Gulf Coast MSSP Information

ACO Name and Location

Privia Quality Network Gulf Coast II, LLC
Previous Names:N/A
1200 Binz Street, Ste 1490
Houston, TX 77004
No medical care is delivered at this address

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 (Enter Y or N)
Richard Allen Le MD PA N
Pucillo Family Practice, PA N
Gary Lew N
Endocrine and Psychiatry Center EPC LLC N
Texas Endocrinology Group, PA N
Spangler Medical Enterprises, PA N
St. Elizabeth Family Care, LLC N
Ami C. Foster, M.D., P.A. N
Venkata Lakshmi Achanta N
Camille Goff N
Victor Knopp N
Privia Medical Group Gulf Coast, Pllc N
Spirit of Texas Family Medicine PLLC N
The Neurology Center, P.A. N
Panther Creek Medical Village, PA N
Hansa Bhakti Medley M.D. P.A. N
Alice A. Lim, M.D., P.A. N
Physicians Group of the Woodlands N
Memorial Wellness Center PA N
1960 Physician Associates N
Neighborhood Medical Clinic PLLC 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 RN 1 ACO Participant Representative N/A
Dunwoody David 1 Medicare Beneficiary Representative N/A

Key ACO Clinical and Administrative Leadership:

 Keith Fernandez  ACO Executive
 Keith Fernandez  Medical Director
 Dana Fields  Compliance Officer
 Tiffany Johnson  Quality Assurance/Improvement Officer

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 – 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

  • First Agreement Period
    • Performance Year 2018, $4,203,425

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%

Quality Performance Results

2018 Quality Performance Results:

ACO# Measure Name  Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 84.44 86.14
ACO-2 CAHPS: How Well Your Providers Communicate 92.44 93.93
ACO-3 CAHPS: Patients’ Rating of Provider 90.78 92.45
ACO-4 CAHPS: Access to Specialists 82.31 81.50
ACO-5 CAHPS: Health Promotion and Education 59.61 59.26
ACO-6 CAHPS: Shared Decision Making 60.94 61.94
ACO-7 CAHPS: Health Status/Functional Status 71.69 73.35
ACO-34 CAHPS: Stewardship of Patient Resources 34.61 26.26
ACO-8 Risk Standardized, All Condition Readmission 15.20 14.98
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 18.58 18.59
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 33.38 37.01
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 76.00 76.75
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 57.96 59.00
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.91 1.98
ACO-11 Use of Certified EHR Technology 98.26 98.20
ACO-12 Medication Reconciliation Post-Discharge 93.38 85.91
ACO-13 Falls: Screening for Future Fall Risk 73.60 79.73
ACO-44 Use of Imaging Studies for Low Back Pain 60.00 64.36
ACO-14 Preventive Care and Screening: Influenza Immunization 67.31 72.71
ACO-15 Pneumonia Vaccination Status for Older Adults 64.00 75.97
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 62.60 76.83
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 65.22 72.81
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 47.12 66.74
ACO-19 Colorectal Cancer Screening 60.15 68.27
ACO-20 Breast Cancer Screening 53.13 71.96
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 79.13 81.47
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 16.47 15.51
ACO-41 Diabetes: Eye Exam 34.12 52.42
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 69.69 73.10
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 80.08 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.

Note:- In the Quality Performance Results file(s) above, search for “PQN – Georgia, LLC” or “Privia Quality Network of Georgia” to view the quality performance results. This ACO can also be found by using the ACO ID A3236 in the public use files on data.cms.gov.

Payment Rule Waivers

  • No, our ACO does not use the SNF 3-Day Rule Waiver.