ACO NAME & LOCATION
ACO Health Partners, LLC
2326 South Congress Avenue, Suite 2F
Palm Springs, Florida 33406
2326 South Congress Avenue, Suite 2F
Palm Springs, Florida 33406
ACO PRIMARY CONTACT
Contact Name: Gianna Trombino
Phone Number: 561-762-1086
Email Address gtrombino@pbaco.org
Phone Number: 561-762-1086
Email Address gtrombino@pbaco.org
ORGANIZATIONAL INFORMATION
ACO PARTICIPANTS:
| ACO Participant in Joint Venture | |
| ALL AROUND CARE LLC | N |
| AMOS R MENENDEZ MDPA | N |
| ARACELI YAPOR MD PA | N |
| CESAR FIGUEROA MDPA | N |
| DAVID GABROS | N |
| FAMILY WELLNESS CENTER GCS INC | N |
| GARCIA SAEZ MEDICAL GROUP CORP | N |
| GRACE PRIMARY CARE PLLC | N |
| HEALING TOUCH C&C INC | N |
| HEALTHY LIVING PRIMARY CARE | N |
| JAMES F CONNOR PA | N |
| JOSE DELOS SANTOS | N |
| KENDALL SOUTH MEDICAL CENTER INC | N |
| NEXUSDOCS INC | N |
| NORTH CLARK MEDICAL GROUP LLC | N |
| OASIS FAMILY PRACTICE | N |
| OMAR BENITEZ MD PA | N |
| PHYSICIANS GROUP SERVICES, PA | N |
| ROBERT G BEITMAN, MD PA | N |
| SHORE ATLANTIC GERIATRICS LLC | N |
| SMITHVILLE MEDICAL ASSOCIATES LLC | N |
| SOUTHERN OCEAN PRIMARY CARE ASSOCIATES LLC | N |
| SUKETU NANAVATI MD PA | N |
| UNIQUE MEDICAL CENTER OF MIAMI LLC | N |
| WEDAD MICHAEL | N |
| WELLNESS THERAPY & MEDICAL CARE CENTER INC | N |
ACO GOVERNING BODY:
| FIRST NAME | LAST NAME | TITLE / POSITION | VOTING POWER | MEMBERSHIP TYPE | LEGAL BUSINESS NAME / DBA |
| Marsha | Bogges | Member/CEO | 8.34% | Other | |
| Nicole | Bradberry | Member/CEO | 8.33% | Other | |
| George | O'Leary | Member | 8.33% | Other | |
| Sam | Armitage | Member/Medical Dir | 10.72% | ACO Participant Representative | Pelican Family Medicine, P.A. |
| Maria | Connor | Member | 10.72% | ACO Participant Representative | James F Connor PA |
| Suhas | Gandhi | Member | 10.71% | ACO Participant Representative | North Clark Medical Group LLC |
| Bridget | Roberts | Member | 10.71% | ACO Participant Representative | Physicians Group Services, PA |
| Athanasios | Papastamelos | Member | 10.71% | ACO Participant Representative | Nikhil Parikh |
| Michael | Edwards | Member | 10.71% | ACO Participant Representative | Physicians Group Services, PA |
| Walter | Miller | Member | 10.72% | ACO Participant Representative | Southern Ocean Primary Care Associates, LLC |
| Onsy | Salib | Member | 0.00% | Medicare Beneficiary Representative |
KEY ACO CLINICAL & ADMINISTRATIVE LEADERSHIP:
ACO Executive: Mr. David Klebonis
Medical Director: Dr. Rohit Dandiya
Compliance Officer: Mr. Adam Zhamukhanov
Quality Assurance/Improvement Officer: Mrs. Amanda Larschan
Medical Director: Dr. Rohit Dandiya
Compliance Officer: Mr. Adam Zhamukhanov
Quality Assurance/Improvement Officer: Mrs. Amanda Larschan
ASSOCIATED COMMITTEES & COMMITTEE LEADERSHIP:
Committee Name Committee Leader Name and Position
Care Coordination and Quality Assurance Joanne Ryan, Chairperson
Compliance Joanne Ryan, Chairperson
Care Coordination and Quality Assurance Joanne Ryan, Chairperson
Compliance Joanne Ryan, Chairperson
TYPES OF ACO PARTICIPANTS, OR COMBINATIONS OF PARTICIPANTS, THAT FORMED THE ACO:
Network of Individual Practices of ACO professionals
SHARED SAVINGS AND LOSSES
AMOUNT OF SHARED SAVINGS / LOSSES:
- Third Agreement Period
- Performance Year 2022 $2,883,146.00
- Performance Year 2021 $0.00
- Performance Year 2020 $ 2,419,312.00
- Performance Year 2019 $767,744.00
- Second Agreement Period
- Performance Year 2019 $767,744
- Performance Year 2018 $1,920,318
- Performance Year 2017 $2,356,843
- Performance Year 2016 $0
- First Agreement Period
- Performance Year 2015, $3,103,401
- Performance Year 2014 $2,715,442
- Performance Year 2013 $0
Note: Our ACO participated in multiple performance years during calendar year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
SHARED SAVINGS DISTRIBUTION:
- Third Agreement Period
i. Proportion invested in infrastructure: 10%
ii. Proportion invested in redesigned care processes/resources: 40%
iii. Proportion of distribution to ACO participants: 50%
a. Performance Year 2021
i. Proportion invested in infrastructure: n/a
ii. Proportion invested in redesigned care processes/resources: n/a
iii. Proportion of distribution to ACO participants: n/a
b. Performance Year 2020
i. Proportion invested in infrastructure: 10%
ii. Proportion invested in redesigned care processes/resources: 40%
iii. Proportion of distribution to ACO participants: 50%
c. Performance Year 2019
i. Proportion invested in infrastructure: 30%
ii. Proportion invested in redesigned care processes/resources:30%
iii. Proportion of distribution to ACO participants: 40%
- Second Agreement Period
b. Performance Year 2019
i. Proportion invested in infrastructure: 30%
ii. Proportion invested in redesigned care processes/resources:30%
iii. Proportion of distribution to ACO participants: 40%
c. Performance Year 2018
i. Proportion invested in infrastructure: 10%
ii. Proportion invested in redesigned care processes/resources: 10%
iii. Proportion of distribution to ACO participants: 80%
d. Performance Year 2017
i. Proportion invested in infrastructure: 0%
ii. Proportion invested in redesigned care processes/resources: 50%
iii. Proportion of distribution to ACO participants: 50%
e. Performance Year 2016
i. Proportion invested in infrastructure: N/A
ii. Proportion invested in redesigned care processes/resources: N/A
iii. Proportion of distribution to ACO participants: N/A - First Agreement Period
a. Performance Year 2015
i. Proportion invested in infrastructure: 15%
ii. Proportion invested in redesigned care processes/resources: 70%
iii. Proportion of distribution to ACO participants: 15%
b. Performance Year 2014
i. Proportion invested in infrastructure: 15%
ii. Proportion invested in redesigned care processes/resources: 70%
iii. Proportion of distribution to ACO participants: 15%
c. Performance Year 2013
i. Proportion invested in infrastructure: N/A
ii. Proportion invested in redesigned care processes/resources: N/A
iii. Proportion of distribution to ACO participants: N/A
Note: Our ACO participated in multiple performance years during calendar year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
QUALITY PERFOMANCE RESULTS
2022 QUALITY PERFORMANCE RESULTS:
Quality performance results are based on CMS Web Interface.
Quality performance results are based on CMS Web Interface.
| ACO Quality Measure | Measure Name | Rate | ACO Mean |
|---|---|---|---|
| Measure #: 001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control | 20.16 | 10.71 |
| Measure #: 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | 73.28 | 76.97 |
| Measure #: 236 | Controlling High Blood Pressure | 84.58 | 76.16 |
| Measure #: 318 | Falls: Screening for Future Fall Risk | 74.66 | 87.83 |
| Measure #: 110 | Preventative Care and Screening: Influenza Immunization | 60.84 | 77.34 |
| Measure #: 226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | 90.62 | 79.27 |
| Measure #: 113 | Colorectal Cancer Screening | 60.08 | 75.32 |
| Measure #: 112 | Breast Cancer Screening | 76.16 | 78.07 |
| Measure #: 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 86.13 | 86.37 |
| Measure #: 370 | Depression Remission at Twelve Months | 13.33 | 16.03 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | 81.42 | 83.96 |
| CAHPS-2 | How Well Providers Communicate | 92.49 | 93.47 |
| CAHPS-3 | Patient’s Rating of Provider | 91.61 | 92.06 |
| CAHPS-4 | Access to Specialists | 76.46 | 77.00 |
| CAHPS-5 | Health Promotion and Education | 61.72 | 62.68 |
| CAHPS-6 | Shared Decision Making | 65.34 | 60.97 |
| CAHPS-7 | Health Status and Functional Status | 70.77 | 73.06 |
| CAHPS-8 | Care Coordination | 85.20 | 85.46 |
| CAHPS-9 | Courteous and Helpful Office Staff | 89.66 | 91.97 |
| CAHPS-11 | Stewardship of Patient Resources | 20.21 | 25.62 |
| Measure #: 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups | 0.1637 | 0.1510 |
| Measure #: 484 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC) | 32.39 | 30.97 |
For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov.
PAYMENT RULE WAIVERS
1. Waiver for Payment for Telehealth Services:
a. Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.
2. ACO Participation Waiver:
The following information describes each arrangement for which our ACO seeks protection under the ACO participation Waiver, including any material amendment or modification to a disclosed arrangement.
Parties to the Arrangement: ACO Health Partners, LLC and Quest Diagnostics Incorporated
Date of Arrangement: 06/01/2021
Items, services, Goods, or facility Provided: Clinical Laboratory Testing Services, Support and collaboration for enhancing the ACO’s Infrastructure, network development, and clinical quality in the design and implementation of clinical support programs for CKD, Diabetes, and Colorectal Cancer Screening.
Date and Nature of any amendments to the arrangement: Not Applicable
a. Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.
2. ACO Participation Waiver:
The following information describes each arrangement for which our ACO seeks protection under the ACO participation Waiver, including any material amendment or modification to a disclosed arrangement.
Parties to the Arrangement: ACO Health Partners, LLC and Quest Diagnostics Incorporated
Date of Arrangement: 06/01/2021
Items, services, Goods, or facility Provided: Clinical Laboratory Testing Services, Support and collaboration for enhancing the ACO’s Infrastructure, network development, and clinical quality in the design and implementation of clinical support programs for CKD, Diabetes, and Colorectal Cancer Screening.
Date and Nature of any amendments to the arrangement: Not Applicable