CARE IS PRIMARY ACO

AN ACCOUNTABLE CARE

ORGANIZATION

AN OVERVIEW OF CARE IS PRIMARY ACO

Care is Primary ACO, LLC is R-Health’s new Accountable Care Organization (ACO), which operates under the Medicare Shared Savings Program (MSSP). It is the first ACO in Southeastern Pennsylvania consisting exclusively of smaller, independent primary care practices.

Care is Primary ACO delivers value-based care by partnering with physicians throughout the five counties of Southeastern Pennsylvania to focus on practice transformation from a volume-based model to a value-driven approach. The value-based system rewards practices when they achieve positive health outcomes for patients.

Primary care has the ability to transform healthcare, delivering better, more personalized care to patients at lower costs. The participating independent practitioners in Care is Primary ACO have demonstrated success through value-based contracts and are expected to achieve even greater outcomes through Care is Primary ACO.

The unique collaboration fostered by Care is Primary ACO enables the participating independent practices to leverage collective expertise, share best practices, and help each practice deliver superior care to patients.

The Care is Primary ACO currently includes nearly 77 high-quality independent providers. The ACO anticipates serving over 9,500 Medicare beneficiaries through the Medicare Shared Savings Program.

What is an Accountable Care Organization (ACO)?

It is a model of care that brings together a select group of physicians to deliver coordinated care to Medicare beneficiaries. It focuses on the critical shift from fragmented, episodic care to continuous, relationship-based care that stresses prevention and management of chronic diseases. 

77

# of participating independent physicians

9,500

# of Medicare beneficiaries

17

# of participating practices

FOR BENEFICIARIES

Accountable Care Organizations (ACOs) are one way that Medicare is working to better coordinate your care.

How ACOs work*:

  • Local health care providers and hospitals volunteer to work together to provide you with coordinated care.
  • The doctors and other providers who are helping care for you will communicate with each other, and partner with you in making health care decisions.
  • You may spend less time filling out medical history paper work because your doctors may already have this information in an electronic health record.
  • You’ll likely have fewer repeated medical tests because your doctors and hospitals will share information and coordinate your care.
  • You’ll be in the center of care, and your doctors will be better able to keep you informed, and to keep listening and honoring your choices.
  • Unlike HMOs, managed care, or some insurance plans, an ACO cannot tell you which healthcare providers to see and can’t change your Medicare benefits. Only people with Original Medicare can be assigned to an ACO. You can’t be assigned to an ACO if you have a Medicare Advantage Plan (Part C), like an HMO or a PPO.

*Medicare.gov

FOR HEALTHCARE PROVIDERS

What are the benefits to participating in Care is Primary ACO?

We are currently looking for more high-quality, independent practices to join Care is Primary ACO.

As a participant in Care is Primary ACO, there are many benefits, including:

  • Assistance with practice transformation
  • Monthly best practice calls
  • Workflow re-design
  • Assistance with MACRA compliance
  • Shared care manager resources
  • Patient-centered Medical Home (PCMH) certification

PUBLIC REPORTING

ACO Name and Location

Care is Primary ACO LLC
210 Yorktown Plaza
Elkins Park, Pennsylvania 19027

ACO Primary Contact

Primary Contact Name Nancy Meisinger
Primary Contact Phone Number 215.600.4590
Primary Contact Email Address nancy@r-health.md

Organizational Information

ACO participants:

ACO Participants ACO Participant in Joint Venture (Enter Y or N)
Lisa Ducker Y
Simon Su Y
Elmwood Family Physicians Y
Tabernacle Family Physicians Llc Y
Jeffrey Weisman Y
Matthew Frankel Y
Mt Airy Family Practice Y
Ninth Street Internal Medicine Associates Ltd Y
Detweiler Family Medicine & Asso Y
G.S. Peter Gross, DO P.C. Y
Vincent E. Baldino DO P.C. Y
Medical Grp At Maple Commons Y
Greenhouse Internists, P.C. Y
Bernard S Zoranski D O P C Y
North Willow Grove Family Medicine, P.C. Y
Bruce Richman DO PC Y
Radnor Family Practice, Professional Limited Liability Company Y
Regional Cardiology Consultants, PC Y
Michael D. Overbeck, M.D.P.A Y
Dr. Jeffrey S. Weisman, PC Y
Bralow Medical Group Y


ACO governing body:

Member Member’s Voting Power Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable
Last Name First Name Title/Position
Meisinger Nancy Co-Chair Yes ACO Executive Care is Primary ACO, LLC
Crimm Allan Co-Chair Yes ACO Participant Representative Ninth Street Internal Medicine Associates Ltd
O’Connor Houston Feather Member Yes Medicare Beneficiary Representative
Michael Attanasio Member Yes ACO Participant Representative Vincent E Baldino DO P.C. (DBA Ritner Medical)
Fabens Tish Member Yes ACO Participant Representative Greenhouse Internists PC
Lyon Tom Member Yes ACO Participant Representative Mt. Airy Family Practice
Detweiler Robert Member Yes ACO Participant Representative Detweiler Family Medicine & Assoc
Walker Rockland Member Yes ACO Participant Representative Radnor Family Practice, Professional LLC

 Key ACO clinical and administrative leadership:

Nancy Meisinger ACO Executive
Allan Crimm Medical Director
Nancy Meisinger Compliance Officer
Allan Crimm Quality Assurance/Improvement Officer

 

Associated committees and committee leadership:

Committee Name Committee Leader Name and Position
Population Health Committee Dr. Allan Crimm, Chair
Care Management Performance Committee Dr. Allan Crimm, Chair
Quality Improvement Committee Dr. Allan Crimm, Chair
Compliance Committee Nancy Meisinger, Chair
IT Security Committee Jozef Kurlanski, Chair

 

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

  • Networks of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2017, $0

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2017, $0
        • Proportion invested in infrastructure: N/A
        • Proportion invested in redesigned care processes/resources: N/A
        • Proportion of distribution to ACO participants: N/A

Quality Performance Results

2017 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 81.74 80.60
ACO-2 CAHPS: How Well Your Providers Communicate 93.41 93.13
ACO-3 CAHPS: Patients’ Rating of Provider 92.76 92.31
ACO-4 CAHPS: Access to Specialists 83.79 83.32
ACO-5 CAHPS: Health Promotion and Education 66.13 62.30
ACO-6 CAHPS: Shared Decision Making 79.07 75.85
ACO-7 CAHPS: Health Status/Functional Status 73.86 73.05
ACO-34 CAHPS: Stewardship of Patient Resources 25.43 25.68
ACO-8 Risk Standardized, All Condition Readmission 15.08 15.01
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 18.41 18.46
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 52.46 53.95
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 74.36 79.16
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 61.10 61.74
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 2.01 1.93
ACO-11 Use of Certified EHR Technology 100.00 98.48
ACO-12 Medication Reconciliation 96.34 75.32
ACO-13 Falls: Screening for Future Fall Risk 82.88 74.38
ACO-44 Imaging Studies for Low Back Pain 82.86 67.32
ACO-14 Preventive Care and Screening: Influenza Immunization 78.47 72.52
ACO-15 Pneumonia Vaccination Status for Older Adults 85.62 72.92
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 78.35 70.69
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 85.26 90.48
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 74.55 61.98
ACO-19 Colorectal Cancer Screening 70.74 64.58
ACO-20 Breast Cancer Screening 70.53 70.05
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 74.40 79.89
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 18.52 16.74
ACO-41 Diabetes: Eye Exam 56.67 50.37
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 71.12 71.47
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 83.40 86.86

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

Note: In the Quality Performance Results file(s) above, search for “Care is Primary ACO LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A10885 in the public use files on data.cms.gov.

Payment Rule Waivers

  • No, our ACO does not use the SNF 3-Day Rule Waiver.

CONTACT

Care is Primary ACO, LLC
210 Yorktown Plaza
Elkins Park, PA 19027

Nancy Meisinger
nancy@r-health.md
215.600.4590

For questions on the Shared Savings Program:

800.633.4227

Teletypewritter users: 877.486.2048