Public Information — Physicians Accountable Care Services, LLC

Physicians Accountable Care Solutions, LLC

Medicare Shared Savings Program

Accountable Care Organization - A2636

68 Bridge St, Suite 118, Suffield, CT 06078

Anonymous 24/7 Compliance Hotline: 860-986-6606

ACO Primary Contact

Dr. Phil Gaziano
pgaziano@qhideas.com
413-544-0179

ACO Participants: See full roster here

Identification of 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
    

    Name
    Title
    Voting
    Participant Representative
    Member Status
    

    Philip Gaziano, MD
    CEO and Board Chair
    Yes
    N/A
    ACO Vendor
  

    Robert Russo, MD
    Secretary and Treasurer
    Yes
    Medical Specialty Group
    Participant
  

    Brian Zehnder, MD
    Quality Assurance Officer
    Yes
    Exodus Healthcare Network, PLLC
    Participant
  

    Jan Gillespie, MD
    Medical Director
    Yes
    Northern CO. Pain Management
    Participant
  

    William Klas, MD
    
    Yes
    Marshall Medical Center
    Participant
  

    Kevin Halbritter, MD
    
    Yes
    West Virginia University Hospitals, Inc.
    Participant
  

    Brian Johnson, MD
    
    Yes
    Allegheny Clinic
    Participant
  

    Steven Miller, MD
    
    Yes
    Intermountain Ear Nose And Throat Specialists LLC
    Participant
  

    Gerald Rossman, MD
    
    Yes
    Allegheny Clinic
    Participant
  

	Dr. Frank Sammarco
   	
    Yes
    Soundview Medical Associates, LLC
   	Participant
 

	Dr. Jill Owens
   	
    Yes
    Bradford Family Medicine, Inc.
   	Participant
 

    Lynn Carlson
    Medicare Beneficiary Representative
    Yes
    N/A
    Beneficiary
  

    Philip Gaziano, MD
    Data Use Custodian
    Yes
    N/A
    ACO Vendor
  

    Thomas Gaziano, MD
    
    No
    Harvard Institute for Global Health
    Community Stakeholder
  

    John Wood, Esq.
    Compliance Officer
    No
    N/A
    Consumer Advocate
  

ACO Governing Body
Name	Title	Voting	Participant Representative	Member Status
Philip Gaziano, MD	CEO and Board Chair	Yes	N/A	ACO Vendor
Robert Russo, MD	Secretary and Treasurer	Yes	Medical Specialty Group	Participant
Brian Zehnder, MD	Quality Assurance Officer	Yes	Exodus Healthcare Network, PLLC	Participant
Jan Gillespie, MD	Medical Director	Yes	Northern CO. Pain Management	Participant
William Klas, MD		Yes	Marshall Medical Center	Participant
Kevin Halbritter, MD		Yes	West Virginia University Hospitals, Inc.	Participant
Brian Johnson, MD		Yes	Allegheny Clinic	Participant
Steven Miller, MD		Yes	Intermountain Ear Nose And Throat Specialists LLC	Participant
Gerald Rossman, MD		Yes	Allegheny Clinic	Participant
Dr. Frank Sammarco		Yes	Soundview Medical Associates, LLC	Participant
Dr. Jill Owens		Yes	Bradford Family Medicine, Inc.	Participant
Lynn Carlson	Medicare Beneficiary Representative	Yes	N/A	Beneficiary
Philip Gaziano, MD	Data Use Custodian	Yes	N/A	ACO Vendor
Thomas Gaziano, MD		No	Harvard Institute for Global Health	Community Stakeholder
John Wood, Esq.	Compliance Officer	No	N/A	Consumer Advocate

Key Clinical and Administrative Leadership Personnel

  
      Title
      Name
    
    ACO Executive
    Philip Gaziano, MD
  
    Medical Director
    Jan Gillespie, MD.
  
    Compliance Official
    John Wood, Esq.
  
    Quality Assurance/Improvment Officer
    Brian Zehnder, MD
    
    Secretary and Treasurer
    Robert Russo, MD

Title	Name
ACO Executive	Philip Gaziano, MD
Medical Director	Jan Gillespie, MD.
Compliance Official	John Wood, Esq.
Quality Assurance/Improvment Officer	Brian Zehnder, MD
Secretary and Treasurer	Robert Russo, MD

Finance and Audit Committee: Chair Robert Russo, MD, Treasurer

Compliance Committee: Chair John Wood, Esq., Chief Compliance Officer

Quality Committee: Chair Brian Zehnder, MD, Quality Assurance Officer

Data Security, Analytics, Utilization, and Reporting Committee: Chair Philip Gaziano, MD, Data Use Custodian

Shared Savings Committee: Philip Gaziano, MD, Data Use Custodian

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

ACO professionals in a group practice arrangement
A network of individual practices of ACO professionals
A hospital employing ACO professionals
A critical access hospital (CAH) billing under Method II
A rural health center (RHC)

Amount of Shared Savings/Losses

Agreement Period beginning January 1, 2015, Performance Year 2015: $0

How Shared Savings Are Distributed:

Agreement Period beginning January 1, 2015, Performance Year 2015:

Proportion invested in infrastructure: 20%

Proportion invested in redesigned care processes/resources: 5%

Proportion of distribution to ACO participants: 75%

Payment Rule Waivers

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

Quality Reporting Results

   
    
    
    
    
  
 
  Measure Number
  Measure Name
  ACO Performance Rate
  Mean Performance Rate (SSP-
  ACOs)

 

  ACO-1
  CAHPS: Getting Timely Care,
  Appointments, and Information
  80.06
  80.61

 

  ACO-2
  CAHPS: How Well Your Providers
  Communicate
  91.14
  92.65

 

  ACO-3
  CAHPS: Patients’ Rating of
  Provider
  90.90
  91.94

 

  ACO-4
  CAHPS: Access to Specialists
  83.00
  83.61

 

  ACO-5
  CAHPS: Health Promotion and
  Education
  55.01
  59.06

 

  ACO-6
  CAHPS: Shared Decision Making
  77.67
  75.17

 

  ACO-7
  CAHPS: Health Status/Functional
  Status
  70.65
  72.30

 

  ACO-34
  CAHPS: Stewardship of Patient
  Resources*
  29.32
  26.87

 

  ACO-8
  Risk Standardized, All Condition
  Readmission
  14.98
  14.86

 

  ACO-35
  Skilled Nursing Facility 30-Day
  All-Cause Readmission Measure (SNFRM)* Readmission
  18.24
  18.07

 

  ACO-36
  All-Cause Unplanned Admissions
  for Patients with Diabetes*
  56.33
  54.60

 

  ACO-37
  All-Cause Unplanned Admissions
  for Patients with Heart Failure*
  80.01
  76.96

 

  ACO-38
  All-Cause Unplanned Admissions
  for Patients with Multiple Chronic Conditions
  65.90
  62.92

 

  ACO-9
  Ambulatory Sensitive Condition
  Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults
  (AHRQ Prevention Quality Indicator (PQI) #5)
  1.21
  1.11

 

  ACO-10
  Ambulatory Sensitive Conditions
  Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)
  1.05
  1.04

 

  ACO-11
  Percent of Primary Care
  Physicians who Successfully Meet Meaningful Use Requirements
  79.48
  76.22

 

  ACO-39
  Documentation of Current
  Medications in the Medical Record*
  89.78
  84.07

 

  ACO-13
  Falls: Screening for Future Fall
  Risk
  40.06
  56.46

 

  ACO-14
  Preventive Care and Screening:
  Influenza Immunization
  51.93
  62.03

 

  ACO-15
  Pneumonia Vaccination Status for
  Older Adults
  59.52
  63.73

 

  ACO-16
  Preventive Care and Screening:
  Body Mass Index (BMI) Screening and Follow-up
  70.37
  71.15

 

  ACO-17
  Preventive Care and Screening:
  Tobacco Use: Screening and Cessation Intervention
  92.25
  90.16

 

  ACO-18
  Preventive Care and Screening:
  Screening for Clinical Depression and Follow-up Plan
  32.42
  45.25

 

  ACO-19
  Colorectal Cancer Screening
  56.49
  60.06

 

  ACO-20
  Breast Cancer Screening
  64.72
  65.67

 

  ACO-21
  Preventive Care and Screening:
  Screening for High Blood Pressure and Follow-Up Documented
  75.10
  70.04

 

  ACO-40
  Depression Remission at Twelve
  Months*
  0.00
  6.11

 

  ACO-27
  Diabetes Mellitus: Hemoglobin
  A1c Poor Control
  14.83
  20.38

 

  ACO-41
  Diabetes: Eye Exam*
  36.12
  41.05
  

  ACO-28
  Hypertension: Controlling High
  Blood Pressure
  67.19
  69.62

 

  ACO-30
  Ischemic Vascular Disease: Use
  of Aspirin or Another Antithrombotic
  85.56
  83.82

 

  ACO-31
  Heart Failure: Beta-Blocker
  Therapy for Left Ventricular Systolic Dysfunction (LVSD)
  88.53
  87.22

 

  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%)
  77.99
  77.73
   
 

  CAHPS = Consumer
  Assessment of Healthcare Providers and Systems, PQI = Prevention Quality
  Indicator, LVSD = left ventricular systolic dysfunction,
  ACE =
  angiotensin-converting enzyme, ARB = 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

 

Measure Number	Measure Name	ACO Performance Rate	Mean Performance Rate (SSP- ACOs)
ACO-1	CAHPS: Getting Timely Care, Appointments, and Information	80.06	80.61
ACO-2	CAHPS: How Well Your Providers Communicate	91.14	92.65
ACO-3	CAHPS: Patients’ Rating of Provider	90.90	91.94
ACO-4	CAHPS: Access to Specialists	83.00	83.61
ACO-5	CAHPS: Health Promotion and Education	55.01	59.06
ACO-6	CAHPS: Shared Decision Making	77.67	75.17
ACO-7	CAHPS: Health Status/Functional Status	70.65	72.30
ACO-34	CAHPS: Stewardship of Patient Resources*	29.32	26.87
ACO-8	Risk Standardized, All Condition Readmission	14.98	14.86
ACO-35	Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)* Readmission	18.24	18.07
ACO-36	All-Cause Unplanned Admissions for Patients with Diabetes*	56.33	54.60
ACO-37	All-Cause Unplanned Admissions for Patients with Heart Failure*	80.01	76.96
ACO-38	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions	65.90	62.92
ACO-9	Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)	1.21	1.11
ACO-10	Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)	1.05	1.04
ACO-11	Percent of Primary Care Physicians who Successfully Meet Meaningful Use Requirements	79.48	76.22
ACO-39	Documentation of Current Medications in the Medical Record*	89.78	84.07
ACO-13	Falls: Screening for Future Fall Risk	40.06	56.46
ACO-14	Preventive Care and Screening: Influenza Immunization	51.93	62.03
ACO-15	Pneumonia Vaccination Status for Older Adults	59.52	63.73
ACO-16	Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up	70.37	71.15
ACO-17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	92.25	90.16
ACO-18	Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan	32.42	45.25
ACO-19	Colorectal Cancer Screening	56.49	60.06
ACO-20	Breast Cancer Screening	64.72	65.67
ACO-21	Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented	75.10	70.04
ACO-40	Depression Remission at Twelve Months*	0.00	6.11
ACO-27	Diabetes Mellitus: Hemoglobin A1c Poor Control	14.83	20.38
ACO-41	Diabetes: Eye Exam*	36.12	41.05
ACO-28	Hypertension: Controlling High Blood Pressure	67.19	69.62
ACO-30	Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic	85.56	83.82
ACO-31	Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)	88.53	87.22
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%)	77.99	77.73
CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = 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

For more information on how to interpret scores on the above quality performance measures, see http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/MSSP-QM-Benchmarks.pdf For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048.