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ACO Public Reporting Information

ACO Name and Location

Memorial Hermann Accountable Care Organization
929 Gessner, Suite 2700
Houston, Texas 77024

ACO Primary Contact

Primary Contact NameNicole Clarke Luck
Primary Contact Phone Number(713) 338-6465
Primary Contact Email AddressNicole.ClarkeLuck@memorialhermann.org

Organizational Information

ACO participants: 

ACO ParticipantsACO Participant in Joint Venture (Y or N)
Ilsong Jason Chong, MD, PAN
Dr. Richard C. Lock M.D.N
Carol A Strickland, MD, PAN
Rudolph Medical AssociatesN
Pinewood Medical Clinic, PAN
Star Primary Care PAN
Kannappan KrishnaswamyN
Ike Eni, M.D., P.A.N
Luis DiazN
Lakshmi SeshadriN
Family Healthcare Affiliates PLLCN
UT Physicians Specialty ServicesY
Spuhler Medical Associates, PAN
Jimin Wang, MD, PAN
Fairfield Family PhysiciansN
Wang & Jiang MD PAN
DEIRDRE MCMULLEN M.D.N
College Park Medicine PAN
DR. SYED VIQAR AHMED MDN
Faizun Anwar, M.D. P.A.N
QUOC LEN
Center for Integrated Medicine, PAN
Pratibha R Kulkarni, MD, PAN
HAZEM EL ZUFARI MD PAN
Raja Abusharr, MD, PAN
ROSEWOOD FAMILY PHYSICIANS I PLLCN
Memorial Hermann Medical GroupY
Titus K. Venyah, Md, PaN
Premier NW Houston Medical Group PAN
Southeast Medical Group PaN
Barker Cypress Family Practice, PaN
Rishi Hingorani DO, PAN
Michael Y Chang, DO, PAN
Gregg C. Castillo, MD, PAN
G A Valdez & Associates IncN
Town and Country Internal Medicine, P.A.N
MICHAEL E. BUXBAUM, D.O. P.A.N
Nibu MathewN
Ambreen Sharaf, MD, PAN
Allison Blazek, MD, PAN
Murtaza MussajiN
Westwood Primary Care PLLCN
Memorial Hermann Rehabilitation Hospital Katy, LlcY
Orlando Fonseca, MD, PLLCN
BAY AREA TOTAL HEALTH MEDICAL GRP PAN
Suparna Chhibber MD PAN
Thomas FP, PLLCN
Brian C Castillo, MD PAN
Arun Kumar MD PAN
Trinity Primary Care PaN
V. Lakshmi Achanta Md.,paN
Dr Mubarak Khawaja PaN
Everstar Medical, LllpN
Rios Family Medicine Clinic PaN
Dr. A Family ClinicN
Abbas Jafri Md PaN
Dr Saleha AhmedN
Nghia C. Nguyen M.D.N
Zealth Care PllcN
Alexandria Medical Association PAN
INTERNAL MEDICINE ASSOCIATES OF HOUSTON PAN
INPATIENT PROVIDERS OF TEXAS, PLLCN
IMD Healthcare and ImagingN
Tehmina Sami MD PAN
Qingguo Tao MD PAN
Adnan M Rafiq Md PaN
Zhengnan Yin, MDN
NorthWoodsFamilyMedicinePLLCN
Conroe Family Doctor PllcN
Family Medicine Associates of Conroe PLLCN
St Johns Physician Associates PaN
TLC CLINIC, PLLCN
JY Family Medicine & Urgent Care PLLCN
Medical Associates of Katy PLLCY
Fuqua Family Practice and Urgent Care PAN
Geriatric & Palliative Care Associates PaN
First Colony Primary Care, P.AN
Gulf Coast Primary Care, PllcN
Sr Medical Clinic PllcN
Nneka Edokpayi MD PLLCN
Samuel GanN
HUAIGUANG LI M.D., PLLCN
MTL MD PLLCN
Berta De Leon Scaglia Md PaN
Katy Supportive MedicineN
Integrative Primary Care PLLCN
PRIMECARE MEDICAL GROUP, PLLCY
Alfredo Huerta Jr MDN
Genesis Family Care, P.A.N
Family Practice Clinic Of Crestwater LlcN
High Tech Family Care And Women's Health PaN
Tanveer F. Syed, M.D., P.A.N
Nghia C. Nguyen M.D.N
Rajnikant KushwahaN
Memorial Hermann Hospital SystemN
Ivor W Foox, MD, PAN
DR. ROBERT D MOCK MDN
MOONAT MEDICAL ASSOC INCN
Sistla B Krishna, MDN
Stuart A Shapiro, MDN
Thanh Ho Taylor, DO, PAN
Cesario A Castillo MD PAN
Georgina Loya MD PAN
Virgil C CarandangN
Providence Family Practice, PAN
Tran & Thomas, PAN
Tara H Shani, MD, PAN
Southwest Family Physicians, PAN
MehtaMedicalGroupPLLCN
Robert McdonaldN
Samuel L Siegler,ii,j.D.,m.D.,p.A.N
J Kevin Giglio, MD, PAN
MHS Physicians of TexasY
KATY INTERNAL MEDICINE ASSOCIATES, L.L.PY
Medical Colleagues of Texas, LLPY
Trang T Trinh, MD, PAY
Thanh K. Hoang, M.D., P.A,N
Shengkun Yao, MD, PAN
Sylvia Wu, Md, PaN
Gary W BrewtonN
NORTHEAST PRIMARY CARE ASSOCIATES P.A.N
Bellaire DoctorsN
Northeast Medical AssociatesN
Affiliates Of Family Medicine IncN
Campbell, Ghebranious, Hung, PLLCN
Ella Family Medicine PaN
Anil A Dara M.D. P.A.N
Southwest Memorial Physician Associates, PAN
Aslam Loya MD PAN
Anuradha KantamaniN
ImranNathaniMDPAN
David E Auer, MD, PAN
SUGAR LAND MED PED CLINIC, P.A.N
Durga P Sunkara, MD, PAN
MIRACLE MEDICAL CLINICN
Sugar Lakes Family Practice, PAN
Conroe Family Medicine PAN
Tamirisa Renu PaN
Bay Area GeriatricsN
WoodlandsPrimaryCarePAN
PachieSChanMDPLLCN
Heidi Schultz, MD, PAN
Westchase Clinical PLLCN
MA Medical Care PLLCN
Spring Valley Primary Care PAN
Fulshear Medical Associates PLLCN
Premier Internal Medicine Associates Of Houston PllcN
Ruan Medical GroupN
SYED A GARDEZIN
Leena Chacko MD PAN
Woodlands Internal Medicine PaN
WESTLAKE MEDICAL SERVICES LLLPN

ACO governing body:

Member
Last NameFirst NameTitle/Position
Member's Voting Power Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable
StokesCharlesChairperson1Participant RepresentativeMemorial Hermann Health System
AlexanderCharlotteServes on Board of Directors1Participant RepresentativeMemorial Hermann Health System
AulbaughCarrolServes on Board of Directors; Treasurer1Participant RepresentativeMemorial Hermann Health System
ShabotMichaelServes on Board of Directors1Participant RepresentativeMemorial Hermann Health System
GiglioJ. KevinServes on Board of Directors1Participant RepresentativeJ. Kevin Giglio, MD, PA
DoshiAnkurServes on Board of Directors1Participant RepresentativePrimecare Medical Group, PLLC
GogolaJonServes on Board of Directors1Participant RepresentativeMemorial Hermann Health System
JacksonGroverServes on Board of Directors1Medicare Beneficiary RepresentativeN/A
CannonDeborahServes on Board of Directors1Other; MHHS Board MemberMemorial Hermann Health System

Key ACO clinical and administrative leadership:

Charlotte Alexander, MDACO Executive
J. Kevin Giglio, MDMedical Director
Charles BumpassCompliance Officer
Angela Shippy, MDQuality Assurance/Improvement Officer
Deborah GordonSecretary

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

  • Network of individual practices of ACO professionals
  • Partnership or joint venture arrangement between hospitals and ACO professionals
  • Hospital employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Second Agreement Period
    • Performance Year 2016, $14,025,212
  • First Agreement Period
    • Performance Year 2015, $41,912,527
    • Performance Year 2014, $22,723,305
    • Performance Year 2013, $28,338,705

Shared Savings Distribution:

  • Second Agreement Period
    • Performance Year 2016
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 65%
  • First Agreement Period
    • Performance Year 2015
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 65%
    • Performance Year 2014
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 65%
    • Performance Year 2013
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources: 10%
      • Proportion of distribution to ACO participants: 75%

Quality Performance Results

2016 Quality Performance Results:

ACO #Measure NameRateACO Mean
ACO-1CAHPS: Getting Timely Care, Appointments, and Information79.8379.9
ACO-2CAHPS: How Well Your Providers Communicate93.0792.63
ACO-3CAHPS: Patients' Rating of Provider92.6691.93
ACO-4CAHPS: Access to Specialists85.583.52
ACO-5CAHPS: Health Promotion and Education58.9360
ACO-6CAHPS: Shared Decision Making71.2775.28
ACO-7CAHPS: Health Status/Functional Status69.6571.82
ACO-34CAHPS: Stewardship of Patient Resources24.7427.52
ACO-8Risk-Standardized, All Condition Readmission15.0614.7
ACO-35Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)21.418.17
ACO-36All-Cause Unplanned Admissions for Patients with Diabetes47.553.2
ACO-37All-Cause Unplanned Admissions for Patients with Heart Failure65.0975.23
ACO-38All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions53.2759.81
ACO-9Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)10.649.27
ACO-10Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)11.8814.53
ACO-11Percent of PCPs who Successfully Meet Meaningful Use Requirements93.9582.72
ACO-39Documentation of Current Medications in the Medical Record95.6287.54
ACO-13Falls: Screening for Future Fall Risk60.1364.04
ACO-14Preventive Care and Screening: Influenza Immunization63.7868.32
ACO-15Pneumonia Vaccination Status for Older Adults66.9969.21
ACO-16Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up83.9974.45
ACO-17Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention94.9390.98
ACO-18Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan43.1853.63
ACO-19Colorectal Cancer Screening57.0561.52
ACO-20Breast Cancer Screening59.7467.61
ACO-21Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented92.3676.84
ACO-42Statin Therapy for the Prevention and Treatment of Cardiovascular Disease80.0577.72
ACO-27Diabetes Mellitus: Hemoglobin A1c Poor Control 14.5518.24
ACO-41Diabetes: Eye Exam 38.8744.94
ACO-28Hypertension (HTN): Controlling High Blood Pressure65.6670.52
ACO-30Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic91.385.05
ACO-31Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)79.6488.67
ACO-33Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF ‹ 40%)78.7579.67

 

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 “Memorial Hermann Accountable Care Organization” to view the quality performance results. This ACO can also be found by using the ACO ID A65526 in the public use files on data.cms.gov.

Payment Rule Waivers

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

Participation Waivers

  • The Memorial Hermann Health System (“MHHS”), a participant in the Memorial Hermann Accountable Care Organization, will engage MHMD, the Memorial Hermann Physician Network, to administer a program to advance evidence-based medicine, increase patient satisfaction, and manage the cost of care for the hospitalist service line of MHHS, and may be extended to intensivists and anesthesiologists. The focus will be inpatients and observation and eligible physicians will be eligible for compensation based upon meeting quality and cost metrics. In September 2015 the program was modified to establish the physician compensation caps, clarify the dates for measurement and other program administrative changes. In March 2016, the program was modified to make the program adaptable as new information becomes available to incentive activities to advance MSSP, while maintaining the overall purposes of the original program. The program was extended through the end of the MSSP renewal period in 2019.
  • The Memorial Hermann Health System (“MHHS”), a participant in the Memorial Hermann Accountable Care Organization, will engage MHMD, the Memorial Hermann Physician Network, to administer a program to advance evidence-based medicine, increase patient satisfaction, and manage the cost of care for the orthopedic service line of MHHS. The focus will be total joint replacement, and other inpatient services and eligible physicians will be eligible for compensation based upon meeting quality and cost metrics. The program was approved in February 2014. In May of 2014, the program was supplemented to permit MHMD to develop criteria for a physician list eligible to receive referrals from call centers, nurse navigators or other sources using criteria such as geographic proximity, and the physician’s overall level of experience and expertise. In September 2015 the program was modified to establish the physician compensation caps, clarify the dates for measurement and other program administrative changes. In March 2016, the program was modified to make the program adaptable as new information becomes available to incentive activities to advance MSSP, while maintaining the overall purposes of the original program. The program was extended through the end of the MSSP renewal period in 2019.
  • The Memorial Hermann Health System (“MHHS”), a participant in the Memorial Hermann Accountable Care Organization, will engage MHMD, the Memorial Hermann Physician Network, to administer a program to advance evidence-based medicine, increase patient satisfaction, and manage the cost of care for the cardiovascular service line of MHHS. The focus will be inpatient surgeries services and eligible physicians will be eligible for compensation based upon meeting quality and cost metrics. In September 2015 the program was modified to establish the physician compensation caps, clarify the dates for measurement and other program administrative changes. In March 2016, the program was modified to make the program adaptable as new information becomes available to incentive activities to advance MSSP, while maintaining the overall purposes of the original program. The program was extended through the end of the MSSP renewal period in 2019.
  • The Memorial Hermann Accountable Care Organization (“MHACO”) will provide referral coordination service to physicians who participate in MHACO. MHACO will identify preferred providers, utilizing quality, cost and operational efficiency considerations, but will also coordinate referrals to physicians outside the preferred network. The expectation is that this will make the delivery of care more efficient, and will influence patients to utilize physicians with demonstrated quality and efficiency. The program was approved in February 2014.
  • The Memorial Hermann Health System (“MHHS”), a participant in the Memorial Hermann Accountable Care Organization (“MHACO”) has engaged the University of Texas Health Science Center (“UTHSC”) to provide academic, professional and administrative services, including the configuration of an ambulatory orthopedic network. Additionally, UTHSC will provide clinical and administrative leadership to advance quality and safety metrics of the orthopedic service line inclusive of a regional leadership structure; supplement and support the orthopedics call coverage requirements of the Hospital emergency departments; provide qualified physician leaders to coordinate the medical direction of local campuses and programs; provide guidance on operating room efficiency and operations to ensure the safest environment possible for patient care where requested; provide guidance on strategic sourcing solutions to improve overall quality of care and value to patients; and provide high quality care. The arrangement was approved for a June 1, 2014 start date with a 5 year term.
  • The Memorial Hermann Health System (“MHHS”), a participant in the Memorial Hermann Accountable Care Organization (“MHACO”) has engaged the MHS Physicians of Texas (“PhyTex”), a certified nonprofit healthcare corporation of which MHHS is the sole member, to provide academic, professional and administrative services, including the configuration of an ambulatory neuroscience network. Additionally, PhyTex will provide clinical and administrative leadership to advance quality and safety metrics of the neuroscience service line inclusive of a regional leadership structure; supplement and support the neuroscience call coverage requirements of the Hospital emergency departments; provide qualified physician leaders to coordinate the medical direction of local campuses and programs; provide guidance on operating room efficiency and operations to ensure the safest environment possible for patient care where requested; provide guidance on strategic sourcing solutions to improve overall quality of care and value to patients; provide high quality care. An initial component of the program will provide financial incentives to neurosurgeons for meeting defined quality and cost metrics. The arrangement was approved April for April 15, 2014, for a one year automatically renewing term.
  • The MHACO Board has approved a pilot program to utilize a scribe in certain clinically integrated physician offices to determine whether the program should be expanded and utilized to increase physician productivity, quality and patient satisfaction. The program was approved to commence July 1. The subsidy for the service would be for a 1 year period with staggered start dates after the commencement for the participating physician offices.
  • The MHACO Board has approved a subsidy to cover part of the cost for its academic affiliated physician group to transition to the EMR platform as Memorial Hermann.
  • The Memorial Hermann Accountable Care Organization Board has approved a small holdback of the available bonus pool if in-network utilization for the MHACO members remains flat or declines over the baseline. The MHACO Board considered documentation showing evidence that use of the network improved care quality and decreased the overall cost on a per patient basis. The impact on the bonus pool is aggregate, and does not take into account the utilization of physicians at the individual level. The program was approved for the 2016 bonus year.
  • The Memorial Hermann Health System (“MHHS”), a participant in the Memorial Hermann Accountable Care Organization (“MHACO”) and MHMD, the Memorial Hermann Physician Network, will administer a program to place a percentage of payment subject to risk based upon the achievement of certain quality metrics for intensivist providers.
  • The Memorial Hermann Health System (“MHHS”), a participant in the Memorial Hermann Accountable Care Organization, may offer certain physician and administrative leaders the opportunity to participate in comprehensive educational programs designed to focus on leadership, development, business, strategy and communication with the goal of strengthening the accountable care network.