ACO Name and Location

  • Privia Quality Network Gulf Coast II, LLC
  • 1200 Binz Street, Ste 1490
  • Houston, TX 77004

ACO Primary Contact

Lynne Vaassen
Phone: 571-366-8850
Email: lvaassen@priviahealth.com

Organizational Information

ACO Participants:

ACO Participants ACO Participant in Joint Venture
Camille Goff N
Gary L. Gilcrease MD, PA N
Mark J Florian MD PA N
Memorial Wellness Center PA N
Panther Creek Medical Center, PA N
Privia Medical Group Gulf Coast Pllc N
Pucillo Family Practice, PA N
Richard Allen Le MD PA N
San Marcos Family Medicine N
Shavano Family Practice PA N
Spangler Medical Enterprises, PA N
St. Elizabeth Family Care, LLC N
Texas Endocrinology Group, PA N
Jennifer Gwozdz  N

ACO Governing Body:

Member First Name Member Last Name Member Title/Position Member’s Voting Power –Expressed as a percentage or number Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable
Keith Fernandez MD 1 ACO Executive Privia Medical Group Gulf Coast, PLLC
Mark Cone MD 1 ACO Participant Representative Privia Medical Group Gulf Coast, PLLC
Thimos Paschalis MD 1 ACO Participant Representative Privia Medical Group Gulf Coast, PLLC
Christopher Prihoda MD 1 ACO Participant Representative Privia Medical Group Gulf Coast, PLLC
Susan Vogel MD 1 ACO Participant Representative Privia Medical Group Gulf Coast, PLLC
Jaclyn Harrison MD 1 ACO Participant Representative Privia Medical Group Gulf Coast, PLLC
Daniel Dawson MD 1 ACO Participant Representative Privia Medical Group Gulf Coast, PLLC
Allen Lee MD 1 ACO Participant Representative Privia Medical Group Gulf Coast, PLLC
Lynne Vaassen BSN, RN 1 ACO Participant Representative Privia Medical Group Gulf Coast, PLLC
David Dunwoody – 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 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

    • 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
        • Proportioninvested in infrastructure: 45%
        • Proportion invested in redesigned care processes/resources: 5%
        • Proportion of distribution to ACO participants: 50%

Quality Performance Results

2021 Quality Performance Results:

Quality performance results are based on CMS Web Interface.

Measure # Measure Name Rate ACO
Mean
Measure # 001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control2 10.32 12.46
Measure # 134 Preventative Care and Screening: Screening for Depression and Follow-up Plan 72.4 74.38
Measure # 236 Controlling High Blood Pressure 78.4 74.87
Measure #318 Falls: Screening for Future Fall Risk 91.38 87.03
Measure #110 Preventative Care and Screening: Influenza Immunization 74.11 80.52
Measure #226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention 70 80.97
Measure #113 Colorectal Cancer Screening 78 73.63
Measure #112 Breast Cancer Screening 71.09 75.11
Measure #438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 81.92 84.24
Measure #479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2 0.16 0.154
Measure #MCC1 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2 29.12 33.99
       
Measure # Measure Name Rate ACO
Mean
CAHPS-1 Getting Timely Care, Appointments, and Information 81.95 84.67
CAHPS-2 How Well Providers Communicate 92.78 93.56
CAHPS-3 Patient’s Rating of Provider 92.76 92.19
CAHPS-4 Access to Specialists 75.87 78.8
CAHPS-5 Health Promotion and Education 64 61.61
CAHPS-6 Shared Decision Making 60.68 60.89
CAHPS-7 Health Status and Functional Status 69.09 71.78
CAHPS-8 Care Coordination 87.11 85.66
CAHPS-9 Courteous and Helpful Office Staff 89.39 91.88
CAHPS-11 Stewardship of Patient Resources 27.05 24.71

Please note, the Quality ID #: 370 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