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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

LeTesha Montgomery
(713) 338-6465
Letesha.Montgomery@memorialhermann.org

Organizational Information

ACO Participants

*ACO participants in joint ventures between ACO professionals and hospitals (annotated by asterisk [*])

Abbas Jafri Md Pa
Affiliates Of Family Medicine Inc
Alexandria Medical Association PA
Alfredo Huerta Jr MD
Allison Blazek, MD, PA
Ambreen Sharaf, MD, PA
Ami C Foster, MD, PA
Anil A Dara M.D. P.A.
Balance Family Medicine, Lllp
Barker Cypress Family Practice, Pa
Bay Area Geriatrics
BAY AREA TOTAL HEALTH MEDICAL GRP PA
Bellaire Doctors
Berta De Leon Scaglia Md Pa
Bharat B Latthe, MD, PA
Brian C Castillo, MD PA
Campbell, Ghebranious, Hung, PLLC
Carol A Strickland, MD, PA
Center for Integrated Medicine, PA
Cesario A Castillo MD PA
Click It Clinic, Pllc
College Park Medicine PA
Conroe Family Doctor Pllc
Conroe Family Medicine PA
David E Auer, MD, PA
DEIRDRE MCMULLEN M.D.
Dr Mubarak Khawaja Pa
Dr Saleha Ahmed
Dr. A Family Clinic
DR. ALICE A. LIM M.D.
Dr. Richard C. Lock M.D.
DR. ROBERT D MOCK MD
DR. SYED VIQAR AHMED MD
Durga P Sunkara, MD, PA
Ella Family Medicine Pa
Faizun Anwar, M.D. P.A.
Family Practice Clinic Of Crestwater Llc
Family & Senior Medical Clinic, PA
First Colony Primary Care, P.A
Fuqua Family Practice and Urgent Care PA
G A Valdez & Associates Inc
Gary W Brewton
Genesis Family Care, P.A.
Georgina Loya MD PA
Gregg C. Castillo, MD, PA
Gulf Coast Primary Care, Pllc
HAZEM EL ZUFARI MD PA
Heidi Schultz, MD, PA
High Tech Family Care And Women's Health Pa
Houston Urology Partners, PA
HUAIGUANG LI M.D., PLLC
Ike Eni, M.D., P.A.
Ilsong Jason Chong, MD, PA
IMD Healthcare and Imaging
ImranNathaniMDPA
INPATIENT PROVIDERS OF TEXAS, PLLC
Integrative Primary Care PLLC
INTERNAL MEDICINE ASSOCIATES OF HOUSTON PA
Ivor W Foox, MD, PA
J Kevin Giglio, MD, PA
Jimin Wang, MD, PA
JOSE FERNANDO ZAVALETA M.D., P.A.
JY Family Medicine & Urgent Care PLLC
KATY INTERNAL MEDICINE ASSOCIATES, L.L.P*
Katy Supportive Medicine
MA Medical Care PLLC
Medical Associates of Katy PLLC*
Medical Colleagues of Texas, LLP*
MehtaMedicalGroupPLLC
Memorial Hermann Hospital System
Memorial Hermann Medical Group*
Memorial Hermann Rehabilitation Hospital Katy, Llc*
Memorial-Katy Gastroenterology Constultants, P.A.
MHS Physicians of Texas
MICHAEL E. BUXBAUM, D.O. P.A.
Michael Y Chang, DO, PA
MIRACLE MEDICAL CLINIC
MOONAT MEDICAL ASSOC INC
MTL MD PLLC
Murtaza Mussaji
Nghia C. Nguyen M.D.
Nghia C. Nguyen M.D.
Nibu Mathew
Northeast Medical Associates
NORTHEAST PRIMARY CARE ASSOCIATES P.A.
NorthWoodsFamilyMedicinePLLC
Orlando Fonseca, MD, PLLC
PachieSChanMDPLLC
Panther Creek Medical Center, PA
PhysiciansGroupofTheWoodlandsPA
Pinewood Medical Clinic, PA
Pratibha R Kulkarni, MD, PA
PRIMECARE MEDICAL GROUP, PLLC
Providence Family Practice, PA
Pucillo Family Practice, PA
Qingguo Tao MD PA
QUOC LE
Raja Abusharr, MD, PA
Rios Family Medicine Clinic Pa
Rishi Hingorani DO, PA
ROSEWOOD FAMILY PHYSICIANS I PLLC
Rudolph Medical Associates
Samuel Gan
Samuel L Siegler,ii,j.D.,m.D.,p.A.
Shengkun Yao, MD, PA
Sistla B Krishna, MD
Southeast Medical Group Pa
Southwest Family Physicians, PA
Southwest Memorial Physician Associates, PA
Spring Valley Primary Care PA
Spuhler Medical Associates, PA
Sr Medical Clinic Pllc
St Elizabeth Family Care LLC
St Johns Physician Associates Pa
Stuart A Shapiro, MD
Sugar Lakes Family Practice, PA
SUGAR LAND MED PED CLINIC, P.A.
Suparna Chhibber MD PA
SYED A GARDEZI
Sylvia Wu, Md, Pa
Tamirisa Renu Pa
Tanveer F. Syed, M.D., P.A.
Tara H Shani, MD, PA
Thanh Ho Taylor, DO, PA
Thanh K. Hoang, M.D., P.A,
Thomas Diaz
Thomas Diaz
Thomas FP, PLLC
TLC CLINIC, PLLC
Town and Country Internal Medicine, P.A.
Tran & Thomas, PA
Trang T Trinh, MD, PA*
Trinity Primary Care Pa
UT Physicians Specialty Services
V. Lakshmi Achanta Md.,pa
Virgil C Carandang
Wang & Jiang MD PA
WESTLAKE MEDICAL SERVICES LLLP
Westwood Primary Care PLLC
Woodlands Internal Medicine Pa
WoodlandsPrimaryCarePA
Zealth Care Pllc
Zhengnan Yin, MD

MHACO Governing Body

Name

Member Type

Governing Body Role

Voting Capacity

ACO Participant (TIN) Legal Name

Charles D. Stokes

Chairperson

Serves on Board of Directors; Chairperson

Voting Member (1)

Memorial Hermann Hospital System

Chris Lloyd

ACO Participant Representative

Serves on Board of Directors; CEO

Voting Member (1)

Memorial Hermann Hospital System

Dennis L. Laraway

ACO Participant Representative

Serves on Board of Directors; Treasurer

Voting Member (1)

Memorial Hermann Hospital System

M. Michael Shabot, MD

ACO Participant Representative

Serves on Board of Directors; Serves as principal officer of Board of Directors

Voting Member (1)

Memorial Hermann Hospital System

Charlotte Alexander, MD

ACO Participant Representative

Serves on Board of Directors

Voting Member (1)

Memorial Hermann Hospital System

Ankur Doshi, MD

ACO Participant Representative

Serves on Board of Directors

Voting Member (1)

Primecare Medical Group, PLLC

J. Kevin Giglio, MD

ACO Participant Representative

Serves on Board of Directors

Voting Member (1)

J. Kevin Giglio, MD, PA

Jon Gogola, MD

ACO Participant Representative

Serves on Board of Directors

Voting Member (1)

Memorial Hermann Hospital System

Grover Jackson

Medicare Beneficiary Representative

Serves on Board of Directors

Voting Member (1)

N/A

Deborah Cannon

Other; MHHS Board Member

Serves on Board of Directors

Voting Member (1)

N/A

MHACO Committees and Key Leadership Personnel

  • Christopher Lloyd, CEO
  • Michael Davidson, MD, Chief Medical Officer
  • Charlie Bumpass, Chief Compliance Officer
  • Angela Shippy, MD, Chief Quality Officer
  • Charles Stokes, Board Chairperson
  • Dennis Laraway, Treasurer
  • Deborah Gordon, Secretary
  • Nicole Clarke-Luck, VP, ACO Finance
  • LeTesha Montgomery, VP, ACO Operations and Network Management

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

  1. Network of individual practices of ACO professionals
  2. Partnership or joint venture arrangement between hospitals and ACO professionals
  3. Hospital employing ACO professionals

Shared Savings and Losses:

Amount of Shared Savings/Losses
  • Agreement period beginning 2013, Performance Year 1: $28,338,705
  • Agreement period beginning 2013, Performance Year 2014: $22,723,305
  • Agreement period beginning 2013, Performance Year 2015: $41,912,527

Shared losses are designated with a minus sign (-) in front of the dollar amount and red font.

Shared Savings Distribution
  • Agreement period beginning 2013, Performance Year 1
    • Proportion invested in infrastructure: 15%
    • Proportion invested in redesigned care processes/resources: 10%
    • Proportion of distribution to ACO participants: 75%
  • Agreement period beginning 2013, Performance Year 2014
    • Proportion invested in infrastructure: 20%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 65%
  • Agreement period beginning 2013, Performance Year 2015
    • Proportion invested in infrastructure: 20%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 65%

Arrangements Disclosed

The MHACO Board has approved the following arrangements for the waivers authorized by CMS and the OIG pursuant to the “Medicare Program; Final Waivers in Connection with the Shared Savings Program” originally published on November 2, 2011 and finalized on October 29, 2015.

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. For purposes of managing covered lives including MSSP, the MHACO Board approved certain network utilization tools for MHACO or MHMD to utilize along with its participants, partners, and affiliated entities. The network tools include the publication and distribution of reports to inform leadership on the various metrics and for the development of care networks for population health management; the publication and distribution of network directories; the development of limited, aggregate financial incentives to align network utilization to the extent that it advances MSSP purposes, and other similar related tools as necessary for these purposes. The network resources would be utilized for the duration of the MSSP renewal period through 2019.
  11. MHACO does not utilize the SNF 3-Day Rule Waiver.

Quality Performance Results