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Dartmouth-Hitchcock Health's D-HH Accountable Care, LLC Next Generation Accountable Care Organization (ACO)

Building upon experience from the Medicare Pioneer ACO Model and the Medicare Shared Savings Program, the Medicare Next Generation ACO Model offers a new opportunity in accountable care and alternative payment models – one that sets predictable financial targets, enables providers and Medicare beneficiaries greater opportunities to coordinate care, and aims to attain the highest quality standards of care.

D-HH Accountable Care is one of 51 organizations selected by the Centers for Medicare and Medicaid Services (CMS) Innovation Center to participate in the Medicare Next Generation ACO Model.

ACO Primary Contacts

Lynn Guillette, CPA, MBA, MHCDS
Vice President – Payment Innovation
ACO Executive, D-HH Accountable Care
Dartmouth-Hitchcock Health
One Medical Center Drive
Lebanon NH 03756
(603) 653-1260

Steven Paris, MD
Regional Medical Director
Interim ACO Medical Director, D-HH Accountable Care
5 Bedford Farms Drive
Bedford NH 03110
(603) 695-2524

Name and Location of the ACO

D-HH Accountable Care, LLC
One Medical Center Drive
Lebanon NH 03756

Hours of Operation: Monday – Friday, 8:00 am – 4:00 pm EST

Other Contacts

Centers for Medicare and Medicaid Services (CMS)
7500 Security Boulevard
Baltimore, MD 21244

If you need more information about this model, please feel free to contact your primary care provider's office or call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

You can also get more information online at the websites below:

ACO Providers and Participants

Next Generation ACO Participants and Next Generation ACO Professionals

D-HH Accountable Care, LLC is a wholly-owned subsidiary of Dartmouth-Hitchcock Health, a New Hampshire nonprofit corporation. The Next Generation ACO Participants and Next Generation ACO Professionals listed below participate in the D-HH Accountable Care Next Generation ACO. These Next Generation ACO Participants and Next Generation ACO Professionals include primary care providers, as well as specialists in diabetes management, cancer care, heart disease, rheumatology, neurology, orthopedic medicine, and more. We also have relationships with local hospitals and other area healthcare providers. To access a provider listing of the individual participating Next Generation ACO Professionals by location in the D-HH Accountable Care Next Generation ACO, please click on the applicable Dartmouth-Hitchcock Clinic practice listed below.

Next Generation ACO Preferred Providers

The following Skilled Nursing Facilities ("SNFs") participate in the D-HH Accountable Care Next Generation ACO as "Preferred Providers." Original Medicare beneficiaries who are attributed to a Next Generation ACO may take advantage of a benefit enhancement made available to these individuals when they meet clinical criteria to be admitted directly to a SNF instead of being admitted for a three-day inpatient hospital stay prior to admission to a SNF. Eligible Next Generation ACO Medicare beneficiaries can choose from one of the listed D-HH Accountable Care Next Generation ACO Preferred Provider SNFs in order to utilize this Original Medicare benefit enhancement.


Skilled Nursing Facilities

Facility Name City State
Bel-Air Nursing & Rehab Goffstown NH
Cheshire County - Maplewood Westmoreland NH
Courville Manchester Manchester NH
Courville Nashua Nashua NH
Crestwood Center Milford NH
Epsom Health Epsom NH
Fairview Nursing Home Hudson NH
Genesis Applewood Winchester NH
Genesis Lebanon Center Lebanon NH
Genesis Westwood Center Keene NH
Good Shepard Jaffrey NH
Hanover Hill Manchester NH
Maple Leaf Health Ctr. Manchester NH
Merrimack County Boscawen NH
Mount Carmel Rehab Manchester NH
Presidential Oaks Concord NH
Rockingham County Brentwood NH
Saint Teresa Rehab Manchester NH
Villa Crest Manchester NH

ACO Waiver Disclosures

There are no joint ventures between or among D-H Health ACO and any of its Participants and Preferred Providers.

Aggregate Amount of Shared Savings/Losses

For the calendar year 2017 performance period, D-HH Accountable Care LLC was liable for its share of losses in the amount of $608,415. D-HH Accountable Care remitted payment in full to CMS in November 2018.

Please click the link below for a copy of the Next Generation Accountable Care Organization Model Performance Year 2 (2017) Results worksheet that details overall performance results for all 44 Next Generation ACOs that participated in the CMS as publicly released by CMS on December 21, 2018.

View the Next Generation Accountable Care Organization Model Performance Year 2 (2017) Results worksheet (XLSX).

How Shared Savings Are Distributed

As noted above, D-HH Accountable Care, LLC repaid its share of the loss for the calendar year 2017 performance period to CMS. There were no shared savings to distribute for this performance period.

Quality Performance

There are four quality measure domains in the Next Generation ACO Model. The Calendar Year 2017 performance period marked the first year of participation in this model by D-HH Accountable Care, LLC, and, as such, was a “pay-for-reporting” period. D-HH Accountable Care was able to successfully report on all required quality measures, and, as a result, earned a quality performance score of 100%.

It should be noted when comparing the calendar year 2017 quality performance of all participating Next Generation ACOs that, while 2017 was a “pay-for-reporting” period for those ACOs who joined the model in 2017, it was also a “pay-for-performance” period for those ACOs who joined the model in 2016.

D-H Health Next Generation ACO Additional Benefits

Not all Medicare patients were aligned to the ACO model. If you are aligned to the ACO model you will receive a written Beneficiary notice of your alignment from Dartmouth-Hitchcock. Your primary care provider will work with you and other doctors and nurses as needed to coordinate and manage the care you receive. Your regular Medicare services will continue to be covered, and you can still see your current doctor and any other doctor you choose.

As a part of being associated with this ACO, there are a few new benefits for you. You can get a $25 check as a Coordinated Care Reward when you get your Annual Wellness Visit from your doctor at Dartmouth-Hitchcock who participates in the D-H Health ACO. An Annual Wellness Visit is a chance for you to discuss your health, your medications, and your team of doctors with your primary doctor to ensure s/he can coordinate your care. An Annual Wellness Visit isn’t a physical; it’s a distinct visit that can be received once a year, which lets you have a conversation with your doctor about your health. Such visits have been shown to improve health care for beneficiaries, which is why you will be rewarded for receiving an Annual Wellness Visit.

The Centers for Medicare & Medicaid Services (CMS), which is the agency that runs Medicare, will send the check to the address you have listed with the Social Security Administration (SSA). CMS will identify beneficiaries who qualify for the reward on a quarterly basis, so that you can get your $25 check as soon as possible within the next quarter following your Annual Wellness Visit. To get this check please make sure Social Security has your current mailing address by creating an account and updating your profile on their website,

There are several reasons why Medicare will send you a Coordinated Care Reward if you receive an Annual Wellness Visit from your doctor who participates in the D-H Health ACO. Patients who get good care stay healthier, have fewer complications, and require fewer hospitalizations. Coordinated care avoids wasted time and costs for repeated tests and unneeded appointments. It is easier to spot potential problems before they become more serious – like avoiding drug interactions that can result if one doctor is unaware of what another doctor has prescribed. Medicare understands the value that coordinated care provides, and will therefore be rewarding patients who help us meet this goal with a Coordinated Care Reward.

Please know that even with this reward you are not limited to a fixed set of providers. You are still free to use any doctor or hospital that accepts Medicare. If you choose to receive an Annual Wellness Visit from a provider that accepts Medicare, but does not belong to the D-H Health ACO, you will not receive the reward but the visit will still be covered by Medicare. Details are also available on our website at: MLNProducts/downloads/AWV_chart_ICN905706.pdf

Special Benefits Available to the D-H Health ACO

  • 3-day Skilled Nursing Facility (SNF) Rule Waiver: Under current Medicare law, Medicare only covers care in a SNF if a patient has a prior 3-day inpatient hospital stay. This new feature may allow you to get Medicare covered SNF services at a participating SNF without a mandatory 3-day inpatient hospital stay. For a list of participating SNFs, please visit our website at:
  • Telehealth Expansion: Telehealth services allow you to receive some health care services using real-time communication between you and your primary care doctor or specialist. For a list of participating physicians, please visit our website

D-H Health ACO Beneficiary Letter