Medicare Shared Savings Program Participation Waiver Notification

The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that may otherwise limit innovations by ACO’s participating in the Medicare Shared Savings Program (“MSSP”). In accordance with the ACO Participation Waivers set forth in 76 Fed. Reg. 67992 (Nov. 2, 2011), Accountable Care Medical Group of Florida, Inc. (“ACMG”) seeks waiver protection for the arrangement described below: 

ACMG participates in the Medicare Shared Savings Program (MSSP) and certain waivers available to it through the MSSP. Specifically, ACMG has utilized the MSSP Participation Waivers in connection with the following program.  ACMG’s governing body made a bona fide determination that the arrangement between ACMG, its Participants and Laboratory Corporation of America Holdings (“LabCorp”) are reasonably related to the purposes of the MMSP.  As part of its efforts to: (1) promote better care for individuals; (2) promote better health for populations; and (3) lower growth expenditures, ACMG has contracted with LabCorp to assist in the implementation and on-going operation of care coordination in general and for the treatment and prevention ACMG’s Medicare beneficiaries with chronic kidney disease.  The care coordination support will help ACMG ACO facilitate its efforts to implement case management and care coordination of its MSSP attributed lives.  As ACMG implements the program across its ACO beneficiary population, ACMG will promote the better health of populations and lower growth expenditures. (76 Fed. Reg. at 68000 and 68002). 

I.     ACO Name and Location

Accountable Care Medical Group of Florida, Inc.
806 South Douglas Road, Suite 700
Coral Gables, FL  33135

II.    ACO Primary Contact

III.   Organizational Information

IV.   ACO Governing Body:

Key ACO clinical and administrative leadership:

Associated committees and committee leadership:

Types of ACO participants, or combinations of participants, that formed the ACO:

• Network of individual practices of ACO professionals

V.    Shared Savings and Losses

Amount of Shared Savings/Losses

Third Agreement Period

• Performance Year 2020 $6,103,788

Second Agreement Period

• Performance Year 2019, $8,816,386
• Performance Year 2018, $4,658,586
• Performance Year 2017, $4,561,189

First Agreement Period

• Performance Year 2016, $3,422,384
• Performance Year 2015, $4,117,497
• Performance Year 2014, $0

Shared Savings Distribution

Third Agreement Period

Performance Year 2020

• Proportion invested in infrastructure: 30%
• Proportion invested in redesigned care processes/resources: 20%
• Proportion of distribution to ACO participants: 50%

Second Agreement Period

Performance Year 2019

• Proportion invested in infrastructure: 30%
• Proportion invested in redesigned care processes/resources: 20%
• Proportion of distribution to ACO participants: 50%

Performance Year 2018

• Proportion invested in infrastructure: 30%
• Proportion invested in redesigned care processes/resources: 20%
• Proportion of distribution to ACO participants: 50%

Performance Year 2017

• Proportion invested in infrastructure: 24%
• Proportion invested in redesigned care processes/resources: 26%
• Proportion of distribution to ACO participants: 50%

First Agreement Period

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

2020 Quality Performance:

Quality Performance Results:

• For Previous Years' Financial and Quality Performance Results, please visit data.cms.gov.

Please note, the ACO-40 Depression Remission at 12 months quality measure is notincluded in public reporting due to low sample size.

Note: In the Quality Performance Results file(s) above, search for “Accountable Care Medical Group of Florida, Inc.” or “ACMG” to view the quality performance results. This ACO can also be found by using the ACO ID A2033 in the public use files on data.cms.gov.

Payment Rule Waivers

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

Beneficiary Incentive Program

• Our ACO did not participate in the Beneficiary Incentive Program (BIP).