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2019 ACO Quality & Performance Results

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2020 Report

Primary Care Alliance, LLC.
18550 US HWY 441
Mt Dora, FL 32757

Primary Contact
Rachel Corbitt
407-274-9294

ACO Participants

Aegis Medical Group, LLC
Jefferson
Barba
MD
Aegis Medical Group, LLC
Dan
Boggus
MD
Aegis Medical Group, LLC
Enrique Jose
De La Cruz Hernandez
MD
Aegis Medical Group, LLC
Donald T
Eagle
MD
Aegis Medical Group, LLC
Jose Leonardo
Estrella
MD
Aegis Medical Group, LLC
Miguel
Fernandez Barreras
MD
Aegis Medical Group, LLC
Yalieski
Garcia
MD
Aegis Medical Group, LLC
Brian Charles
Kinsey
ARNP
Aegis Medical Group, LLC
Robert
Lynch
MD
Aegis Medical Group, LLC
Sharon
Marquez
MD
Aegis Medical Group, LLC
Vijaya
Nagabhairu
MD
Aegis Medical Group, LLC
Francis
Pellegrino
MD
Aegis Medical Group, LLC
Yadira
Perez Velez
MD
Aegis Medical Group, LLC
Rashmee
Pokharel
APRN
Aegis Medical Group, LLC
Brenton
Priest
DO
Aegis Medical Group, LLC
Gerardo A.
Rojas
MD
Aegis Medical Group, LLC
Nadia
Sadek
MD
Aegis Medical Group, LLC
Allen
Schwartz
MD
Aegis Medical Group, LLC
Alejandro
Victoria
MD
Aegis Medical Group, LLC
Sharon L
White-Findley
DO
Aegis Physician Group, LLC
Dan
Boggus
MD
Aegis Physician Group, LLC
Enrique Jose
De La Cruz Hernandez
MD
Aegis Physician Group, LLC
Donald T
Eagle
MD
Aegis Physician Group, LLC
Jose Leonardo
Estrella
MD
Aegis Physician Group, LLC
Miguel
Fernandez Barreras
MD
Aegis Physician Group, LLC
Yalieski
Garcia
Aegis Physician Group, LLC
Brian Charles
Kinsey
ARNP
Aegis Physician Group, LLC
Robert
Lynch
MD
Aegis Physician Group, LLC
Sharon
Marquez
MD
Aegis Physician Group, LLC
Vijaya
Nagabhairu
MD
Aegis Physician Group, LLC
Francis
Pellegrino
MD
Aegis Physician Group, LLC
Yadira
Perez Velez
MD
Aegis Physician Group, LLC
Rashmee
Pokharel
APRN
Aegis Physician Group, LLC
Gerardo A.
Rojas
MD
Aegis Physician Group, LLC
nadia
sadek
MD
Aegis Physician Group, LLC
Allen
Schwartz
MD
Aegis Physician Group, LLC
Alejandro
Victoria
MD
Aegis Physician Group, LLC
Sharon L
White-Findley
DO
Aegis Physicians Group, LLC
Jefferson
Barba
MD
Aegis Physicians Group, LLC
Brenton
Priest
DO
Bishnu P Verma MD PA
Bishnu
Verma
MD
Brightcare Medical Group LLC
Gustavo
Sosa
MD
Central Florida Medical Care PA
David
Lichtinger
DO
Central Florida Medical Care PA
Anna
Roswald
ARNP
Eracare Physicians LLC
Emad
Abdelsatar
MD
Eracare Physicians LLC
Alaa
Kandil
MD
Fernhill Family Medicine LLC
Kumaran
Mohan
MD
Florida Internal Medicine PL
Dwaraknadh
Banala
MD
Four Corners Internal Medicine LLC
Srinath
Kosonam
MD
Good Health Physicians, LLC
Jennifer
Parkes
APRN
Good Health Physicians, LLC
Shoba
Sama
MD
Lake Internal Medicine Associates PA
Steven
Tang
MD
Lakeview Healthcare System, LLC
Ma Thuzar
Aung
MD
Lakeview Healthcare System, LLC
Gregory
Avetisov
DO
Lakeview Healthcare System, LLC
Birendra
Bhattarai
MD
Lakeview Healthcare System, LLC
Ajay
Bisht
MD
Lakeview Healthcare System, LLC
Khai
Chang
MD
Lakeview Healthcare System, LLC
Tasneem
Cheema
MD
Lakeview Healthcare System, LLC
Shahbaz
Cheema
MD
Lakeview Healthcare System, LLC
Randa
Ghali
MD
Lakeview Healthcare System, LLC
Sara
Gitte
MD
Lakeview Healthcare System, LLC
Gloria
Hernandez
MD
Lakeview Healthcare System, LLC
Nirmala
Jacob
MD
Lakeview Healthcare System, LLC
Paul
Kilpatrick
PA
Lakeview Healthcare System, LLC
Tanya
Lambright
ARNP
Lakeview Healthcare System, LLC
Hashani
Perkins
MD
Lakeview Healthcare System, LLC
Michelle
Sidor
ARNP
Lakeview Healthcare System, LLC
Page
Smith
MD
Lakeview Healthcare System, LLC
Lorna
Stobbs
ARNP
Living Florida Healthcare, LLC
Marlene
Lindsay
ARNP
Living Florida Healthcare, LLC
Rishi
Sharma
MD
Louis J Radnothy, D.O., P.A.
Jeffery
Boyd
PA
Louis J Radnothy, D.O., P.A.
Chaundry
Cheema
MD
Louis J Radnothy, D.O., P.A.
Barbara
Endsley
ARNP
Louis J Radnothy, D.O., P.A.
Neeta
Mauskar
ARNP
Mahnaz Qayyum Medical Enterprises LLC
Mahnaz
Qayyum
MD
Mary Ann Tesalona MD Corp
Mary Ann
Tesalona
MD
N Yelamanchi MD PA
Nalini
Yelamanchi
MD
NADIA M. SADEK, M.D., P.A.
nadia
sadek
MD
Naila Khan MD PA
Naila
Khan
MD
Norman S Novis MD PA
Norman
Novis
MD
Scott A Rodger MD
Scott
Rodger
MD
To Your Health of Lake County Inc
Pablo
Cardona
MD
To Your Health of Lake County Inc
Shannon
Carrasco
ARNP
To Your Health of Lake County Inc
Joseph
Carrasco
MD
To Your Health of Lake County Inc
Bali
Wray
ARNP
Weirsdale Family Health Center INC
Jeffery
Boyd
PA
Weirsdale Family Health Center INC
Chaundry
Cheema
MD
Weirsdale Family Health Center INC
Barbara
Endsley
ARNP
Weirsdale Family Health Center INC
Neeta
Mauskar
PA

Key Clinical and Administrative Leaders

Khai Chang, M.D. Compliance Officer

Shabaz Cheema, M.D. Chief Medical Officer

Sidney Morgan CEO

Rachel Corbitt Executive Director

Tim Lima Contracted Consultant Financial Officer

Sneha Bhandari Data Coordinator

Andrew Ervin Director of Quality Improvement

Zachary Hubbard Director of Human Resources

Ingrid Negron Director of Provider Relations

Members of Governing Body

Ajay Bisht,  M.D. Lakeview Internal Medicine

Waheeduz Zaman, M.D. Physicians of Central Florida

Birendra Bhattarai, M.D. Lakeview Internal Medicine

Joseph P. Godfrey Beneficiary Liaison

Nick Visic Community Liason/patient advocate

Chaundry Cheema, M.D. Weirsdale Family Health

Ma Thazaur Aung, M.D. Lakeview Internal Medicine

Khai Chang, M.D. Lakeview Internal Medicine

Shahbaz Cheema, M.D. Lakeview Internal Medicine

Sidney Morgan CEO Aegis Medical Group

Allen Schwartz, MD Aegis Medical Group

Shared Savings and Shared Loses

The amount of any Shared Savings or Shared Losses for any Performance Year; 2020: $15,665,680.75

The amount of any Shared Savings or Shared Losses for any Performance Year; 2019: $20,670,824.25

The amount of any Shared Savings or Shared Losses for any Performance Year; 2018:  7,860,009.42

 

The proportion of Shared Savings invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries; 15%

The proportion of Shared Savings distributed to Next Generation Participants and Preferred Providers. 65% ACO Infrastructure, 35% Participant distribution.

 

Joint Ventures

Primary Care Alliance does not have any joint ventures with Participants or Preferred Providers.

The ACO’s performance on the quality measures described in Appendix F.

2018 Quality Score: 100%

AIM: Better Care for Individuals
Patient/Caregiver Experience
ACO-1
CAHPS: Getting Timely Care, Appointments and Information
Survey
85.19
ACO-2
CAHPS: How Well Your Providers Communicate
Survey
92.34
ACO-3
CAHPS: Patient’s Rating of Provider
Survey
90.86
ACO-4
CAHPS: Access to Specialists
Survey
81.27
ACO-5
CAHPS: Health Promotion and Education
Survey
59.05
ACO-6
CAHPS: Shared Decision Making
Survey
63.2
ACO-7
CAHPS: Health Status/Functional Status
Survey
74.79
ACO-34
CAHPS: Stewardship of Patient Resources
Survey
26.27
Care Coordination/Patient Safety
ACO-8
Risk-Standardized, All Condition Readmission
Claims
14.6
ACO-35
Skilled Nursing Facility 30-Day Readmission (SNFRM)
Claims
17.6
ACO-36
All-Cause Unplanned Admissions for Patients with Diabetes
Claims
29.14
ACO-37
All-Cause Unplanned Admissions for Patients with Heart Failure
Claims
59.18
ACO-38
Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions
Claims
47.43
ACO-43
Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI - #9) (version with additional Risk Adjustment)
Claims
1.72
ACO-12
Medication Reconciliation Post-Discharge
Claims
99.25
ACO-13
Falls: Screening for Future Falls Risk
CMS Web Interface
80.36
ACO-44
Use of Imaging Studies for Low Back Pain
Claims
50
Preventive Health
ACO-14
Preventive Care and Screening: Influenza Immunization
CMS Web Interface
72.47
ACO-15
Pneumonia Vaccination Status for Older Adults
CMS Web Interface
57.63
ACO-16
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up
CMS Web Interface
64.45
ACO-17
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
CMS Web Interface
85.11
ACO-18
Preventive Care and Screening: Screening for Depression and Follow-up Plan
CMS Web Interface
68.77
ACO-19
Colorectal Cancer Screening
CMS Web Interface
69.09
ACO-20
Breast Cancer Screening
CMS Web Interface
67.96
ACO-42
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
CMS Web Interface
76.39
ACO-41
Diabetes: Eye Exam
CMS Web Interface
43.56
Clinical Care for At Risk Population- Depression
ACO-40
Depression Remission at Twelve Months
CMS Web Interface
7.25
Clinical Care for At Risk Population- Diabetes
ACO-27
Diabetes Mellitus: Hemoglobin A1c (HbA1c) Poor Control (>9%)
CMS Web Interface
10.98
Clinical Care for At Risk Population- Hypertension
ACO-28
Hypertension: Controlling High Blood Pressure
CMS Web Interface
79.75
Ischemic Vascular Disease
ACO-30
Ischemic Vascular Disease (IVD): Use of Aspirin of Another Antiplatelet
CMS Web Interface
86.5
DM Composite
37.12