ACO NAME & LOCATION
ACO Health Partners, LLC
9822 Tapestry Park Circle #208
Jacksonville, Florida 32246
9822 Tapestry Park Circle #208
Jacksonville, Florida 32246
ACO PRIMARY CONTACT
Marsha Boggess, ACO Administrator and CEO
904-303-3544
mboggess@curamgt.com
904-303-3544
mboggess@curamgt.com
ORGANIZATIONAL INFORMATION
ACO PARTICIPANTS:
| ACO Participant in Joint Venture | |
| ALL AROUND CARE LLC | N |
| AMOS R MENENDEZ MD PA | N |
| ARTHUR NAHAS | N |
| DAVID GABROS | N |
| FAMILY WELLNESS CENTER GCS INC | N |
| GRACE PRIMARY CARE PLLC | N |
| HEALING TOUCH C&C INC | N |
| HEALTHY LIVING PRIMARY CARE | N |
| HEART HYPERTENSION CHOLESTEROL & DIABETES CARE LLC | N |
| JAMES F CONNOR PA | N |
| KENDALL SOUTH MEDICAL CENTER INC | N |
| MIGUEL J TEPEDINO MD PA | N |
| NEXUSDOCS INC | N |
| NIKHIL PARIKH | N |
| NORTH CLARK MEDICAL GROUP LLC | N |
| OASIS FAMILY PRACTICE | N |
| OMAR BENITEZ MD PA | N |
| PELICAN FAMILY MEDICINE, P.A. | N |
| PHYSICIANS GROUP SERVICES, PA | N |
| PHYSICIANS PRIMARY CARE PLLC | 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 |
| SUBASH GOPAL MEHTA, MD, PA | N |
| UNIQUE MEDICAL CENTER OF MIAMI LLC | N |
| VANITHA YADALLA | N |
| VIVIANA PEREZ MD PA | N |
| WEDAD MICHAEL | N |
| WELLNESS THERAPY & MEDICAL CARE CENTER INC | N |
ACO GOVERNING BODY:
| LAST NAME | FIRST NAME | TITLE / POSITION | VOTING POWER | MEMBERSHIP TYPE | LEGAL BUSINESS NAME / DBA |
| Boggess | Marsha | Member/CEO | 8.34% | Other | |
| Bradberry | Nicole | Member/CEO | 8.33% | Other | |
| O'Leary | George | Member | 8.33% | Other | |
| Dr. Armitage | Sam | Member/Medical Dir | 10.72% | ACO Participant Representative | Pelican Family Medicine, P.A. |
| Connor | Maria | Member | 10.72% | ACO Participant Representative | James F Connor PA |
| Gandhi | Suhas | Member | 10.71% | ACO Participant Representative | North Clark Medical Group LLC |
| Roberts | Bridget | Member | 10.71% | ACO Participant Representative | Physicians Group Services, PA |
| Dr. Papastamelos | Athanasios | Member | 10.71% | ACO Participant Representative | Nikhil Parikh |
| Dr. Edwards | Michael | Member | 10.71% | ACO Participant Representative | Physicians Group Services, PA |
| Dr. Miller | Walter | Member | 10.72% | ACO Participant Representative | Southern Ocean Primary Care Associates, LLC |
| Salib | Onsy | Member | 0.00% | Medicare Beneficiary Representative |
KEY ACO CLINICAL & ADIMINSTRATIVE LEADERSHIP:
ACO Executive: Marsha Boggess
Medical Director: Dr. Sam Armitage
Compliance Officer: Joanne Ryan
Quality Assurance/Improvement Officer: Marsha Boggess
Medical Director: Dr. Sam Armitage
Compliance Officer: Joanne Ryan
Quality Assurance/Improvement Officer: Marsha Boggess
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:
- Second Agreement Period
- Performance Year 2020 $2,419,312
- 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:
- Second Agreement Period
a. 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%
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
2020 QUALITY PERFORMANCE RESULTS:
| QUALITY MEASURE NUMBER | MEASURE NAME | RATE | ACO MEAN |
| ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91) | 1.13 | 95.00% |
| ACO-13 | Falls: Screening for Future Fall Risk | 79.93 | 84.97 |
| ACO-14 | Preventive Care and Screening: Influenza Immunization | 38.08 | 76.03 |
| ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 75 | 81.67 |
| ACO-18 | Preventive Care and Screening: Screening for Depression and Follow-up Plan | 53.11 | 71.46 |
| ACO-19 | Colorectal Cancer Screening | 52.38 | 72.59 |
| ACO-20 | Breast Cancer Screening | 62.25 | 74.05 |
| ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 84.86 | 83.37 |
| ACO-27 | Diabetes Mellitus: Hemoglobin A1c Poor Control | 24.21 | 14.7 |
| ACO-28 | Hypertension (HTN): Controlling High Blood Pressure | 78.79 | 72.87 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.
For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov.
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