ACO Name and Location:

Accountable Care Medical Group of FL, Inc.

6355 NW 36th St, Suite 604, Virginia Gardens, FL 33166

ACO Primary Contact:

Ms. Chris Pertierra T: 786-427-1037 E-mail: Cpertierra@Acmgroupfl.com

Organizational Information:

ACO Participants:

 

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Grace Medical Group

N

Lawrence A. Adjei, Apmc

N

Edwin Herrera, M.D., P.A.

N

T A Medical Group, Inc

N

Little Havana Activities & Nutrition Center Of Dade County, Inc.

N

Green Neal

N

Addison Mizner Medical LLC

N

Francisco Gonzalez Abreu MD

N

Bertha Olazabal MD

N

COULTER CLINIC

N

Eugenio Menendez, D.O., P.A.

N

Manuel D. Gonzalez, MD PA

N

Charles Raine

N

Florida Doctors Group Corp

N

Albert Humphrey, MD

N

Carl I Mitchell MD PA

N

Gregory Singleton

N

Orangeburg Medical Associates, P.A.

N

John A Glenn Jr Center For Community Healthcare Inc

N

Jorge Barbeito

N

Maria Llopiz

N

Manuel Perez-Espinosa MD PA

N

John R. Parnell M.D., P.A.

N

David L. Berndt, D.O., P.A.

N

Francisco J. Mora MD PA

N

Renato Dominguez, MD

N

Ramon M Garciaseptien Pa

N

Orlando Heart Specialist, P.A.

N

RAYPAR, Inc.

N

SANTEE FAMILY MEDICAL CENTER, INC.

N

Francisco Miranda, M.D. P.A.

N

Doctor's Medical Center, Inc

N

Grisel Mac Williams, M.D., P.A.

N

Physicians Associates, P.A.

N

Hammock Medical Center Inc

N

John Bancroft Hylton Pa

N

South Dade Primary Care

N

Gilbert Leung, M.D., P.A.

N

Salah Amer M.D., PA

N

Royal Palm Health Center, Inc.

N

Julian Marquez Md Pa

N

Central Medical Group, P.A.

N

Rogelio J. Zaldivar, M.D., P.A.

N

Ramses Vega, M.D., P.A.

N

Angel's Medical Company

N

H & T Benazet, M.D., P.A.

N

Jose David Suarez, M.D., P.A.

N

MCV Investment, Inc.

N

Integral Medicine Group Inc

N

Palmetto Bay Medical Center, Inc.

N

Pro Care Health Center, Inc

N

Juvenal E. Martinez, M.D., P.A.

N

Rios Medical Center, Inc.

N

Susan Fox, D.O., P.A.

N

Waldo Acebo, M.D., P.A.

N

First Harbour Medical Centers, LLC

N

Augustin Martinez M.D., P.A.
N
Barbara M. Muina M.D. P.A. 
N
Gilberto Jimenez MD, Inc. 
N
Jeffrey A Loman MD, PA
N
Carlos Delgado MD PA
N
Ivan D Castano MD
N
Med-Care Medical Center Inc
N
Dr. Jorge Travieso MD PA
N
Mobile Practioner Services To You, Inc
N
Nano Health Associates, LLC
N
Orangeburg Family Physicians, P.A.
N
Ramiro Coro, M.D., P.A.
N
Steven Fields, M.D., P.A. 
N
Virgilio Del Pino, MD
N
Royal Care Medical Center, Inc.
N
Miguel Chamah, M.D., P.A.
N
Bayview Medical, LLC
N
Singleton Health Center, LLC. 
N
Medical Center Of Santee LLC
N
Herrera Medical Center, LLC
N
Fernando De La Cruz MD
N
Diagnostic Clinic Medical Group
N
Project Access Foundation, Inc
N
Comprehensive Medical Access, Inc.
N
Ronald L. Johnson M.D.
N
Seneca Healthcare District
N
Juan Carlos Rey M.D., P.A. 
N
Craig A. Miller D.O.
N
Dr. Erica L. O'Donnell, D.O.
N
Specialists of Ocala, LLC.
N
SMC Medical Center
N
Primecare Family Health Centers, Inc.
N
Christopher Yuvienco
N
Optimum Point of Care
N
Marion Heart Center, P.A
N
OPH Medical
N
Kumar Ravi Md Faac Pc (Arizona Heart Specialist) 
N

 

 

ACO Participants in joint venture with ACO professionals and Hositals:


No participants are involved in a joint venture between ACO professionals and Hospitals.

ACMG ACO Governing Body (Voting Members):
 

ACO governing body:

Member

Member's Voting Power

Membership Type

ACO Participant TIN Legal Business Name/DBA, if Applicable

Last Name

First Name

Title/Position

Pertierra

Chris

CEO and Board Chair

1 of 16 Votes

Voting Member

ACMG

Suarez, MD

Jose

CMO and Board Member

1 of 16 Votes

ACO Participant and Voting Member

Jose David Suarez, M.D., P.A.

Leon, MD

Ramon

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

South Dade Primary Care

Mac Willaims, MD

Grisel

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

Grisel Mac Williams, M.D., P.A.

Leung, MD

Gilbert

Borad Member

1 of 16 Votes

ACO Partcipant and Voting Member

Gilbert Leung, M.D., P.A.

Menendez, MD

Eugenio

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

Eugenio Menendez, D.O., P.A.

Zeiger

Sandy

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

Central Medical Group, P.A.

Romanello

Bruce

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

First Harbour Medical Centers, LLC

Singleton

Monnie

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

Singleton Health Center, LLC

Herrera, MD

Edwin

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

Edwin Herrera, M.D., P.A.

Adjei, MD

Lawrence

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

Lawrence A. Adjei, Apmc

Olazabal, MD

Bertha

Board Member

1 of 16 Votes

ACO Partcipant and Voting Member

Bertha Olazabal, MD

Marquez, MD

Julian

Board Member

1 of 16 Votes

ACO Participant and Voting Member

Julian Marquez MD PA

Martinez, MD

Juvenal

Board Member

1 of 16 Votes

ACO Participant and Voting Member

Juvenal Martinez MD PA

Miranda, MD

Francisco

Board Member

1 of 16 Votes

ACO Participant and Voting Member

Francisco Miranda MD PA

Sternberg

Fred

Board Member

1 of 16 Votes

Voting Member

ACO Beneficiary Representative


Key Leadership Personnel:

 

Chris Pertierra

ACO Executive

Jose Suarez

Medical Director

Manuel Lopez

Compliance Officer

Susan Fernandez

Quality Assurance/Improvement Officer

 

ACO Committees:

Committee Name

Committee Leader Name and Position

Executive and Finance

Chris Pertierra, Chair

Information and Technology

Bruce Romanello, Chair

Medical Standards and Quality

Dr. Jose David Suarez, Chair

Compliance

Manuel Lopez, JD, Chair

Post-Acute and Care Coordindation

Alex Sino, PhD, Chair

Preventive Health

Susan Fernandez, Chair




Identification of the types of ACO Participants or Combinations of Participants in the ACO Composition:

1. We are a network of individual practices of ACO professionals.

Amount of Shared Savings/Losses:

  • Agreement Period Beginning In 2014, 
    • Performance Year 2014: "$0"
    • Performance Year 2015: "$4,117,479"
    •  Performance Year 2016: "3,422,384"

Shared Savings Distribution:

  • Agreement Period Beginning In 2014

 Performance Year 2016: 

  • Proportion Invested in Infrastructure: 23%
  • Proportion invested in Redesigned care processes/resources: 27%
  • Proportion of Distribution to ACO participants: 50%



 Performance Year 2015: 

  • Proportion Invested in Infrastructure: 40%
  • Proportion invested in Redesigned care processes/resources: 10%
  • Proportion of Distribution to ACO participants: 50%


Performance Year 2014:

  • Proportion Invested in Infrastructure: N/A
  • Proportion invested in Redesigned care processes/resources: N/A
  • Proportion of Distribution to ACO participants: N/A

 

Payment Rule Waivers:

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

Quality Performance Results:

 

2016 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

76.91

79.9

ACO-2

CAHPS: How Well Your Providers Communicate

94.22

92.63

ACO-3

CAHPS: Patients' Rating of Provider

91.31

91.93

ACO-4

CAHPS: Access to Specialists

83.88

83.52

ACO-5

CAHPS: Health Promotion and Education

60.41

60

ACO-6

CAHPS: Shared Decision Making

73.79

75.28

ACO-7

CAHPS: Health Status/Functional Status

68.61

71.82

ACO-34

CAHPS: Stewardship of Patient Resources

33.96

27.52

ACO-8

Risk-Standardized, All Condition Readmission

15.71

14.7

ACO-35

Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)

19.73

18.17

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

49.7

53.2

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

78.32

75.23

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

60.61

59.81

ACO-9

Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)

11.81

9.27

ACO-10

Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 )

15.69

14.53

ACO-11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

47.83

82.72

ACO-39

Documentation of Current Medications in the Medical Record

67.06

87.54

ACO-13

Falls: Screening for Future Fall Risk

37.05

64.04

ACO-14

Preventive Care and Screening: Influenza Immunization

23.32

68.32

ACO-15

Pneumonia Vaccination Status for Older Adults

5.72

69.21

ACO-16

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up

77.8

74.45

ACO-17

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

83.88

90.98

ACO-18

Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan

16.2

53.63

ACO-19

Colorectal Cancer Screening

25.91

61.52

ACO-20

Breast Cancer Screening

39.84

67.61

ACO-21

Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented

80.26

76.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

77.23

77.72

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

32.22

18.24

ACO-41

Diabetes: Eye Exam  

13.13

44.94

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

59.52

70.52

ACO-30

Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

92.64

85.05

ACO-31

Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

90.35

88.67

ACO-33

Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)

85.9

79.67



Table 3. 2015 Quality Performance Results Table

Table 4. 2012-2014 Quality Measure Reporting

    Contact Information

6355 NW 36th St. Suite 604
Virginia Gardens, FL 33166

Phone: 305-400-4849

Data@AcmgroupFL.com

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Copyright 2015 Accountable Care Medical Group of Florida, Inc. For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048.