Gulf Coast MSSP Information
ACO Name and Location
Privia Quality Network Gulf Coast II, LLC
1200 Binz Street, Ste 1490
Houston, TX 77004
ACO Primary Contact
Primary Contact Name | Lynne Vaassen |
---|---|
Primary Contact Phone Number | (713) 512-7001 |
Primary Contact Email Address | lvaassen@priviahealth.com |
Organizational Information
ACO Participants:
ACO Participants | ACO Participant in Joint Venture |
---|---|
Austin Medical Group PLLC | N |
Alice A. Lim, M.D., P.A. | N |
Ami C. Foster, M.D., P.A. | N |
Camille Goff | N |
Endocrine and Psychiatry Center EPC LLC | N |
Hansa Bhakti Medley M.D. P.A. | N |
Mark J Florian MD PA | N |
Memorial Wellness Center PA | N |
Neighborhood Medical Clinic PLLC | N |
Panther Creek Medical Center, PA | N |
Physicians Group of the Woodlands | N |
Privia Medical Group Gulf Coast Pllc | N |
Pucillo Family Practice, PA | N |
Richard Allen Le MD PA | N |
San Marcos Family Medicine | N |
Spangler Medical Enterprises, PA | N |
St. Elizabeth Family Care, LLC | N |
Texas Endocrinology Group,PA | N |
The Neurology Center, P.A. | N |
Victor Knopp | N |
Gary L Gilcrease MD, PA | N |
Shavano Family Practice PA | N |
ACO Governing Body:
Member | Member’s Voting Power – Expressed as a percentage or number |
|||||
---|---|---|---|---|---|---|
Last Name | First Name | Title/Position | Membership Type | ACO Participant TIN Legal Business Name/DBA, if Applicable | ||
Fernandez | Keith | MD | 1 | ACO Executive | Privia Medical Group Gulf Coast, PLLC | |
Cone | Mark | MD | 1 | ACO Executive | Privia Medical Group Gulf Coast, PLLC | |
Paschalis | Thimos | MD | 1 | ACO Participant Representative | Privia Medical Group Gulf Coast, PLLC | |
Prihoda | Chris | MD | 1 | ACO Participant Representative | Privia Medical Group Gulf Coast, PLLC | |
Vogel | Susan | MD | 1 | ACO Participant Representative | Privia Medical Group Gulf Coast, PLLC | |
Patel | Rakesh | MD | 1 | ACO Participant Representative | Privia Medical Group Gulf Coast, PLLC | |
Vaassen | Lynne | BSN, RN | 1 | ACO Participant Representative | Privia Medical Group Gulf Coast, PLLC | |
Harrison | Jaclyn | MD | 1 | ACO Participant Representative | Privia Medical Group Gulf Coast, PLLC | |
Dawson | Daniel | MD | 1 | ACO Participant Representative | Privia Medical Group Gulf Coast, PLLC | |
Lee | Allen | MD | 1 | ACO Participant Representative | Privia Medical Group Gulf Coast, PLLC | |
Dunwoody | David | – | 1 | Medicare Beneficiary Representative | Privia Medical Group Gulf Coast, PLLC |
Key ACO Clinical and Administrative Leadership:
ACO Executive | Keith Fernandez, MD |
Medical Director | Keith Fernandez, MD |
Compliance Officer | Dana Fields |
Quality Assurance/Improvement Officer | Tiffany Johnson |
Associated Committees and Committee Leadership:
Committee Name | Committee Leader Name & Position |
---|---|
Finance Committee | Fred Huang |
Quality Assurance Committee | Christopher Prihoda, M.D. – Chair |
Compliance Committee | Dana Fields |
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
- First Agreement Period
- Performance Year 2018, $4,203,425
- Performance Year 2019, $2,470,186.33
Shared Savings Distribution
-
- First Agreement Period
- Performance Year 2018
- 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
- First Agreement Period
Quality Performance Results
2019 Quality Performance Results:
ACO# | Measure Name | Rate | ACO Mean |
---|---|---|---|
ACO-1 | CAHPS: Getting Timely Care, Appointments, and Information | 83.76 | 85.86 |
ACO-2 | CAHPS: How Well Your Providers Communicate | 92.54 | 94.11 |
ACO-3 | CAHPS: Patients’ Rating of Provider | 90.39 | 92.69 |
ACO-4 | CAHPS: Access to Specialists | 80.24 | 81.54 |
ACO-5 | CAHPS: Health Promotion and Education | 59.77 | 60.44 |
ACO-6 | CAHPS: Shared Decision Making | 60.34 | 62.78 |
ACO-7 | CAHPS: Health Status/Functional Status | 76.47 | 73.79 |
ACO-34 | CAHPS; Stewardship of Patient Resources | 27.62 | 26.17 |
ACO-45 | CAHPS: Courteous and Helpful Office Staff | 89.09 | 92.84 |
ACO-46 | Care Coordination | 85.53 | 86.89 |
ACO-8 | Risk Standardization, All Condition Readmission | 14.68 | 14.86 |
ACO-38 | All-Cause Readmissions for Patients with Multiple Chronic Conditions | 60.62 | 58.15 |
ACP-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91) | 2.01 | 1.87 |
ACO-13 | Falls: Screening for Future Fall Risk | 94.44 | 84.04 |
ACO-14 | Preventative Care and Screening: Influenza Immunization | 68.87 | 74.77 |
ACO-17 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | 73.68 | 78.04 |
ACO-18 | Preventative Care and Screening: Screening for Clinical Depression and Follow-up Plan | 49.82 | 70.40 |
ACO-19 | Colorectal Cancer Screening | 66.42 | 70.76 |
ACO-20 | Breast Cancer Screening | 66.94 | 73.84 |
ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 79.67 | 82.17 |
ACO-27 | Diabetes Mellitus: Hemoglobin A1c Poor Control | 9.82 | 13.88 |
ACO-28 | Hypertension (HTN): Controlling High Blood Pressure | 70.03 | 75.04 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.
Payment Rule Waivers
Skilled Nursing Facility (SNF) 3-day Rule Waiver:
- Our ACO does not use the SNF 3-Day Rule Waiver, pursuant to 42 CFR §425.612.
Waiver for Payment for Telehealth Services:
- Our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR §425.612(f) and 42 CFR §425.613.
Beneficiary Incentive Program
Our ACO does not use the Beneficiary Incentive Program (BIP) established under 42 CFR §425.304(c).