Medicare Shared Savings Program (MSSP) Public Reporting

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ACO Name and Location

Arizona Care Network, LLC
3030 N. Central Avenue #1000
Phoenix, AZ  85012

 

ACO Primary Contact

Todd Ricotta, Executive Director
todd.ricotta@azcarenetwork.org
602-406-6613

 

Organizational Information

ACO Participants

American Medical Associates Pllc
Cigna HealthCare of Arizona, Inc.
Dr. Matthew Khumalo, M.D., PC
Family Medical and Wellness Care, PLC
Good Health Medical PC
Harmony Healthcare Pllc
Jigna Patel Md Pllc
Maricopa County Special Health Care District
Medical Clinic of Arizona, LLC
OMG ARIZONA LLC
West Valley Internal Medicine
William T. Holland, M.D., P.C.

 

ACO Participants in Joint Ventures between ACO Professionals and Hospitals

No participants are involved in a joint venture between ACO professionals and hospitals.

 

ACO Governing Body

Board Member Voting Status Role Participant Status Participant Name
Dr. Natasha Bhuyan Voting Member Physician Manager ACO Participant Representative OMG ARIZONA LLC
Dr. Ravinder Dawke Voting Member Physician Manager ACO Participant Representative Cigna HealthCare of Arizona, Inc.
Dr. Kevin Ellis Voting Member Physician Manager ACO Participant Representative Cigna HealthCare of Arizona, Inc.
Dr. Bhargavi Joshi Voting Member Physician Manager ACO Participant Representative Maricopa County Special Health Care District
Dr. Kevin Lopez Voting Member Physician Manager ACO Participant Representative Maricopa County Special Health Care District
Dr. Christina Smarik Voting Member Physician Manager ACO Participant Representative Maricopa County Special Health Care District
TBD Voting Member Medicare Beneficiary Representative Other N/A
Dr. David Hanekom Voting Member Hospital Manager Other N/A

 

Key Clinical and Administrative Leadership

Chief Executive Officer - David Hanekom, MD
Chief Medical Officer - Ed Clarke, MD
Chief Information Officer - Robert Davis
Chief Financial Officer - Alex Nuñez
Compliance Officer - Tracey Craig, JD
Quality Assurance/Improvement Officer - Jennifer Brooks
Executive Director, Operations - Jami Berger, RN
Executive Director, Marketing & Communication - Debra Stevens
Executive Director, Provider Network & Government Relations - Todd Ricotta

 

ACO Committees and Committee Leadership

Quality Committee: Dr. M. Randy Keller, Chair
Compliance Committee: Dr. Linda Brown, Chair
Care Coordination & Performance Committee: Dr. Dana Seltzer, Chair
Finance and Payer Contracting Committee: Dr. Edward Tokatlian, Chair
Network Committee: Dr. Jonathan Hackenyos, Chair

 

Types of ACO participants, or combinations of participants that formed the ACO

  • ACO professionals in a group practice arrangement
  • Networks of individual practices of ACO professionals
  • Partnerships or joint venture arrangements between hospitals and ACO professionals
  • Hospital employing ACO professionals
  • Federally Qualified Health Center (FQHC)

 

Shared Savings and Losses

Amount of Shared Savings & Losses

  • Second Agreement Period
    • Performance Year 2016: $0
  • First Agreement Period
    • Performance Year 2015: $0
    • Performance Year 2014: $0
    • Performance Year 2013: $0

How Shared Savings are Distributed

  • Second Agreement Period
    • Performance Year 2016
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
  • First Agreement Period
    • Performance Year 2015
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2014
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2013
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A

Payment Rule Waivers

Our ACO does not utilize the SNF 3-Day Rule Waiver.

2016 Quality Performance Results

 Measure Number  Measure Name ACO Performance Rate Mean Performance Rate (SSP-ACOs)
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 75.51 79.9
ACO-2 CAHPS: How Well Your Providers Communicate 90.77 92.63
ACO-3 CAHPS: Patients’ Rating of Provider 90.3 91.93
ACO-4 CAHPS: Access to Specialists 80.42 83.52
ACO-5 CAHPS: Health Promotion and Education 56.15 60
ACO-6 CAHPS: Shared Decision Making 74 75.28
ACO-7 CAHPS: Health Status/Functional Status 71.68 71.82
ACO-34 CAHPS: Stewardship of Patient Resources 27.9 27.52
ACO-8 Risk Standardized, All Condition Readmission 13.78 14.7
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)  18.22 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes  36.87 53.2
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure  55.61 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 44.89 59.81
ACO-9 Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 6.42 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 ) 13.46 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 72.44 82.72
ACO-39 Documentation of Current Medications in the Medical Record  72.05 87.54
ACO-13 Falls: Screening for Future Fall Risk 71.24 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization 66.05 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults 63.98 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up 70.84 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 92.76 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 56.32 53.63
ACO-19 Colorectal Cancer Screening 63.02 61.52
ACO-20 Breast Cancer Screening 64.54 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented 57.23 76.84
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 78.39 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 17.36 18.24
ACO-41 Diabetes: Eye Exam 42.36 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 70.53 70.52
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 88.99 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 78.24 88.67
ACO-33 ACE or ARB Therapy for patients with CAD and Diabetes or LVSD (LVEF < 40%) 76.14 79.67

CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin receptor blocker, CAD = coronary artery disease.

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.   

 

2015 Quality Performance Results

 Measure Number  Measure Name ACO Performance Rate Mean Performance Rate (SSP-ACOs)
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 76.37 80.61
ACO-2 CAHPS: How Well Your Providers Communicate 90.40 92.65
ACO-3 CAHPS: Patients’ Rating of Provider 89.36 91.94
ACO-4 CAHPS: Access to Specialists 81.07 83.61
ACO-5 CAHPS: Health Promotion and Education 61.32 59.06
ACO-6 CAHPS: Shared Decision Making 77.14 75.17
ACO-7 CAHPS: Health Status/Functional Status 71.01 72.30
ACO-34 CAHPS:Stewardship of Patient Resources* 26.68 26.87
ACO-8 Risk Standardized, All Condition Readmission 15.79 14.86
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) * Readmission 17.35 18.07
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes * 65.98 54.60
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure * 89.01 76.96
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 74.59 62.92
ACO-9 ASC Admissions: COPD or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 0.70 1.11
ACO-10 ASC Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) 1.06 1.04
ACO-11 Percent of Primary Care Physicians who Succesfully Meet Meaningful Use Requirements 65.17% 80.14%
ACO-39 Documentation of Current Medications in the Medical Record * 59.37% 84.07%
ACO-13 Falls: Screening for Future Fall Risk 68.09% 56.46%
ACO-14 Preventive Care and Screening: Influenza Immunization 62.90% 62.03%
ACO-15 Pneumonia Vaccination Status for Older Adults 67.12% 63.73%
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up 71.07% 71.15%
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 90.02% 90.16%
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 49.23% 45.25%
ACO-19 Colorectal Cancer Screening 64.69% 60.06%
ACO-20 Breast Cancer Screening 69.20% 65.67%
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented 72.46% 70.04%
ACO-40 Depression Remission at Twelve Months * N/A N/A
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 16.82% 20.38%
ACO-41 Diabetes: Eye Exam 38.08% 41.05%
ACO-28 Hypertension: Controlling High Blood Pressure 70.48% 69.62%
ACO-30 Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic 83.60% 83.82%
ACO-31 Heart Failure: Beta-Blocker Therapy for LVSD 83.23% 87.22%
ACO-33 ACE or ARB Therapy for patients with CAD and Diabetes or LVSD (LVEF < 40%) 77.19% 77.73%

CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin receptor blocker, CAD = coronary artery disease.

* = Measure required beginning Reporting Year 2015

N/A = Reporting on the depression remission measure is not required for 2015, as indicated by N/A

 

2012-2014 Quality Performance Results

  2012 2013 2014
    ACO performance Mean performance rate for all ACOs ACO performance Mean performance rate for all ACOs ACO performance Mean performance rate for all ACOs
ACO-1 Getting Timely Care, Appointments, and Information Not in operations Not in operations N/A N/A 80.26 80.13
ACO-2 How Well Your Doctors Communicate Not in operations Not in operations N/A N/A 90.61 92.39
ACO-3 Patients’ Rating of Doctor Not in operations Not in operations N/A N/A 90.31 91.58
ACO-4 Access to Specialists Not in operations Not in operations N/A N/A 82.89 83.97
ACO-5 Health Promotion and Education Not in operations Not in operations N/A N/A 57.27 58.29
ACO-6 Shared Decision Making Not in operations Not in operations N/A N/A 73.41 74.60
ACO-7 Health Status/Functional Status Not in operations Not in operations N/A N/A 70.63 71.10
ACO-8 Risk Standardized, All Condition Readmissions Not in operations Not in operations 15.50 14.90 15.68 15.15
ACO-9 ASC Admissions: COPD or Asthma in Older Adults Not in operations Not in operations 0.86 1.17 .79 1.08
ACO-10 ASC Admission: Heart Failure Not in operations Not in operations 1.31 1.20 1.17 1.19
ACO-11 Percent of PCPs who Qualified for EHR Incentive Payment Not in operations Not in operations 32.25% 66.21% 44.82% 76.71%
ACO-12 Medication Reconciliation Not in operations Not in operations N/A N/A 74.55% 82.61%
ACO-13 Falls: Screening for Fall Risk Not in operations Not in operations N/A N/A 48.11% 45.60%
ACO-14 Influenza Immunization Not in operations Not in operations N/A N/A 59.06% 57.51%
ACO-15 Pneumococcal Vaccination Not in operations Not in operations N/A N/A 54.09% 55.03%
ACO-16 Adult Weight Screening and Follow-up Not in operations Not in operations N/A N/A 71.24% 66.75%
ACO-17 Tobacco Use Assessment and Cessation Intervention Not in operations Not in operations N/A N/A 92.53% 86.79%
ACO-18 Depression Screening Not in operations Not in operations N/A N/A 35.77% 39.27%
ACO-19 Colorectal Cancer Screening Not in operations Not in operations N/A N/A 53.00% 56.14%
ACO-20 Mammography Screening Not in operations Not in operations N/A N/A 63.53% 61.41%
ACO-21 Proportion of Adults who had blood pressure screened in past 2 years Not in operations Not in operations N/A N/A 65.13% 60.24%
ACO-22 Hemoglobin A1c Control (HbA1c) (<8 percent) Not in operations Not in operations N/A N/A 72.90% N/A
ACO-23 Low Density Lipoprotein (LDL) (<100 mg/dL) Not in operations Not in operations N/A N/A N/A N/A
ACO-24 Blood Pressure (BP) <140/90 Not in operations Not in operations N/A N/A 74.19% N/A
ACO-25 Tobacco Non Use Not in operations Not in operations N/A N/A 87.10% N/A
ACO-26 Aspirin Use Not in operations Not in operations N/A N/A 90.83% N/A
ACO-27 Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent) Not in operations Not in operations N/A N/A 20.51% 20.35%
ACO-28 Percent of beneficiaries with hypertension whose BP <140/90 Not in operations Not in operations N/A N/A 73.73% 68.02%
ACO-29 Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dl Not in operations Not in operations N/A N/A N/A N/A
ACO-30 Percent of beneficiaries with IVD who use Aspirin or other antithrombotic Not in operations Not in operations N/A N/A 89.46% 80.79%
ACO-31 Beta-Blocker Therapy for LVSD Not in operations Not in operations N/A N/A 85.27% 82.71
ACO-32 Drug Therapy for Lowering LDL Cholesterol Not in operations Not in operations N/A N/A N/A N/A
ACO-33 ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD Not in operations Not in operations N/A N/A 81.87% N/A
Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease, EHR = electronic health record, IVD = ischemic vascular disease, LVSD = left ventricular systolic dysfunction, ACE = angiotensin receptor blocker, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

A Physician and Health System Collaboration