Heather Spry, MD
Voting Member, ACO Participant, Cornerstone Health Care

Jason Kihneman, MD
Voting Member, ACO Participant, Catawba Valley Medical Group

Elisabeth Stambaugh, MD
Chair and Voting Member, ACO Participant, Cornerstone Health Care

Robert Ford, MD
Voting Member, Medicare Beneficiary & Consumer Advocate

Robert Dough, MD
Voting Member, ACO Participant, Wake Forest University Health Sciences

CHESS NextGen Key Clinical and Administrative
Leadership

Medical Director:
Elisabeth Stambaugh, MD, Cornerstone Health Care

ACO Executive:
Michael J. Berwanger, CHESS

Compliance Official:
Melissa Pollock, CHESS

Chief Quality Officer:
Yates Lennon, MD, CHESS

Associated Committees and Key Leadership
Personnel

Performance Improvement Committee (Quality):
Chair – Jason Kihneman, MD, Catawba Valley Medical Group

Compliance Committee:
Chair – Yates Lackey, Wake Forest University Health Sciences

Finance Committee:
Chair – Robert Dough, MD, Cornerstone Health Care

Aggregate Amount of Shared Savings/Losses

Performance Year 1: -$63,570.23

Performance Year 2: $4,347,584.04

Performance Year 3: $13,688,012

How Shared Savings Are Distributed

  • Proportion invested in infrastructure: 5%
  • Proportion invested in redesigned care processes and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries: 35%
  • Proportion of distribution to ACO Participants and Preferred Providers: 60%

Quality Performance Results

See 2016 Quality Performance Results table here
See 2017 Quality Performance Results table here
See 2018 Quality Performance Results table here

For Patients

I’m a Medicare Beneficiary, so what does this mean for me?

  • I received a Voluntary Alignment form. What is this? (PDF)
  • What is the 3-day Skilled Nursing Facility Rule Waiver? (PDF)
  • What is the Telehealth Waiver? (PDF)
  • What is the Post-Discharge Home Visit Waiver? (PDF)

Public Disclosures

Next Generation ACO Participation Waiver

Questions or Concerns?

If you have any questions about CHESS NextGen or the Next Generation ACO Model, contact CHESS at 336-802-2661 or contact Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.