ACO Public Reporting Information

ACO Public Reporting Information

 

Organizational Information

• ACO Participants by Medical Specialty
  

ACO Participants	ACO Participants in Joint Venture (Y or N)
Advanced Endoscopy Consultants	N
Mohammed Al-Jasim, MD	N
Allergy and Rheumatology Medical Clinic	N
Alvera Podiatry Group	N
ANZ Clinics	N
Marcella Bonnici, MD	N
Marisel Chibas, MD	N
Puja Chitkara, MD (CARE Rheumatology)	N
Maribeth Chong, MD (Well Being Medical Clinic)	N
Yoo Jin Chong, MD (Well Being Medical Clinic)	N
Kathy Clewell, MD	N
Andrew Deemer, MD (Coastal Surgeons)	N
Dermatologist Medical Group of North County	N
El Centro Regional Medical Center	N
Mohammed Elsayed, MD	N
Rhoda Estrella-Itchon, MD	N
Expert Surgeons Of California Inc (Coastal Surgeons)	N
Linda S. Falconio, MD (The Doctor's Office)	N
Get Well Stay Well Medical	N
Patrick & Edivina Gonzales Medical Group	N
Genesis Healthcare Partners	N
Seung S Gwon, MD	N
Mostafa A Hamdy	N
Susan Dabney Heifetz, MD (North County Internal Medicine)	N
Anthony Huynh Medical Group (El Centro Dermatology & Laser Center)	N
IGO Medical Group	N
Imperial Valley Family Care Medical Group	N
Jurkowski Medical Corporation (MD Today)	N
John A La Fata, MD (North County Internal Medicine)	N
Xiangli Li MD (North County Internal Medicine)	N
Kiran Mahl-Sansone, MD (North County Internal Medicine)	N
Elias Moukarzel, MD	N
Brian L Nguyen, MD	N
North Coast Family Medical Group	N
North County Endocrine Medical Group (Advanced Metabolic Care)	N
Monica Perlman, MD	N
Radiance OB-GYN	N
Rancho Family Medical Group	N
Rawi Medical	N
Sumana & Ananthram Reddy, MD	N
Regents Of The University Of California	N
Jorge F. Robles, MD, Medical Associates	N
SD Sports Medicine and Family Health Center	N
San Dieguito Orthopedic Medical Center (Core Orthopedic)	N
Scripps Ranch Medical Clinic	N
Southwest Heart Institute Medical Corporation	N
Synergy Specialists Medical Group	N
Temecula Valley Cardiology Medical Group	N
Temecula Valley Digestive Disease Consultants (United Gastroenterologists)	N
Tri-City Hospital	N
Tri City Primary Care Medical Group	N
Tri-Valley Urology Medical Group	N
Toosiemd Inc (Coastal Surgeons)	N
Torrey Pines Orthopaedic Medical Group	N
Two Zeds Medical Corporation (MD Today)	N
UC San Diego Health	N
UC San Diego Health Community Group	N
Valderrama MD Inc.	N
Paul D. Wagner, MD (San Diego Medical Group)	N
Sabina R Wallach, MD	N
Todd Wine, MD (North County Internal Medicine)	N
Morris Wisniewski, MD (North County Internal Medicine)	N
Hamid Zadeh, MD (Zadeh Cosmetics/OBGYN)	N

Skilled Nursing Facility (SNF) Affiliates

•  AG Murrieta SNF 
•  Arbor Hills Nursing Center
  
• Aviara Healthcare Center
• Balboa Nursing & Rehabilitation Center
• Brookdale Carmel Valley
  
• Carlsbad by the Sea Care Center
• Castle Manor
• Cottonwood Canyon Healthcare Center
  
•  Imperial Heights Healthcare & Wellness Centre
  
• Kearny Mesa Skilled Nursing and Rehabilitation Center
  
•  La Jolla Nursing and Rehabilitation Center
•  La Paloma Healthcare Center
  
•  Life Care Center of Vista
  
•  Poway Healthcare Center
  
•  Reo Vista Healthcare Center
• The Cove at La Jolla
• The Springs at Pacific Regent La Jolla
• University Care Center
• Villa Las Palmas Healthcare Center
  
•  Villa Rancho Bernardo Health Care
  
•  Village Square HealthCare Center
  

Governing Body

Member & Position	​Voting Power	​Membership Type	ACO Participant (TIN) Legal Name
​Thomas Moore, MD, Chairperson	​1	​ACO Participant Representative	Regents of the University of California - UCSD Medical Center
​Patty Maysent, MPH, MBA, Voting Member	​1	ACO Participant Representative	Regents of the University of California - UCSD Medical Center
​Duncan Campbell, Non-voting Member	​0	​Other - ACO Executive	​Regents of the University of California - UCSD Medical Center
​Tyson Ikeda, MD, Voting Member	​1	ACO Participant Representative	Regents of the University of California - UCSD Medical Center
​Dustin Lillie, MD, Voting Member	​1	​ACO Participant Representative	​Regents of the University of California - UCSD Medical Center
​Joe Califano, MD, Voting Member	​1	ACO Participant Representative	Regents of the University of California - UCSD Medical Center
​Parag Agnihotri, MD, Voting Member	​1	​ACO Participant Representative	​Regents of the University of California - UCSD Medical Center
​Lee Ralph, MD, Voting Member	​1	ACO Participant Representative	San Diego Sports Medicine and Family Health Center
​Vachas Palakodeti, MD, Voting Member	​1	​ACO Participant Representative	​Imperial Valley Family Care Medical Group, APC
​Steve Dietlin, Voting Member	​1	ACO Participant Representative	Tri-City Hospital
​Adolphe Edward, Voting Member	​1	​ACO Participant Representative	​El Centro Regional Medical Center
​Jack Dixon, Voting Member	​1	Medicare Beneficiary	N/A

Clinical & Administrative Leadership 

• Duncan Campbell, ACO Executive
• Larry Friedman, MD, Sr. Medical Director and Quality Assurance/ Improvement Officer
• Parag Agnihotri, MD, Chief Medical Officer, Population Health Services
  
• Cheryl Wagonhurst, Compliance Officer
  

Associated Committees & Committee Leadership

• Larry Friedman, MD, Medical Director - Quality & Utilization Committee
• Loc Le, CFO - Finance / Contracting Committee
• Duncan Campbell, ACO Executive & COO - Network Participation Committee
• Amy Sitapati, MD, Chief Medical Information Officer - Analytics / Population Health Data Committee
  

Types of ACO participants or combinations of ACO participants

• Networks of individual practices of ACO professionals
• Hospital employing ACO professionals
• ACO professionals in a group practice arrangement
  

Shared Savings & Losses

Amount of Shared Savings & Losses

First Agreement Period

• Performance Year 2018, $0
  

Shared Savings Distribution

First Agreement Period
Performance Year 2018

• Proportion invested in infrastructure: N/A
• Proportion invested in redesigned care processes/resources: N/A
• Proportion of distribution to ACO participants: N/A

Quality Performance Results

2018 Quality Performance Results

ACO#	​Measure Name	​Rate	ACO Mean
​ACO-1	​CAHPS: Getting Timely Care, Appointments, and Information	82.63	86.14
​ACO-2	​CAHPS: How Well Your Providers Communicate	93.23	93.93
​ACO-3	CAHPS: Patients’ Rating of Provider	​92.21	​92.45
​ACO-4	CAHPS: Access to Specialists	79.46	81.50
ACO-5	​CAHPS: Health Promotion and Education	​56.12	​59.26
​ACO-6	CAHPS: Shared Decision Making	57.01	61.94
​ACO-7	CAHPS: Health Status/Functional Status	​75.11	​73.35
​ACO-34	​CAHPS: Stewardship of Patient Resources	18.69	26.26
​ACO-8	​Risk Standardized, All Condition Readmission	​14.84	​14.98
​ACO-35	​Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)	19.26	18.59
​ACO-36	​All-Cause Unplanned Admissions for Patients with Diabetes	​29.57	​37.01
​ACO-37	​All-Cause Unplanned Admissions for Patients with Heart Failure	67.74	76.75
​ACO-38	​All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions	48.89	59.0
​ACO-43	​Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91)	1.56	1.98
​ACO-11	​Use of Certified EHR Technology	98.76	98.20
​ACO-12	​Medication Reconciliation Post-Discharge	97.81	85.91
​ACO-13	​Falls: Screening for Future Fall Risk	89.20	79.73
​ACO-44	Use of Imaging Studies for Low Back Pain	68.00	64.36
​ACO-14	​Preventive Care and Screening: Influenza Immunization	58.52	72.71
​ACO-15	​Pneumonia Vaccination Status for Older Adults	70.97	75.97
​ACO-16	​Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up	71.77	76.83
​ACO-17	​Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	81.82	72.81
​ACO-18	​Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan	51.63	66.74
​ACO-19	​Colorectal Cancer Screening	67.34	68.27
​ACO-20	​Breast Cancer Screening	74.19	71.96
​ACO-42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	76.15	81.47
​ACO-27	​Diabetes Mellitus: Hemoglobin A1c Poor Control	16.06	15.51
​ACO-41	​Diabetes: Eye Exam	45.78	52.42
​ACO-28	​Hypertension (HTN): Controlling High Blood Pressure	68.95	73.10
​ACO-30	​Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet	88.40	88.92

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

For 2018 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2018-Shared-Savings-Program-SSP-Accountable-Care-O/v47u-yq84/data.cms.gov

Note: In the Quality Performance Results file(s) above, search for “UC San Diego Health Accountable Care Network, Inc.” or “UC San Diego Health Accountable Care Network” to view the quality performance results. This ACO can also be found by using the ACO ID A3769 in the public use files on data.cms.gov.

Waivers & Arrangements Disclosed

The UC San Diego Health Accountable Care Network 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.

Payment Rule Waiver

• Yes, our ACO does use the SNF 3-Day Rule Waiver.

Waiver for Payment for Telehealth Services

• Yes, our ACO clinicians do provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.

EHR Subsidy Participation Waiver

• The Secretary of the Department of Health and Human Services has made available waivers of certain Federal Fraud and Abuse laws in connection with the operation of Accountable Care Organizations (ACO) that have entered into a Participation Agreement under the Medicare Shared Savings Program (MSSP) with the Centers for Medicare and Medicaid Services (see "Final Waivers in Connection with the Shared Savings Program") (see 80 Fed. Reg. 66,726 (October 29, 2015)) (the "Final Rule")). Pursuant to the Final Rule, UC San Diego Health Accountable Care Network (UCSDH ACO) seeks waiver protection for the arrangement described below ("EHR Subsidy Arrangement"):
  
  The EHR Subsidy Arrangement became effective January 1, 2018. The parties to each subsidy arrangement include UC San Diego Health and the UCSDH ACO on the one hand, and the eligible UCSDH ACO Participant practice on the other. The EHR Subsidy Arrangement has two components—an upfront, one time implementation services component, and an ongoing licensing, maintenance and support component. Under the EHR Subsidy Arrangement, certain UCSDH ACO Participant practices will be given subsidized access to the UCSD Health EPIC Community Connect Platform.
  
  

The EHR Subsidy Arrangement is designed to facilitate the widespread adoption of EHR technology by UCSDH ACO Participant providers who provide medical care to patients assigned to the UCSDH ACO in order to enhance and improve the efficiency, effectiveness and quality care provided to such individuals.

On November 22, 2017, the UCSDH ACO's Board of Directors duly authorized the arrangements described above, and made a bona fide determination that each arrangement is reasonably related to the purposes of the MSSP for the reasons stated above, and has contemporaneously documented such determination.