ACO Name and Location                                

Bethesda Health Quality Alliance, LLC

dba Baptist Health Quality Network ACO

2815 South Seacrest Boulevard

Boynton Beach, FL 33435

 

ACO Primary Contact

  Hugo Elias

  (786) 308-2606

  Hugo.Elias@baptisthealth.net

 

Organizational Information

ACO Participants:

ACO Participants

ACO Participant in Joint Venture

Adel M. Sidky, M.D., P.A.

No

Anil G. Verma, M.D., F.A.C.C., P.A.

No

Ayman L. Atallah, M.D., Corp.

No

Boynton Beach Endocrinology, P.A.

No

Cardiology Associates of South Florida, P.A.

No

Daniel Heart & Vascular Center, P.A.

No

Gregory S. Weatherford, M.D., Inc.

No

Ira Martin Fine, M.D.,P.A.

No

J L Styperek, M.D., P.A.

No

Marie C. Tromans, M.D., P.A.

No

Mario Masserano, M.D., P.A.

No

Metropolitan Neurology, Inc.

No

Nevine M. Carp, M.D., P.A.

No

Om Singh Medical Center, Inc.

No

Pulmonary Specialists of Boynton Beach, Inc.

No

Pulmonology & Sleep Center, LLC

No

Sameer Verma, M.D., P.A.

No

Seema S. Verma, M.D., P.A.

No

South Palm Cardiovascular Associates, Inc.

No

Stuart A. Rubin, M.D., P.A.

No

BocaCare

No

Bethesda Health Physician Group

No

Bethesda Hospital

No

Baptist Health Medical Group Upper Keys

No

Baptist Health Medical Group Physicians

No

ACO Governing Body:

Member

Last Name

Member

First Name

Member

Title/Position

Member's Voting Power (Expressed as a percentage or number)

Membership Type

ACO Participant Legal Business Name and D/B/A, if applicable

Sheehan

Michael

Associate Chief Population Health Officer

12.5%

Active

Bethesda Health Quality Alliance, LLC dba Baptist Health Quality Network ACO

Malias

Pete

VP – Finance - Treasurer

12.5%

Active

Bethesda Health Quality Alliance, LLC dba Baptist Health Quality Network ACO

Cervera

Milady

Systems Operations – Secretary

12.5%

Active

Bethesda Health Quality Alliance, LLC dba Baptist Health Quality Network ACO

Vazquez

Jose L.

System Manager

12.5%

Active

Bethesda Health Quality Alliance, LLC dba Baptist Health Quality Network ACO

Fine

Ira

Independent Physician Manager

12.5%

Consulting

Bethesda Health Quality Alliance, LLC dba Baptist Health Quality Network ACO

Atallah

Aymen

Physician Manager – Vice Chair

12.5%

Consulting

Bethesda Health Quality Alliance, LLC dba Baptist Health Quality Network ACO

Victorica

Carlos

Employed Physician Manager – Chairperson

12.5%

Active

Bethesda Health Quality Alliance, LLC dba Baptist Health Quality Network ACO

Kranys

Rudy

Community Member

12.5%

Active

Bethesda Health Quality Alliance, LLC dba Baptist Health Quality Network ACO

 

Key ACO Clinical and Administrative Leadership:

ACO Executive: Hugo Elias

Medical Director: Michael Sheehan, M.D.

Compliance Officer: Beth Gillis

Quality Assurance/Improvement Officer: Michael Sheehan, M.D.

Shared Savings and Losses

Amount of Shared Savings/Losses:

First Agreement Period

  • Performance Year 2020, $2,522,487.00
  • Performance Year 2019, $0
  • Performance Year 2018, $0

Shared Savings Distribution:

First Agreement Period

  • Performance Year 2020
    • Proportion invested in infrastructure: 15%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 70%
  • Performance Year 2019 – N/A
    • Proportion invested in infrastructure: 0%
    • Proportion invested in redesigned care processes/resources: 0%
    • Proportion of distribution to ACO participants: 0%
  • Performance Year 2018 – N/A
    • Proportion invested in infrastructure: 0%
    • Proportion invested in redesigned care processes/resources: 0%
    • Proportion of distribution to ACO participants: 0%

Quality Performance Results

2020 Quality Performance Results:

 

ACO Quality Measure Number

Measure Name

Rate

ACO Mean

ACO-43

Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))

0.90

0.95

ACO-13

Falls: Screening for Future Fall Risk

83.18

84.97

ACO-14

Preventative Care and Screening: Influenza Immunization

74.87

76.03

ACO-17

Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention

85.19

81.67

ACO-18

Preventative Care and Screening: Screening for Depression and Follow-Up Plan

76.56

71.46

ACO-19

Colorectal Cancer Screening

71.45

72.59

ACO-20

Breast Cancer Screening

85.76

74.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

92.28

83.37

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

13.13

14.70

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

78.74

72.87

 

“Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.”

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

Payment Rule Waivers

  • Waiver for Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.