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 100 high-quality independent providers. The ACO anticipates serving over 13,000 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. 

100

# of participating independent physicians

13,000

# of Medicare beneficiaries

25

# 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
Richard Byrnes Y
Tabernacle Family Physicians Llc Y
Devon Family Practice, LLP Y
Richard Byrnes Y
Dr. Jeffrey S. Weisman, PC Y
PIM Associates PC 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
Ramesh Parchuri, MD Y
North Willow Grove Family Medicine, P.C. Y
Pennsbury Medical Practice, 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
LMG Family Practice, 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
Narzikul Gregory Member Yes ACO Participant Representative Devon Family Practice

 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

  • N/A

Shared Savings Distribution

  • N/A

Quality Performance Results

2016 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information N/A 80.51
ACO-2 CAHPS: How Well Your Providers Communicate N/A 93.01
ACO-3 CAHPS: Patients’ Rating of Provider N/A 92.25
ACO-4 CAHPS: Access to Specialists N/A 83.49
ACO-5 CAHPS: Health Promotion and Education N/A 60.32
ACO-6 CAHPS: Shared Decision Making N/A 75.40
ACO-7 CAHPS: Health Status/Functional Status N/A 72.30
ACO-34 CAHPS: Stewardship of Patient Resources N/A 26.97
ACO-8 Risk Standardized, All Condition Readmission N/A 14.70
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) N/A 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes N/A 53.20
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure N/A 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions N/A 59.81
ACO-9 Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) N/A 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) N/A 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements N/A 82.72
ACO-39 Documentation of Current Medications in the Medical Record N/A 87.54
ACO-13 Falls: Screening for Future Fall Risk N/A 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization N/A 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults N/A 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up N/A 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention N/A 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan N/A 53.63
ACO-19 Colorectal Cancer Screening N/A 61.52
ACO-20 Breast Cancer Screening N/A 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented N/A 76.79
ACO-42 Statin therapy for the Prevention and Treatment of Cardiovascular Disease N/A 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control N/A 18.24
ACO-41 Diabetes: Eye Exam N/A 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure N/A 70.69
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic N/A 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) N/A 88.67
ACO-33 Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) N/A 79.67

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

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