NH-Cares Accountable Care Organization (ACO)

NH-Cares ACO is a joint venture between three hospitals and ACO professionals. It's a not-for-profit organization based in Concord, NH and founded in 2018. The ACO consists of more than 630 healthcare providers employed by Concord Hospital, Mid-State Health Center, Riverbend Community Mental Health, Granite Visiting Nursing Association, Speare Memorial Hospital and Exeter Health Resources who coordinate the health care of more than 24,000+ Medicare Fee-for-Service beneficiaries in their combined service areas. They are dedicated to promoting improved care coordination, improving patient outcomes and creating a collaborative environment with community partners. This approach ensures patients receive high-quality, appropriate care from the right provider at the right time by identifying and addressing problems early. Working with Medicare, NH-Cares ACO provides its beneficiaries with high-quality care while reducing growth in Medicare expenditures.


To strengthen our partnership to achieve optimal wellness for our communities. We will accomplish this by providing high-value, coordinated care, and engaging our patients and their families.


Patient Experience
We will exceed patient expectations.

We will provide the right care, at the right time, in the right place to achieve exceptional performance based on national ACO benchmarks.

We will deliver high-quality, exceptional care while ensuring that care is delivered efficiently and effectively.

Care Coordination
We will develop seamless communications to facilitate a continuum of care that gives patients peace of mind.

Leveraging Data & Technology
We will successfully and efficiently deploy technology and utilize data to enhance communication, improve coordination and advance health.

Contact Information

250 Pleasant Street
Concord, NH 03301

Primary Contact Name: Betsey Rhynhart, ACO Executive Director
Concord Hospital
Primary Contact Email: brhynhar@crhc.org
Primary Contact Phone Number: (603) 227-7000, ext. 7267

For general questions or additional information about Accountable Care Organizations, visit www.medicare.gov/acos.html or call (800) MEDICARE (1-800-633-4227), TTY users call (877) 486-2048.

Organizational Information

ACO Participants
ACO Participants in Joint Venture
Granite Visiting Nurse Association, Inc N
Speare Memorial Hospital N
Riverbend Community Mental Health, Inc N
Mid-State Health Center N
Concord Hospital, Inc N
Exeter Hospital, Inc N
Core Physicians, LLC N
Last Name
Member First Name
Member's Voting Power Expressed – as a Percentage or Number
Membership Type 
ACO Participant Legal Business Name/DBA, if Applicable
Exeter Hospital/Core Physicians 4 members voting as a block with 2 votes
Kenney-Janaosz Linda Director of Population Health Analytics ACO Participant Exeter Hospital, Inc/Core Physicians, LLC
Cassetta Sandra Vice President, Finance ACO Participant Exeter Hospital, Inc/Core Physicians, LLC
Guy Darren Medical Director of Population Health ACO Participant Exeter Hospital, Inc/Core Physicians, LLC
Lanier Melanie Chief Medical Officer ACO Participant Exeter Hospital, Inc/Core Physicians, LLC
Speare Memorial/Mid-State Health Center 2 members voting as a block with 1 vote
McEwen Michelle CEO ACO Participant Speare Memorial Hospital
MacLeod Robert CEO ACO Participant Mid-State Health Center
Granite VNA/Riverbend Community Mental Health 2 members voting as a block with 1 vote
Slepian Beth CEO ACO Participant Granite VNA
Madden Lisa CEO ACO Participant Riverbend Community Mental Health, Inc
Concord Hospital 2 members voting as a block with 1 vote
Sloane Scott Chief Financial Officer ACO Participant Concord Hospital, Inc
McLeod Michael Associate Chief Medical Officer ACO Participant Concord Hospital, Inc
Medicare Beneficiary
Welford Don 1 vote Medicare Beneficiary
Key ACO Clinical and Administrative Leadership
  1. Executive Director: Ms. Betsey Rhynhart
  2. Medical Director: Dr. Darren Guy
  3. Compliance Official: Open
  4. Quality Assurance/Improvement Officer: Dr. Darren Guy
Associated Committees and Committee Leadership
  1. Compliance Committee: Open
  2. Clinical Transformation Committee: Dr. Darren Guy, Chair
  3. Data and Analytics Committee: Mr. Jeffrey Smith, Co-chair Healthcare Analytics & Ms. Linda Kenney-Janosz, Co-chair
  4. Finance Committee: Ms. Allyson Hicks, Chair
Types of ACO participants or combinations of participants that formed the ACO
  1. Partnership or joint venture arrangement between hospital and ACO professionals
  2. Hospital employing ACO professionals
  3. Federally qualified Health Center (FQHC)
  4. Critical access hospital
  5. Rural health center

Shared Savings & Losses

Amount of Shared Savings/Losses

    • First Agreement Period
      • Performance Year 2019, $0

    Shared Savings Distribution

      • N/A

        Quality Performance Results

        2019 Quality Performance Results:

        ACO Quality Measure Number Measure Name Rate ACO Mean
        ACO-1 CAHPS: Getting Timely Care, Appointments and Information 85.65 85.86
        ACO-2 CAHPS: How Well Your Providers Communicate 94.62 94.11
        ACO-3 CAHPS: Patients’ Rating of Provider 92.23 92.69
        ACO-4 CAHPS:  Access to Specialists 81.01 81.54
        ACO-5 CAHPS: Health Promotion and Education 62.48 60.44
        ACO-6 CAHPS:  Shared Decision Making 68.57 62.78
        ACO-7 CAHPS: Health Status/Functional Status 73.87 73.79
        ACO-8 Risk Standardized, All Condition Readmission 12.91 14.86
        ACO-13 Falls: Screening for Future Fall Risk 85.54 84.04
        ACO-14 Preventive Care and Screening: Influenza Immunization 79.26 74.77
        ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 34.62 78.04
        ACO-18 Preventive Care and Screening: Screening for Depression and Follow-up Plan 62.16 70.40
        ACO-19 Colorectal Cancer Screening 80.40 70.76
        ACO-20 Breast Cancer Screening 76.59 73.84
        ACO-27 Diabetes:  Hemoglobin A1c Poor Control (>9%) 11.06 13.88
        ACO-28 Controlling High Blood Pressure 74.74 75.04
        ACO-34 CAHPS: Stewardship of Patient Resources 22.94 26.17
        ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Conditions 61.45 58.15
        ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 87.21 82.17
        ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ*) Prevention Quality Indicator (PQI #91) 1.80 1.87
        ACO-45 CAHPS: Courteous and Helpful Office Staff 92.85 92.84
        ACO-46 CAHPS: Care Coordination 85.39 86.89
        Please note: the ACO-40 Depression Remission at 12 months quality measure is not included in the Public Reporting due to low sample size. For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov