ACO Name and Location

  • Privia Medical Group Gulf Coast PLLC
  • 950 N Glebe Rd Suite 700
  • Arlington, VA 22203

ACO Primary Contact

Lynne Vaassen
Phone: 713-512-7001
Email: lvaassen@priviahealth.com

Organizational Information

ACO Participants:

ACO Participants ACO Participant in Joint Venture
Benjamin Adam Stahl M.D., P.A. N
Camille Goff N
Cheryl Clark-Brown N
Complete Care Obgyn And Family Medicine PLLC N
Doctors Clinic Of Spokane P S N
Edward Kuo, M.D., P.A. N
Family Medicine Associates Of Conroe PLLC N
Family Practice Associates, P.A. N
Gary L. Gilcrease M.D., P.A. N
Hospital Internists Of Texas Clinic PLLC N
Jennifer Gwozdz N
Lewis Family Medicine N
Lori Naglieri, M.D., P.A. N
Medina Lake Clinic P.A. N
Narendra Punjabi M.D., P.A. N
Privia Medical Group Gulf Coast PLLC N
Privia Medical Group West Texas PLLC N
San Antonio Family Physicians N
Spangler Medical Enterprises, P.A. N
St. Elizabeth Family Care, LLC N
Waco Primary Care, P.A. N
Walla Walla Clinic, Inc. N

ACO Governing Body:

Member First Name Member Last Name Member Title/Position *Member’s Voting Power – Expressed as a percentage Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable
Keith Fernandez, MD Director 6.250% ACO Executive N/A
Stephen Cone Director 10.714% ACO Participant Representative Privia Medical Group Gulf Coast PLLC
Mark Florian Director 10.714% ACO Participant Representative Privia Medical Group Gulf Coast PLLC
Thimos Paschalis Director 10.714% ACO Participant Representative Privia Medical Group Gulf Coast PLLC
Christopher Prihoda Director 10.714% ACO Participant Representative Privia Medical Group Gulf Coast PLLC
Susan Vogel Director 10.714% ACO Participant Representative Privia Medical Group Gulf Coast PLLC
Daniel Dawson Director 10.714% ACO Participant Representative Privia Medical Group Gulf Coast PLLC
Alan Lee Director 10.714% ACO Participant Representative Privia Medical Group Gulf Coast PLLC
Lynne Vaassen Director 6.250% VP Population Health, Privia Health N/A
David Dunwoody Director 6.250% Medicare Beneficiary Representative N/A
Evan Varadi Director 6.250% RVP Practice Operations, Privia Health N/A

* –Due to rounding, ‘Member’s Voting Power’ may not equal 100 percent.

Key ACO Clinical and Administrative Leadership:

  • ACO Executive: Keith Fernandez, MD
  • Medical Director: Keith Fernandez, MD
  • Compliance Officer: Stephanie Clark
  • Quality Assurance/Improvement Officer: Tiffany Johnson

 

Associated Committees and Committee Leadership:

 Committee Name  Committee Leader Name & Position
 Finance Committee  David Mountcastle
 Quality Assurance Committee  Christopher Prihoda, M.D. – Chair

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

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

 

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2023: $9,610,568.36
    • Performance Year 2022: $7,631,504.64
  • First Agreement Period
    • Performance Year 2021: $5,344,749.41
    • Performance Year 2020: $5,091,075.46
    • Performance Year 2019: $2,470,186.33
    • Performance Year 2018: $4,203,425

Shared Savings Distribution

    • Second Agreement Period
      • Performance Year 2023
        • Proportion invested in infrastructure: 45%
        • Proportion invested in redesigned care processes/resources: 5%
        • Proportion of distribution to ACO participants: 50%
      • Performance Year 2022
        • Proportion invested in infrastructure: 45%
        • Proportion invested in redesigned care processes/resources: 5%
        • Proportion of distribution to ACO participants: 50%
    • First Agreement Period
      • Performance Year 2021
        • Proportion invested in infrastructure: 45%
        • Proportion invested in redesigned care processes/resources: 5%
        • Proportion of distribution to ACO participants: 50%
      • Performance Year 2020
        • Proportion invested in infrastructure: 45%
        • Proportion invested in redesigned care processes/resources: 5%
        • Proportion of distribution to ACO participants: 50%
      • Performance Year 2019
        • Proportion invested in infrastructure: 45%
        • Proportion invested in redesigned care processes/resources: 5%
        • Proportion of distribution to ACO participants: 50%
      • Performance Year 2018
        • Proportion invested in infrastructure: 45%
        • Proportion invested in redesigned care processes/resources: 5%
        • Proportion of distribution to ACO participants: 50%

Quality Performance Results

2023 Quality Performance Results:

Quality Performance Results are based on CMS Web Interface Measure Set

Measure # Measure Name Collection Type Reported Performance Rate Current Year Mean Performance Rate (SSP ACOs)
Measure # 001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) CMS Web Interface 6.04 9.84
Measure # 134 Preventative Care and Screening: Screening for Depression and Follow-up Plan CMS Web Interface 86.90 80.97
Measure # 236 Controlling High Blood Pressure CMS Web Interface 85.52 77.80
Measure # 318 Falls: Screening for Future Fall Risk CMS Web Interface 92.71 89.42
Measure # 110 Preventative Care and Screening: Influenza Immunization CMS Web Interface 80.18 70.76
Measure # 226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface 100.00 79.29
Measure # 113 Colorectal Cancer Screening CMS Web Interface 84.26 77.14
Measure # 112 Breast Cancer Screening CMS Web Interface 80.88 80.36
Measure # 438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface 90.25 87.05
Measure # 370 Depression Remission at Twelve Months CMS Web Interface 25.00 16.58
Measure # 321 CAHPS for MIPS CMS Web Interface 7.84 6.25
Measure # 479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups CMS Web Interface 0.1554 0.1553
Measure # 484 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions CMS Web Interface — 35.39
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS Survey 82.98 83.68
CAHPS-2 How Well Providers Communicate CAHPS for MIPS Survey 93.71 93.69
CAHPS-3 Patient’s Rating of Provider CAHPS for MIPS Survey 93.29 92.14
CAHPS-4 Access to Specialists CAHPS for MIPS Survey 81.25 75.97
CAHPS-5 Health Promotion and Education CAHPS for MIPS Survey 65.15 63.93
CAHPS-6 Shared Decision Making CAHPS for MIPS Survey 62.61 61.60
CAHPS-7 Health Status and Functional Status CAHPS for MIPS Survey 76.68 74.12
CAHPS-8 Care Coordination CAHPS for MIPS Survey 88.36 85.77
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS Survey 92.40 92.31
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS Survey 32.80 26.69

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov