Website Disclosures For ACO Participation Waiver Protection

MEDICARE SHARED SAVINGS PROGRAM | REQUIRED PUBLIC DISCLOSURE FOR THE ACO PARTICIPATION WAIVER

The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that may otherwise limit innovation by ACOs participating in the Medicare Shared Savings Program (“MSSP”) (see “Final Waivers in Connection With the Shared Savings Program” (See 80 Fed. Reg. 66,726 (Oct. 29, 2015)) (the “Final Rule”)).  The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that may otherwise limit innovation by ACOs participating in the Medicare Shared Savings Program (“MSSP”) (see “Final Waivers in Connection With the Shared Savings Program” (See 80 Fed. Reg. 66,726 (Oct. 29, 2015)) (the “Final Rule”)). The Accountable Care Organization, Ltd. (the “ACO”) is currently participating in the MSSP pursuant to a Participation Agreement with the Centers for Medicare & Medicaid Services (“CMS”). Pursuant to the Final Rule, the ACO seeks waiver protection for the arrangements described below.

DISCLOSED ARRANGEMENTS FOR WHICH THE ACO IS SEEKING ACO PARTICIPATION WAIVER

On September 24, 2020, the ACO Board of Directors approved the following arrangements as reasonably related to the purposes of the MSSP (all arrangements were subject to Board approval and, as such, were not final unless and until approved by the ACO Board of Directors):

Arrangement #1:  The ACO entered into a Network Participation Agreement with Physicians Accountable Care of Utah LLC (the “Network”) effective September 21, 2020 through December 31, 2025 for which the ACO will compensate the Network for providing the following services:

• Facilitate local practice (i.e., local TIN) participation in the ACO and work with ACO regarding the same
• Participate in Joint Steering Committee with ACO leadership concerning local TINs that are participants in ACO, e.g., discuss communication strategies, ACO initiatives to promote quality of care, cost of care and overall care (ACO Initiatives), discuss local TIN performance and cooperation with ACO, etc.
• Coordinate and ensure ACO adequate time in monthly practice manager meetings and Network Board meetings so that ACO may present and discuss ACO Initiatives  and any other topic that local TINs may wish to discuss
• Provide ACO access to information for purposes of ACO communicating with and local TINs (e.g., email distribution lists)
• Engage with local TINs to promote local TIN participation in ACO Initiatives and intervene with local TIN when identified by ACO as an outlier regarding quality or cost of care and work with local TIN to develop a course of action to improve local TIN performance
• Work with ACO to promote data and technology integration with local TINs for purposes of CMS reporting requirements and data used to develop and measure ACO Initiatives
• Designate a Medical Director to serve as the primary contact between ACO and local TINs and an active participant in the relationship between ACO and local TINs

Arrangement #2:  The ACO entered into a Network Participation Agreement with Silver Pine Medical Group, P.L.C. (the “Network”) effective September 21, 2020 through December 31, 2025 for which the ACO will compensate the Network for providing the following services:

• Facilitate local practice (i.e., local TIN) participation in the ACO and work with ACO regarding the same
• Participate in Joint Steering Committee with ACO leadership concerning local TINs that are participants in ACO, e.g., discuss communication strategies, ACO initiatives to promote quality of care, cost of care and overall care (ACO Initiatives), discuss local TIN performance and cooperation with ACO, etc.
• Coordinate and ensure ACO adequate time in monthly practice manager meetings and Network Board meetings so that ACO may present and discuss ACO Initiatives  and any other topic that local TINs may wish to discuss
• Provide ACO access to information for purposes of ACO communicating with and local TINs (e.g., email distribution lists)
• Engage with local TINs to promote local TIN participation in ACO Initiatives and intervene with local TIN when identified by ACO as an outlier regarding quality or cost of care and work with local TIN to develop a course of action to improve local TIN performance
• Work with ACO to promote data and technology integration with local TINs for purposes of CMS reporting requirements and data used to develop and measure ACO Initiatives
• Designate a Medical Director to serve as the primary contact between ACO and local TINs and an active participant in the relationship between ACO and local TINs

Arrangement #3: The ACO entered into a Network Participation Agreement with Tar River Health Alliance, LLC (the “Network”) effective August 20, 2020 through December 31, 2025 for which the ACO will compensate the Network for providing the following services:

• Facilitate local practice (i.e., local TIN) participation in the ACO and work with ACO regarding the same
• Participate in Joint Steering Committee with ACO leadership concerning local TINs that are participants in ACO, e.g., discuss communication strategies, ACO initiatives to promote quality of care, cost of care and overall care (ACO Initiatives), discuss local TIN performance and cooperation with ACO, etc.
• Coordinate and ensure ACO adequate time in monthly practice manager meetings and Network Board meetings so that ACO may present and discuss ACO Initiatives  and any other topic that local TINs may wish to discuss
• Provide ACO access to information for purposes of ACO communicating with and local TINs (e.g., email distribution lists)
• Engage with local TINs to promote local TIN participation in ACO Initiatives and intervene with local TIN when identified by ACO as an outlier regarding quality or cost of care and work with local TIN to develop a course of action to improve local TIN performance
• Work with ACO to promote data and technology integration with local TINs for purposes of CMS reporting requirements and data used to develop and measure ACO Initiatives
• Designate a Medical Director to serve as the primary contact between ACO and local TINs and an active participant in the relationship between ACO and local TINs
   

On November 13, 2020, the ACO Board of Directors approved the following arrangements as reasonably related to the purposes of the MSSP:

Arrangement #1:  Evolent Health LLC (“Evolent”) entered into a Network Participation Agreement with Integrated ACO LLC (the “Network”) effective June 27, 2019 through December 31, 2023 (“Agreement”).  Evolent assigned the rights, and the ACO assumed the duties, under the Agreement effective November 16, 2020.  Under the Agreement, the ACO will compensate the Network for providing the following services:

• Facilitate local practice (i.e., local TIN) participation in the ACO and work with ACO regarding the same
• Participate in Joint Steering Committee with ACO leadership concerning local TINs that are participants in ACO, e.g., discuss communication strategies, ACO initiatives to promote quality of care, cost of care and overall care (ACO Initiatives), discuss local TIN performance and cooperation with ACO, etc.
• Coordinate and ensure ACO adequate time in monthly practice manager meetings and Network Board meetings so that ACO may present and discuss ACO Initiatives  and any other topic that local TINs may wish to discuss
• Provide ACO access to information for purposes of ACO communicating with and local TINs (e.g., email distribution lists)
• Engage with local TINs to promote local TIN participation in ACO Initiatives and intervene with local TIN when identified by ACO as an outlier regarding quality or cost of care and work with local TIN to develop a course of action to improve local TIN performance
• Work with ACO to promote data and technology integration with local TINs for purposes of CMS reporting requirements and data used to develop and measure ACO Initiatives
• Designate a Medical Director to serve as the primary contact between ACO and local TINs and an active participant in the relationship between ACO and local TINs

Arrangement #2:  Evolent Health LLC (“Evolent”) entered into a Network Participation Agreement with Key Physicians PA (the “Network”) effective November 19, 2019 through December 31, 2024.   Evolent assigned the rights, and the ACO assumed the duties, under the Agreement effective November 16, 2020.  Under the Agreement, the ACO will compensate the Network for providing the following services:

• Facilitate local practice (i.e., local TIN) participation in the ACO and work with ACO regarding the same
• Participate in Joint Steering Committee with ACO leadership concerning local TINs that are participants in ACO, e.g., discuss communication strategies, ACO initiatives to promote quality of care, cost of care and overall care (ACO Initiatives), discuss local TIN performance and cooperation with ACO, etc.
• Coordinate and ensure ACO adequate time in monthly practice manager meetings and Network Board meetings so that ACO may present and discuss ACO Initiatives  and any other topic that local TINs may wish to discuss
• Provide ACO access to information for purposes of ACO communicating with and local TINs (e.g., email distribution lists)
• Engage with local TINs to promote local TIN participation in ACO Initiatives and intervene with local TIN when identified by ACO as an outlier regarding quality or cost of care and work with local TIN to develop a course of action to improve local TIN performance
• Work with ACO to promote data and technology integration with local TINs for purposes of CMS reporting requirements and data used to develop and measure ACO Initiatives
• Designate a Medical Director to serve as the primary contact between ACO and local TINs and an active participant in the relationship between ACO and local TINs

Arrangement #3:  The ACO entered into a Network Participation Agreement with Michiana Accountable Care Organization LLC (the “Network”) effective July 24, 2019 through December 31, 2024 for which the ACO will compensate the Network for providing the following services:

• Facilitate local practice (i.e., local TIN) participation in the ACO and work with ACO regarding the same
• Participate in Joint Steering Committee with ACO leadership concerning local TINs that are participants in ACO, e.g., discuss communication strategies, ACO initiatives to promote quality of care, cost of care and overall care (ACO Initiatives), discuss local TIN performance and cooperation with ACO, etc.
• Coordinate and ensure ACO adequate time in monthly practice manager meetings and Network Board meetings so that ACO may present and discuss ACO Initiatives  and any other topic that local TINs may wish to discuss
• Provide ACO access to information for purposes of ACO communicating with and local TINs (e.g., email distribution lists)
• Engage with local TINs to promote local TIN participation in ACO Initiatives and intervene with local TIN when identified by ACO as an outlier regarding quality or cost of care and work with local TIN to develop a course of action to improve local TIN performance
• Work with ACO to promote data and technology integration with local TINs for purposes of CMS reporting requirements and data used to develop and measure ACO Initiatives
• Designate a Medical Director to serve as the primary contact between ACO and local TINs and an active participant in the relationship between ACO and local TINs

On February 23, 2021, the ACO Board of Directors approved the following arrangements as reasonably related to the purposes of the MSSP:

Arrangement #1:  The ACO entered into a Practice Services Agreement with Sockolov & Sockolov effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #2: The ACO entered into a Practice Services Agreement with Vista Complete Care effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #3:  The ACO entered into a Practice Services Agreement with Rocklin Family Practice & Sports Medicine effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #4:  The ACO entered into a Practice Services Agreement with Lincoln Medical Associates effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #5:  The ACO entered into a Practice Services Agreement with Associated Family Physicians, Inc. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #6:  The ACO entered into a Practice Services Agreement with Auburn Medical Group, Inc. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #7:  The ACO entered into a Practice Services Agreement with Dawei Zheng, M.D. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #8:  The ACO entered into a Practice Services Agreement with The Doctor’s In, Inc. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #9:  The ACO entered into a Practice Services Agreement with Loomis Medical Clinic effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #10:  The ACO entered into a Practice Services Agreement with Access Family Medicine of Sacramento effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #11:  The ACO entered into a Practice Services Agreement with Parvez Islam, M.D. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #12:  The ACO entered into a Practice Services Agreement with Sayed Hussain, M.D. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #13:  The ACO entered into a Practice Services Agreement with Mohammed N. Alocozy, M.D. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #14:  The ACO entered into a Practice Services Agreement with Kurtis Fox, M.D. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #15:  The ACO entered into a Practice Services Agreement with Capitol Internal Medicine Associates effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #16:  The ACO entered into a Practice Services Agreement with Folsom Lake Primary Care effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #17:  The ACO entered into a Practice Services Agreement with Natomas Family Practice effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #18:  The ACO entered into a Practice Services Agreement with Douglas Young, M.D. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #19:  The ACO entered into a Practice Services Agreement with Anna Abalos, M.D. Family Medicine effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #20:  The ACO entered into a Practice Services Agreement with Kenan & Wang, LLC effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #21:  The ACO entered into a Practice Services Agreement with Devamani Gowda, M.D. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #22:  The ACO entered into a Practice Services Agreement with Thomas Hopkins, M.D. effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #23:  The ACO entered into a Practice Services Agreement with Family Medicine & Ambulatory Care Center effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

Arrangement #24:  The ACO entered into a Practice Services Agreement with Greenhaven Family Practice effective February 25, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP.  Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

On April 23, 2021, the ACO Board of Directors approved the following arrangement as reasonably related to the purposes of the MSSP.

The ACO entered into a Practice Services Agreement with YSHAY SHLESINGER, M.D., A Professional Corporation (the “Practice”) effective April 26, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout practice;
• Commit to meet with ACO periodically to discuss and agree upon ACO activities to be pursued with the Practice to improve ACO’s and Practice’s performance in the MSSP. Practice shall participate in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with ACO regarding applicable beneficiary education on ACO initiatives and health improvement strategies.

On August 6, 2021, the ACO Board of Directors approved the following arrangements as reasonably related to the purposes of the MSSP (all arrangements were subject to Board approval and, as such, were not final unless and until approved by the ACO Board of Directors):

Arrangement #1:  The ACO entered into a Network Participation Agreement with Patient Physician Holding Co. LLC (the “Network”) effective August 19, 2021for which the ACO will compensate the Network for providing the following services:

• Facilitate local practice participation in the ACO and work with ACO regarding the same
• Participate in Joint Steering Committee with ACO leadership concerning local practices that are participants in ACO, e.g., discuss communication strategies, ACO initiatives to promote quality of care, cost of care and overall care (ACO Initiatives), discuss local practice performance and cooperation with ACO, etc.
• Coordinate and ensure ACO adequate time in monthly practice manager meetings and Network Board meetings so that ACO may present and discuss ACO Initiatives and any other topic that local practices may wish to discuss
• Provide ACO access to information for purposes of ACO communicating with and local practices (e.g., email distribution lists)
• Engage with local practices to promote local practice participation in ACO Initiatives and intervene with local practice when identified by ACO as an outlier regarding quality or cost of care and work with local practice to develop a course of action to improve local practice performance
• Work with ACO to promote data and technology integration with local TINs for purposes of CMS reporting requirements and data used to develop and measure ACO Initiatives
• Designate a Medical Director to serve as the primary contact between ACO and local TINs and an active participant in the relationship between ACO and local TINs

Arrangement #2:  The ACO entered into a Practice Services Agreement with Northern Medical Group, PLLC (the “Practice”) effective September 9, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating the ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout the Practice.
• Meet with the ACO periodically to discuss and agree upon the ACO activities to be pursued with the Practice to improve the ACO’s and Practice’s performance in the MSSP. Practice shall participate in such the ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with the ACO regarding applicable beneficiary education on the ACO initiatives and health improvement strategies.

Arrangement #3:  The ACO entered into a Practice Services Agreement with Sunflower Medical Group, PA (the “Practice”) effective July 30, 2021 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating the ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout the Practice.
• Meet with the ACO periodically to discuss and agree upon the ACO activities to be pursued with the Practice to improve the ACO’s and Practice’s performance in the MSSP. Practice shall participate in such the ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with the ACO regarding applicable beneficiary education on the ACO initiatives and health improvement strategies.

Arrangement #4:  The ACO entered into a Practice Services Agreement with Bond & Steele Clinic (the “Practice”) effective August 6, 2021, and an amendment to the Agreement dated as of September 20, 2021, for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating the ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout the Practice.
• Meet with the ACO periodically to discuss and agree upon the ACO activities to be pursued with the Practice to improve the ACO’s and Practice’s performance in the MSSP. Practice shall participate in such the ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with the ACO regarding applicable beneficiary education on the ACO initiatives and health improvement strategies.

Arrangement #5: The ACO entered into a Practice Services Agreement with Xing-Nong Li MD Inc. (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating the ACO communications for practice, providers and staff to ensure ACO initiatives are well known and implemented throughout the Practice.
• Meet with the ACO periodically to discuss and agree upon the ACO activities to be pursued with the Practice to improve the ACO’s and Practice’s performance in the MSSP. Practice shall participate in such the ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Ensure practice providers’ engagement with the ACO regarding applicable beneficiary education on the ACO initiatives and health improvement strategies.

Arrangement #6: The ACO entered into a Network Participation Agreement with The Mills-Peninsula Medical Group, Inc. (“Network”) effective August 4, 2021 for which the ACO will compensate the Network for providing the following services:

• Facilitate local practice participation in the ACO and work with ACO regarding the same
• Participate in Joint Steering Committee with ACO leadership concerning local practices that are participants in ACO, e.g., discuss communication strategies, ACO initiatives to promote quality of care, cost of care and overall care (ACO Initiatives), discuss local practice performance and cooperation with ACO, etc.
• Coordinate and ensure ACO adequate time in Network Board meetings so that ACO may present and discuss ACO Initiatives and any other topic that local practices may wish to discuss
• Provide ACO access to information for purposes of ACO communicating with and local practices (e.g., addresses, phone numbers)
• Engage with local practices to promote local practice participation in ACO initiatives and intervene with local practice when identified by ACO as an outlier regarding quality or cost of care and work with local practice to develop a course of action to improve local practice performance
• Work with ACO to promote data and technology integration with local practices for purposes of CMS reporting requirements and data used to develop and measure ACO Initiatives.

On January 14, 2022, the ACO Board of Directors approved the following arrangement as reasonably related to the purposes of the MSSP (all arrangements were subject to Board approval and, as such, were not final unless and until approved by the ACO Board of Directors).

The ACO entered into a Practice Services Agreement with Generations Family Practice, PA (the “PSA”) effective January 1, 2022 through December 31, 2026 for which the ACO will compensate the practice for providing the following services:

• Designate certain providers and/or administrators to participate in management forums with the Corporation leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Ensure that the Corporation and the Corporation staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Supply the Corporation access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Meet with the Corporation periodically to discuss and agree upon the Corporation activities to be pursued with Practice providers to improve the Corporation’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in the Corporation initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• Work with the Corporation to contact providers identified as outlier for quality or cost of care to discuss the outlier and, if appropriate, agree upon a course of action.
• Support the Corporation’s engagement with Practice’s providers regarding applicable Member education on the Corporation initiatives and health improvement strategies.
• Work with the Corporation to promote, as needed, data and technology integration.
• Provide the Corporation access to its EMR for promotion of care coordination and quality reporting purposes.

On January 14, 2022,  the ACO Board of Directors approved the ACO entering into the following arrangement as reasonably related to the purposes of the MSSP:

On Friday Mary 13, 2022, the ACO and Progress at Home, LLC dba under the assumed name CorsoCare Home Health (“CorsoCare”) executed and delivered a Care Coordination Agreement to be effective as of January 1, 2022 under which:

• CorsoCare shall provide home health services to ACO assigned beneficiaries located in Michigan as a Medicare FFS provider if referred by the beneficiaries’ treating physicians.  CorsoCare shall submit it claims for these services to Medicare FFS for payment in accordance with CMS requirements.
• CorsoCare may identify ACO assigned beneficiaries that may benefit from additional care management services as part of CorsoCare’s home health services.  If ACO provides these additional care management services to CorsoCare patients that are also ACO assigned beneficiaries, CorsoCare shall compensate ACO for these additional services.
• ACO shall provide CorsoCare access to ACO’s ADT feed for ACO assigned beneficiaries.  CorsoCare shall pay ACO a fee for access to the feed.

On September 16, 2022, the ACO Board of Directors approved the following arrangements as reasonably related to the purposes of the MSSP (all arrangements were subject to Board approval and, as such, were not final unless and until approved by the ACO Board of Directors):

Arrangement #1:  The ACO entered into a Network Participation Agreement with Quality Independent Physicians, LLC (the “Network”) effective September 1, 2022 through December 31, 2025 for which the ACO will compensate the Network for providing the following services:

• Network shall work with TACO and use best efforts to facilitate the Network TINs identified by the Parties to enter into ACO Participant Agreements with TACO.
• Network, represented by 1 (one) network provider from each Network TIN, shall participate in a Joint Steering Committee with TACO leadership that shall meet at least quarterly at a time and location to be mutually agreed to by the Parties.
• Network shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Network’s currently established Board meetings and monthly practice manager meetings.
• Network shall supply TACO access to Network email distribution lists, addresses, phone numbers, etc. for ACO-related communication.
• Prior to each MSSP Performance Year, Network and TACO will engage in cost and quality improvement initiatives that will impact Network’s performance in the MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Network and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with the Network TINs to improve TACO’s and Network TINs’ performance in the MSSP.  Network shall participate in and/or engage with Network TINs to support the Network TINs’ participation in such TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Network shall participate in and/or engage with Network TINs to achieve the ACO Minimum Domain Performance Thresholds as defined in the Agreement.
• In the event that TACO identifies a Network TIN or provider providing health care services on behalf of a Network TIN that is an outlier for quality or cost of care, Network shall, as needed, work with TACO to contact the TIN to discuss the outlier and, if appropriate, agree upon a course of action.
• Network shall, as needed, support TACO’s engagement with Network TINs regarding applicable Member education on TACO initiatives and health improvement strategies.
• Network shall supply or designate a Network Medical Director, to be approved by TACO, who will interact with TACO and the Network TINs regarding TACO initiatives and goals.  The Parties shall mutually agree and determine the full responsibilities and compensation, if any, of the Network Medical Director in a separate agreement between the Parties.  
• Network shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Network shall either provide or ensure that Network TINs provide access to EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Network shall maintain the role of “Data Custodian” under Network’s CMS Data Use Agreement for its MSSP ACO until the CMS deadline for submitting the Certificate of Disposition in 2023.
• Network shall retain all financial, legal, compliance, reporting, and operational responsibilities for the Network TINS participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS, and quality reporting requirements.

Arrangement #2:  The ACO entered into a Practice Services Agreement with CNY Family Care, LLP (the “Practice”) effective September 1, 2022 through December 31, 2025 for which the ACO will compensate the Network for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the time reasonably requested by TACO to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice agrees to engage with TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in the Agreement.
• In the event that TACO reasonably demonstrates that an Eligible Clinician providing health care services on behalf of a Practice is an outlier for quality or cost of care, Practice will contact the Eligible Clinician to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #3: The ACO entered into a Practice Services Agreement with Walla Walla Clinic, LLC (the “Practice”) effective January 1, 2023 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the time reasonably requested by TACO to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice agrees to engage with TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in the Agreement.
• In the event that TACO reasonably demonstrates that an Eligible Clinician providing health care services on behalf of a Practice is an outlier for quality or cost of care, Practice will contact the Eligible Clinician to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #4: The ACO entered into a Practice Services Agreement with Dennis Gray MD PSC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #5: The ACO entered into a Practice Services Agreement with Greater Louisville Internal Medicine PSC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #6: The ACO entered into a Practice Services Agreement with Clover Fork Outpatient Medical Project Inc (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #7: The ACO entered into a Practice Services Agreement with Medical Associates of Southern KY PLLC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #8: The ACO entered into a Practice Services Agreement with Greentree Primary Care PLLC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #9: The ACO entered into a Practice Services Agreement with Gill Medical and Geriatrics Associates LLC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #10: The ACO entered into a Practice Services Agreement with Phillips Pratt & McFarland PSC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #11: The ACO entered into a Practice Services Agreement with Drs. Borders and Associates PSC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #12: The ACO entered into a Practice Services Agreement with LaGrange Family Care Doctors PSC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #13: The ACO entered into a Practice Services Agreement with Sellersburg Internal Medicine & Pediatrics (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #14: The ACO entered into a Practice Services Agreement with Primary Care Centers of Eastern Kentucky LLC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #15: The ACO entered into a Practice Services Agreement with Kemper & Kemper MDS LLP (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #16: The ACO entered into a Practice Services Agreement with Versailles Family Medicine PLLC (the “Practice”) effective September 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Coordinating Care/Quality Improvement/Increased Efficiency. Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review to identify areas of opportunity, attribution campaign via Annual Wellness Visits, engagement with ACO care management programs and post-discharge follow-up visits. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. For clarity, access to EMR means manual access by the appropriate TACO representatives via log-in credentials.
• Practice shall retain all financial, legal, compliance, reporting, and operational responsibilities for their participation in their current MSSP ACO and any other government programs, including, but not limited to, MIPS and quality reporting requirements.

Arrangement #17: The ACO entered into a Practice Services Agreement with Abimbola M Banjo MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #18: The ACO entered into a Practice Services Agreement with Alicia W Grossmann MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #19: The ACO entered into a Practice Services Agreement with Dominion Medical Associates PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #20: The ACO entered into a Practice Services Agreement with Family Medical Center of Georgetown PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #21: The ACO entered into a Practice Services Agreement with Family Medicine Center Clinic (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #22: The ACO entered into a Practice Services Agreement with Family Medicine Clinic (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #23: The ACO entered into a Practice Services Agreement with Jose Sosa (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #24: The ACO entered into a Practice Services Agreement with Joseph A Marotta MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #25: The ACO entered into a Practice Services Agreement with Kendall Wong MD (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Designate a practice manager or leader responsible for ensuring and facilitating Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #26: The ACO entered into a Practice Services Agreement with Kevin Stephens MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #27: The ACO entered into a Practice Services Agreement with Leo Toupin MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #28: The ACO entered into a Practice Services Agreement with North Austin Family Medicine PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #29: The ACO entered into a Practice Services Agreement with North Star Family Medicine PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #30: The ACO entered into a Practice Services Agreement with Odessa Consultants PLLC (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #31: The ACO entered into a Practice Services Agreement with Pankaj J Patel MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #32: The ACO entered into a Practice Services Agreement with Paul E Bristol MD (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #33: The ACO entered into a Practice Services Agreement with Pleasanton Family Medicine PLLC (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #34: The ACO entered into a Practice Services Agreement with Port Lavaca Clinic Associates PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #35: The ACO entered into a Practice Services Agreement with Rajanikant Pandya MD (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #36: The ACO entered into a Practice Services Agreement with Rajesh J Patel MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #37: The ACO entered into a Practice Services Agreement with Sammy Lerma III MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #38: The ACO entered into a Practice Services Agreement with Shroff Cardiology & Internal Medicine Clinic PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #39: The ACO entered into a Practice Services Agreement with Shylesh Ganta MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #40: The ACO entered into a Practice Services Agreement with South Texas Internal Medicine Associates (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #41: The ACO entered into a Practice Services Agreement with Subodh K Mallik MD (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #42: The ACO entered into a Practice Services Agreement with Suresh Prasad MD PA (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #43: The ACO entered into a Practice Services Agreement with Vikram Vadyala MD (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #44: The ACO entered into a Practice Services Agreement with Legends Medical Clinic PLLC (the “Practice”) effective January 1, 2022 for which the ACO will compensate the Practice for providing the following services:

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.
• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign. In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.
• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

On January 17, 2023 the ACO Board of Directors approved the following arrangement as reasonably related to the purposes of the MSSP (all arrangements were subject to Board approval and, as such, were not final unless and until approved by the ACO Board of Directors):

Arrangement #1: The ACO entered into a Network Participation Agreement with Atlantic Medical Management LLC (“AMM”) (the “Network”) effective September 1, 2022 through December 31, 2024 for which the ACO will compensate the Network for providing the following services:

• Designate certain providers and/or administrators to participate in management forums with the ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.  
• Ensure that the ACO and the ACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings. 
• Supply the ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.  
• Prior to each MSSP Performance year, Practice and the ACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  
• Use its best efforts to achieve the ACO Minimum Domain Performance Thresholds (as defined in the Agreement).
• In the event that the ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with the ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• As needed, support the ACO’s engagement with Practice’s providers regarding applicable Member education on the ACO initiatives and health improvement strategies. 
• Work with the ACO to promote, as needed, data and technology integration.  
• Provide the ACO access to its EMR for promotion of care coordination and quality reporting purposes.
• If the parties mutually agree, the Practice shall also provide the following services in support of new practices joining the ACO but not included as part of Practice (“New TINs”):
  • Practice shall designate certain providers and/or administrators to participate in management forums between ACO leadership and New TINs that shall meet at least quarterly at a time and location to be mutually agreed to by the Parties.
  • Practice shall share best practices with New TINs as it relates to ACO cost and quality initiatives.
  • Practice shall make itself available on an ad hoc basis, as reasonably requested by New TINs, to assist New TINs with ACO issues.
  • Practice shall participate from time-to-time in the ACO’s engagement with New TIN providers regarding Member education on ACO initiatives and health improvement strategies.

On September 15, 2023, The Accountable Care Organization Ltd (“ACO”) Board of Directors approved the following arrangements as reasonably related to the purposes of the MSSP (all arrangements were subject to Board approval and, as such, are not final until the later of the ACO Board of Directors approval or the effective date of the arrangement):
 

Arrangement #1:  The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Adult Medicine of Lake County, Inc. (“AMLC”) for which the ACO will compensate AMLC for providing the following services:
 

• AMLC shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• AMLC shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at AMLC’s currently established practice manager meetings.
• AMLC shall supply ACO access to AMLC email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, AMLC and ACO will engage in cost and quality improvement initiatives that will impact AMLC’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, AMLC and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with AMLC providers to improve ACO’s and AMLC’s providers’ performance in the MSSP.  AMLC shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• AMLC shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• In the event that ACO identifies a provider providing health care services on behalf of a AMLC that is an outlier for quality or cost of care, AMLC shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• AMLC shall, as needed, support ACO’s engagement with AMLC’s providers regarding applicable FFS Medicare beneficiary education on ACO initiatives and health improvement strategies.
• AMLC shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• AMLC shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #2:  The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Cardiovascular Association, PLLC (“CA”) for which the ACO will compensate CA for providing the following services: 

• CA shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• CA shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at CA’s currently established practice manager meetings. 
• CA shall supply ACO access to CA email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, CA and ACO will engage in cost and quality improvement initiatives that will impact CA’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, CA and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with CA providers to improve ACO’s and CA’s providers’ performance in the MSSP.  CA shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• CA shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• In the event that ACO identifies a provider providing health care services on behalf of a CA that is an outlier for quality or cost of care, CA shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.
• CA shall, as needed, support ACO’s engagement with CA’s providers regarding applicable FFS Medicare beneficiary education on ACO initiatives and health improvement strategies.
• CA shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• CA shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #3:  The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Diagnostic Affiliates of Northeast Houston, PLLC (“DANH”) for which the ACO will compensate DANH for providing the following services:
 

• DANH shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• DANH shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at DANH’s currently established practice manager meetings. 
• DANH shall supply ACO access to DANH email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, DANH and ACO will engage in cost and quality improvement initiatives that will impact DANH’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, DANH and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with DANH providers to improve ACO’s and DANH’s providers’ performance in the MSSP.  DANH shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.
• DANH shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• In the event that ACO identifies a provider providing health care services on behalf of a DANH that is an outlier for quality or cost of care, DANH shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 
• DANH shall, as needed, support ACO’s engagement with DANH’s providers regarding applicable FFS Medicare beneficiary education on ACO initiatives and health improvement strategies.
• DANH shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• DANH shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #4: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with North Houston Family Medicine, PLLC (“NHFM”) for which the ACO will compensate NHFM for providing the following services:
 

• NHFM shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• NHFM shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at NHFM’s currently established practice manager meetings. 
• NHFM shall supply ACO access to NHFM email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, NHFM and ACO will engage in cost and quality improvement initiatives that will impact NHFM’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, NHFM and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with NHFM providers to improve ACO’s and NHFM’s providers’ performance in the MSSP.  NHFM shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities. 
• NHFM shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• In the event that ACO identifies a provider providing health care services on behalf of a NHFM that is an outlier for quality or cost of care, NHFM shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 
• NHFM shall, as needed, support ACO’s engagement with NHFM’s providers regarding applicable FFS Medicare beneficiary education on ACO initiatives and health improvement strategies.
• NHFM shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• NHFM shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes.
   

Arrangement #5: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Sheikh Ahmed, MD (“SA”) for which the ACO will compensate SA for providing the following services:
 

• SA shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• SA shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at SA’s currently established practice manager meetings. 
• SA shall supply ACO access to SA email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, SA and ACO will engage in cost and quality improvement initiatives that will impact SA’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, SA and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with SA providers to improve ACO’s and SA’s providers’ performance in the MSSP.  SA shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities. 
• SA shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• In the event that ACO identifies a provider providing health care services on behalf of a SA that is an outlier for quality or cost of care, SA shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 
• SA shall, as needed, support ACO’s engagement with SA’s providers regarding applicable FFS Medicare beneficiary education on ACO initiatives and health improvement strategies.
• SA shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• SA shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #6: The ACO entered into a Practice Services Agreement (“PSA”) effective January 1, 2024 with Texas Alliance Medical Group PA (“TAMG”) for which the ACO will compensate TAMG for providing the following services:

• TAMG shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• TAMG shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at TAMG’s currently established practice manager meetings. 
• TAMG shall supply ACO access to TAMG email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, TAMG and ACO will engage in cost and quality improvement initiatives that will impact TAMG’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, TAMG and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with TAMG providers to improve ACO’s and TAMG’s providers’ performance in the MSSP.  TAMG shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities. 
• TAMG shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• In the event that ACO identifies a provider providing health care services on behalf of a TAMG that is an outlier for quality or cost of care, TAMG shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 
• TAMG shall, as needed, support ACO’s engagement with TAMG’s providers regarding applicable FFS Medicare beneficiary education on ACO initiatives and health improvement strategies.
• TAMG shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• TAMG shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes.
   

Arrangement #7:  The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Welcome Family Medicine PA (“WFM”) for which the ACO will compensate WFM for providing the following services:
 

• WFM shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• WFM shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at WFM’s currently established practice manager meetings. 
• WFM shall supply ACO access to WFM email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, WFM and ACO will engage in cost and quality improvement initiatives that will impact WFM’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, WFM and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with WFM providers to improve ACO’s and WFM’s providers’ performance in the MSSP.  WFM shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities. 
• WFM shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• In the event that ACO identifies a provider providing health care services on behalf of a WFM that is an outlier for quality or cost of care, WFM shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 
• WFM shall, as needed, support ACO’s engagement with WFM’s providers regarding applicable FFS Medicare beneficiary education on ACO initiatives and health improvement strategies.
• WFM shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• WFM shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes.

On December 8, 2023, The Accountable Care Organization Ltd (“ACO”) Board of Directors approved the following arrangement as reasonably related to the purposes of the MSSP (all arrangements were subject to Board approval and, as such, are not final until the later of the ACO Board of Directors approval or the effective date of the arrangement):

Arrangement #1:  The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Noble Healthcare Systems (“NHS”) for which the ACO will compensate NHS for providing the following services:
 

• NHS shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• NHS shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at NHS’s currently established practice manager meetings. 
• NHS shall supply ACO access to NHS email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
• Prior to each MSSP Performance year, NHS and ACO will engage in cost and quality improvement initiatives that will impact NHS’s performance in MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review, or launching a voluntary attribution campaign. In addition, NHS and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with NHS providers to improve ACO’s and NHS’s providers’ performance in the MSSP. NHS shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding, and risk adjustment activities.
• NHS shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to the PSA.
• In the event that ACO identifies a provider providing health care services on behalf of a NHS that is an outlier for quality or cost of care, NHS shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 
• NHS shall, as needed, support ACO’s engagement with NHS’s providers regarding applicable FFS Medicare beneficiary education on ACO initiatives and health improvement strategies.
• NHS shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• NHS shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes.

On July 17, 2024, The Accountable Care Organization Ltd (ACO) Board of Directors approved the following arrangements as reasonably related to the purposes of the Medicare Shared Savings Program (all arrangements are subject to Board approval and, as such, are not final unless and until approved by the ACO Board of Directors):
 

Arrangement #1:  The ACO entered into a Practice Services Agreement (the “PSA”) effective May 23, 2024 with Family Practice Center, P.C. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall make its best efforts to ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.

• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  
Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP. Such initiatives may include, but not be limited to,  allowing ACO to perform a coding review or launching a voluntary attribution campaign. In addition,  Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP. Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures or electronic CQMs.

Implementation Activities Prior to PY 2025.

• Practice and ACO will engage in the following activities prior to Performance Year (PY) 2025:

• Practice will allow access for ACO Care Partners (ECP) coding team to conduct retrospective review of claims for Medicare FFS services provided to Assigned

• Beneficiaries. The retrospective review will allow ACO to assess Practice’s current medical record documentation and coding practices regarding Medicare FFS claims and allow ACO to determine whether Practice may benefit from training regarding MSSP requirements regarding medical record documentation and coding.

• Practice will allow the ECP coding team to conduct at least two risk adjustment education sessions with practice providers. The education sessions will focus on the biggest areas of opportunity identified by ECP for Practice’s performance improvement as a participant in the ACO. ACO anticipates that such education sessions will include at least one targeted collaborative improvement project with ECP staff (such as pre-visit planning workflow around coding and quality improvement), panel retention efforts that involve annual wellness visit review of Assigned Beneficiaries not seen by Practice in the last 12 months, as well as providing eCQM file for 2024 performance to identify and collaborate on quality improvement.
   

Arrangement #2:  The ACO entered into an Amendment dated January 1, 2025 (the “Amendment”) effective January 1, 2025 with Silver Pine Medical Group, P.L.C. (the “Network”) for which the ACO will compensate the Network for providing the following services:

Network TIN Participation in ACO

• Network shall work with ACO and use best efforts to facilitate the Network TINs identified by the Parties to enter into ACO Participant Agreements with ACO.

Communication with Network TINs

• Network shall participate in a Joint Steering Committee with ACO leadership that shall meet at least quarterly at a time and location to be mutually agreed to by the Parties.

• Network shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at Network’s currently established Board meetings and monthly practice manager meetings.

• Network shall supply ACO access to Network email distribution lists, addresses, phone numbers, etc. for ACO-related communication. 

Coordinating Care/Quality Improvement/Increased Efficiency.

Prior to each MSSP Performance Year, Network and ACO will engage in cost and quality improvement initiatives that will impact Network’s performance in the MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign. In addition, Network and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with the Network TINs to improve ACO’s and Network TINs’ performance in the MSSP. Network shall participate in and/or engage with Network TINs to support the Network TINs’ participation in such ACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Network TIN Accountability for Care

• Network shall participate in and/or engage with Network TINs to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that ACO identifies a Network TIN or provider providing health care services on behalf of a Network TIN that is an outlier for quality or cost of care, Network shall, as needed, work with ACO to contact the TIN to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Network shall, as needed, support ACO’s engagement with Network TINs regarding applicable Member education on ACO initiatives and health improvement strategies.

Medical Director: Network shall supply or designate a Network Medical Director, to be approved by ACO, who will interact with ACO and the Network TINs regarding ACO initiatives and goals. The Parties shall determine the full responsibilities and compensation, if any, of the Network Medical Director in a separate agreement between the Parties.

Technology. 

• Network shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Network shall either provide or ensure that Network TINs provide access to EMR for promotion of care coordination and quality reporting purposes. 

Arrangement #3:  The Corporation entered into an Amendment dated January 1, 2023 (the “Amendment”) to the Network Participation Agreement effective November 19, 2019 (collectively the “NPA”) with Key Physicians PA (the “Network”) for which the ACO will compensate the Network for providing the following services:

• Provide ACO with reasonable access to Network TINs by: (i) ensuring that ACO and ACO staff are offered the opportunity to provide an ACO update at Network's quarterly practice or multi-practice ACO meetings and monthly practice manager meetings; and (ii) supplying ACO access to Network email distribution lists for ACO-related communication; and (iii) including ACO-related information approved in advance by Network in regularly scheduled Network updates and other appropriate communication;

• Use commercially reasonable efforts to cause Network TINs to provide EMR access for care advising and quality reporting purposes should a Network TIN agree to grant that access;

• Pe1mit ACO to present MSSP updates and performance projections at Network committee and Board of Directors meetings quarterly or as needed, provided that all agenda items and proposed meeting materials are supplied in advance to Network for Network's review;

• Participate in and/or engage with Network TINs participating in ACO to support ACO initiatives including but not limited to utilizing a preferred post-acute network, network initiatives to reduce unnecessary cost and utilization, quality improvement, and appropriate coding; and

• Collaborate with ACO to select a Network Medical Director who will dedicate a minimum of five (5) hours per week engaging Network TINs around ACO initiatives and goals.
   

Arrangement #4:  The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Alvi Prime Time Clinics, PLLC (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #5: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Capital Family Physicians, P.A. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #6: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Cary Internal Medicine & The Diabetes Center, P.A. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #7: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Family First Primary Care, PLLC (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #8: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Internal Medicine & Pediatric Associates, P.A. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #9: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with North Carolina Internal Medicine PC (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #10: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Raleigh Medical Group, PA (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #11: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Wake Internal Medicine Consultants, Inc., P.C. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #12: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Capital Family Medicine, P.A. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #13: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Cary Healthcare Associates, P.A. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #14: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with David Paul Adams, M.D., P.A. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #15: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Imperial Center Family Medicine and Immediate Care, PLLC (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

Arrangement #16: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Jacobs and Van Cleef Internal Medicine, PC (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #17: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Raleigh Family Practice, P.A. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers. 

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #18: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Shah & Associates Family Practice, P.A. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

 Arrangement #19: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2024 with Western Wake Wellness PLLC (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall ensure that TACO and TACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established practice manager meetings.

• Practice shall supply TACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency.  Prior to each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that will impact Practice’s performance in MSSP.  Such initiatives, may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition,  Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, utilizing a preferred post-acute network, specific activities focused on reducing unnecessary cost and utilization, quality improvement activities, appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:  Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes.

On August 29, 2024, The Accountable Care Organization Ltd (ACO) Board of Directors approved the following arrangements as reasonably related to the purposes of the Medicare Shared Savings Program (all arrangements are subject to Board approval and, as such, are not final unless and until approved by the ACO Board of Directors):

Arrangement #1: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Middletown Medical, P.C. (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall make arrangements to provide TACO and TACO staff with appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.

• Practice shall work with TACO to educate Practice and share   ACO-related communication to its practice managers and/or providers. 

Coordinating Care/Quality Improvement/Increased Efficiency. 

Prior to and during each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its commercially reasonable efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology. 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (“eCQMs”).

• TACO shall provide Practice with all claims, attribution and other data within 7 days of  receiving such data from CMS related to the Practice’s patients and performance under this Agreement.

Arrangement #2: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Generations Family Practice, PA (the “Practice”) for which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.   

• Practice shall designate certain providers and/or administrators to participate in management forums with TACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.

• Practice shall make arrangements to provide TACO and TACO staff with appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.

• Practice shall work with TACO to educate Practice and share   ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.
Prior to and during each MSSP Performance year, Practice and TACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing TACO to perform a coding review or launching a voluntary attribution campaign.  In addition, Practice and TACO shall meet periodically to discuss and agree upon TACO activities to be pursued with Practice providers to improve TACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in TACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its commercially reasonable efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.

• In the event that TACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with TACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education: 
Practice shall, as needed, support TACO’s engagement with Practice’s providers regarding applicable Member education on TACO initiatives and health improvement strategies.

Technology: 

• Practice shall work with TACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

• Practice shall provide TACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures or electronic CQMs.

On November 8, 2024, The Accountable Care Organization Ltd (ACO) Board of Directors approved the following arrangements as reasonably related to the purposes of the Medicare Shared Savings Program (all arrangements are subject to Board approval and, as such, are not final unless and until approved by the ACO Board of Directors):

Arrangement #1: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Aegis Medical Center PLLC (the “Practice”) under which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall make arrangements to provide ACO and ACO staff with appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings. 
• Practice shall work with ACO to educate Practice and share   ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its commercially reasonable efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #2: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Family Medicine, Inc. (the “Practice”) under which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall make arrangements to provide ACO and ACO staff with appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall work with ACO to educate Practice and share   ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its commercially reasonable efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies. 
  Technology.
• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #3: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Camil I. Kreit MD PA (the “Practice”) under which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall make arrangements to provide ACO and ACO staff with appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall work with ACO to educate Practice and share   ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.  In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.  Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its commercially reasonable efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.

Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #4: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Stephens City Family Medicine, LLC (the “Practice”) under which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #5: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Michelle Trippel MD, Inc. (the “Practice”) under which the ACO will compensate the Practice for providing the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

On December 17, 2024, The Accountable Care Organization Ltd (ACO) Board of Directors approved the following arrangements as reasonably related to the purposes of the Medicare Shared Savings Program (all arrangements are subject to Board approval and, as such, are not final unless and until approved by the ACO Board of Directors):

Arrangement #1: The ACO entered into a Network Participation Agreement (the “NPA”) effective January 1, 2025 with Shenandoah Independent Practice Association (the “Network”) under which the ACO will compensate Network to provide the following services:

Network TIN Participation in ACO.

• Network shall work with ACO and use best efforts to facilitate the Network TINs identified by the Parties to enter into ACO Participation Agreements with ACO.

Communication with Network TINs.

• Network shall meet with ACO leadership at a frequency, time, and location to be mutually agreed to by the Parties, provided the Parties shall meet at least once annually.
• Network shall ensure that ACO and ACO staff are allocated the appropriate time to provide updates, as needed, at Network’s currently established Board meetings, provider meetings and monthly practice manager meetings.
• Network shall supply ACO access to Network email distribution lists, addresses, phone numbers, etc. for ACO-related communication.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to each MSSP Performance Year, Network and ACO will engage in cost and quality improvement initiatives that will impact Network’s performance in the MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign. In addition, Network and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with the Network TINs to improve ACO’s and Network TINs’ performance in the MSSP. Network shall participate in and/or engage with Network TINs to support the Network TINs’ participation in such ACO initiatives, which initiatives may include, but are not limited to, care management activities, specific activities focused on reducing unnecessary cost and utilization, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Network TIN  Accountability for Care.

• Network shall participate in and/or engage with Network TINs to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that ACO identifies a Network TIN or provider providing health care services on behalf of a Network TIN that is an outlier for quality or cost of care, Network shall, as needed, work with ACO to contact the TIN to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Network shall, as needed, support ACO’s engagement with Network TINs regarding applicable Member education on ACO initiatives and health improvement strategies.

Medical Director.

• If requested by ACO, Network shall supply or designate a Network Medical Director, to be approved by ACO, who will interact with ACO and the Network TINs regarding ACO initiatives and goals. The Parties shall determine the full responsibilities and compensation, if any, of the Network Medical Director in a separate agreement between the Parties.

Technology.

• Network shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Network shall either provide or ensure that Network TINs provide access to EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #2: The ACO entered into a Network Participation Agreement (the “NPA”) effective January 1, 2025 with Hawaii Independent Physicians Association (the “Network”) under which the ACO will compensate Network to provide the following services:

Network TIN Participation in ACO.

• Network shall work with ACO and use best efforts to facilitate the Network TINs identified by the Parties to enter into ACO Participation Agreements with ACO.

Communication with Network TINs.

• Network shall meet with ACO leadership at a frequency, time, and location to be mutually agreed to by the Parties, provided the Parties shall meet at least once annually.
• Network shall ensure that ACO and ACO staff are allocated the appropriate time to provide updates, as needed, at Network’s currently established Board meetings, provider meetings and monthly practice manager meetings.
• Network shall supply ACO access to Network email distribution lists, addresses, phone numbers, etc. for ACO-related communication.

Coordinating Care/Quality Improvement/Increased Efficiency.

Prior to each MSSP Performance Year, Network and ACO will engage in cost and quality improvement initiatives that will impact Network’s performance in the MSSP. Such initiatives, may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign. In addition, Network and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with the Network TINs to improve ACO’s and Network TINs’ performance in the MSSP. Network shall participate in and/or engage with Network TINs to support the Network TINs’ participation in such ACO initiatives, which initiatives may include, but are not limited to, care management activities, specific activities focused on reducing unnecessary cost and utilization, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Network TIN  Accountability for Care. 

• Network shall participate in and/or engage with Network TINs to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that ACO identifies a Network TIN or provider providing health care services on behalf of a Network TIN that is an outlier for quality or cost of care, Network shall, as needed, work with ACO to contact the TIN to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Network shall, as needed, support ACO’s engagement with Network TINs regarding applicable Member education on ACO initiatives and health improvement strategies.

Medical Director.

• If requested by ACO, Network shall supply or designate a Network Medical Director, to be approved by ACO, who will interact with ACO and the Network TINs regarding ACO initiatives and goals. The Parties shall determine the full responsibilities and compensation, if any, of the Network Medical Director in a separate agreement between the Parties.

Technology.

• Network shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Network shall either provide or ensure that Network TINs provide access to EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #3: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Kihei-Wailea Medical Center, LLC (the “Practice”) under which the ACO will compensate the Practice to provide the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its commercially reasonable efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education: 

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies. 

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #4: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Curtis Takemoto-Gentile MD Inc. (the “Practice”) under which the ACO will compensate the Practice to provide the following services: 

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall make arrangements to provide ACO and ACO staff with appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP. 
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A to this Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #5: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Russell M. Tom, LLC (the “Practice”): 

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.
  Coordinating Care/Quality Improvement/Increased Efficiency. 
• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities. 

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #6: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Thomas K S Tan MD Inc. (the “Practice”):

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allocated the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #7: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with St. Lukes Clinic Ala Moana, Inc. (the “Practice”): 

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allocated the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #8: The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Manakai O Malama Integrative (the “Practice”): 

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allocated the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies. 

Technology. 

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall use best efforts to provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

Arrangement #9:  The ACO entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Carmen Baybayan MD, LLC  (the “Practice”) under which the ACO will compensate the Practice to provide the following services:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allocated the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed to  impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign. 
• In addition, Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities. 

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in Exhibit A in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action. 

Member Education:

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies. 

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall use best efforts to provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).

On February 5, 2025, The Accountable Care Organization Ltd (ACO) Board of Directors approved the following arrangement as reasonably related to the purposes of the Medicare Shared Savings Program (all arrangements are subject to Board approval and, as such, are not final unless and until approved by the ACO Board of Directors):
Arrangement

Domus Care Solutions
The Corporation entered into a Practice Services Agreement (the “PSA”) effective January 1, 2025 with Domus Care Solutions (the “Practice”).

1. Services:

The Practice agreed to provide the following services in support of the ACO:

Communication with Practice Providers.

• Practice shall designate certain providers and/or administrators to participate in management forums with ACO leadership that shall meet no more than quarterly at a time and location to be mutually agreed to by the Parties.
• Practice shall ensure that ACO and ACO staff are allotted the appropriate time to provide updates, as needed, at Practice’s currently established provider meetings and practice manager meetings.
• Practice shall supply ACO access to Practice email distribution lists, addresses, phone numbers, etc. for ACO-related communication to its practice managers and/or providers.

Coordinating Care/Quality Improvement/Increased Efficiency.

• Prior to and during each MSSP Performance year, Practice and ACO will engage in cost and quality improvement initiatives that are designed that will impact Practice’s performance in MSSP.  Such initiatives may include, but not be limited to, allowing ACO to perform a coding review or launching a voluntary attribution campaign.
• Practice and ACO shall meet periodically to discuss and agree upon ACO activities to be pursued with Practice providers to improve ACO’s and Practice’s providers’ performance in the MSSP.
• Practice shall participate in and/or engage with its providers to support their participation in ACO initiatives, which initiatives may include, but are not limited to, activities focused on reducing unnecessary cost and utilization, care management activities, quality improvement and reporting activities, and appropriate coding and risk adjustment activities.

Practice Accountability for Care.

• Practice shall use its best efforts to achieve the ACO Minimum Domain Performance Thresholds as defined in the Agreement.
• In the event that ACO identifies a provider providing health care services on behalf of a Practice that is an outlier for quality or cost of care, Practice shall, as needed, work with ACO to contact the provider to discuss the outlier and, if appropriate, agree upon a course of action.

Member Education.

• Practice shall, as needed, support ACO’s engagement with Practice’s providers regarding applicable Member education on ACO initiatives and health improvement strategies.

Technology.

• Practice shall work with ACO to promote, as needed, data and technology integration. Examples of such data integration may include, facilitating access to local/regional health information exchanges, hospital-based data feeds, lab feeds, pharmacy data, historical patient data and patient contact data.
• Practice shall provide ACO access to its EMR for promotion of care coordination and quality reporting purposes. This may include, but will not be limited to, reporting of Clinical Quality Measures (CQMs) or electronic CQMs (eCQMs).