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).
ACO Name and Location
Accountable Care Medical Group of Florida, Inc.
Previous Names: N/A
6355 NW 36 Street
Suite 604
Virginia Gardens, FL, FL 33166
ACO Primary Contact
|
Primary Contact Name |
Ms. Chris Pertierra |
|
Primary Contact Phone Number |
786-427-1037 |
|
Primary Contact Email Address |
CPertierra@ACMGroupFL.com |
Organizational Information
ACO participants:
|
ACO Participants |
ACO Participant in Joint Venture (Enter Y or N) |
|
Gilberto Jimenez MD, Inc. |
N |
|
Med-Care Medical Center Inc |
N |
|
Singleton Health Center LLC |
N |
|
Comprehensive Medical Access (CMA), Inc. |
N |
|
Ivan Castano |
N |
|
Erica O Donnell |
N |
|
DEERFIELD MEDICAL GROUP LLC |
N |
|
Grace Medical Group |
N |
|
Lawrence A. Adjei, Apmc |
N |
|
ATLANTA PRIMARY CARE PEACHTREE, PC |
N |
|
Edwin Herrera, M.D., P.A. |
N |
|
Kumar Ravi Md Facc Pc. |
N |
|
STEVEN D CORK D.O. PL |
N |
|
Marion Heart Center, P.A |
N |
|
VOLUSIA MEDICAL CENTER LLC |
N |
|
Ronald Johnson |
N |
|
Family Practice of Jeffersonville LLC |
N |
|
Jeffersonville Family And Geriatric Medicine LLC |
N |
|
Little Havana Activities & Nutrition Center Of Dade County, Inc. |
N |
|
Green Neal |
N |
|
Gregory Singleton |
N |
|
Addison Mizner Medical LLC |
N |
|
A PRESTIGE WELLNESS CENTER PA |
N |
|
EFFINGHAM MEDICAL PARTNERS, LLC |
N |
|
Bertha Olazabal MD |
N |
|
Marc S. Rabinowitz, M.D., P.C. |
N |
|
COULTER CLINIC |
N |
|
Royal Care Medical Center, Inc. |
N |
|
Oph Medical |
N |
|
Eugenio Menendez, D.O., P.A. |
N |
|
JOSEFINA LOZANO, MD, PLLC |
N |
|
Medical Center of Santee LLC |
N |
|
ORMOND INTERNAL MEDICINE LLC |
N |
|
Craig Miller |
N |
|
Charles Raine |
N |
|
Virgilio Del Pino MD, P.A. |
N |
|
Herrera Medical Center, LLC |
N |
|
Nano Health Associates, L.L.C. |
N |
|
BAYVIEW MEDICAL LLC |
N |
|
Albert Humphrey, MD |
N |
|
Carl I Mitchell MD PA |
N |
|
Orangeburg Family Physicians, P.A. |
N |
|
CAMPBELL FAMILY PRACTICE |
N |
|
Orangeburg Medical Associates, P.A. |
N |
|
JUAN BARROSO |
N |
|
Fernando De La Cruz |
N |
|
Steven Fields, M.D. P.A. |
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 |
|
Ramon M Garciaseptien Pa |
N |
|
Diagnostic Clinic Medical Group, Inc. |
N |
|
RAYPAR, Inc. |
N |
|
ADULT MEDICINE OF LAKE COUNTY INC |
N |
|
CARLOS L DOMINGUEZ MD PA |
N |
|
SANTEE FAMILY MEDICAL CENTER, INC. |
N |
|
CENTRAL FLORIDA MEDICAL ASSOCIATES, 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 |
|
Miguel A. Chamah, M.D., P.A. |
N |
|
Julian Marquez Md Pa |
N |
|
Ramiro Coro, M.D., P.A. |
N |
|
Central Medical Group, P.A. |
N |
|
Dr. Jorge Travieso, M.D., P.A. |
N |
|
Carlos Delgado MD PA |
N |
|
Ramses Vega, M.D., P.A. |
N |
|
Angel's Medical Company |
N |
|
Jose David Suarez, M.D., P.A. |
N |
|
Project Access Foundation, Inc. |
N |
|
MCV Investment, Inc. |
N |
|
Integral Medicine Group Inc |
N |
|
Agustin Martinez, M.D., P.A. |
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 |
|
Seneca Healthcare District |
N |
ACO Governing Body:
|
Member |
Member's Voting Power – Expressed as a percentage or number |
Membership Type |
ACO Participant 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 Participant and Voting Member |
South Dade Primary Care |
|
Mac Williams, MD |
Grisel |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Grisel Mac Williams, M.D., P.A. |
|
Leung, MD |
Gilbert |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Gilbert Leung, M.D., P.A. |
|
Menendez, MD |
Eugenio |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Eugenio Menendez, D.O., P.A. |
|
Zeiger |
Sandi |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Central Medical Group, P.A. |
|
Hernandez |
Dr. Humerto |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Integral Medicine Group Inc |
|
Singleton |
Monnie |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Singleton Health Center, LLC |
|
Rojas, MD |
Michelle |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Grace Medical Group
|
|
Adjei, MD |
Lawrence |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Lawrence A. Adjei, Apmc |
|
Olazabal, MD |
Bertha |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Bertha Olazabal, MD |
|
Marquez, MD |
Julian |
Board Member |
1 of 16 Votes |
ACO Participant and Voting Member |
Julian Marquez MD |
|
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 |
ACO Participant and Voting Member |
ACO Beneficiary Representative |
Key ACO clinical and administrative leadership:
|
Chris Pertierra |
ACO Executive |
|
Jose Suarez |
Medical Director |
|
Manuel Lopez |
Compliance Officer |
|
Susan Fernandez |
Quality Assurance/Improvement Officer |
Associated committees and committee leadership:
|
Committee Name |
Committee Leader Name and Position |
|---|---|
|
Executive and Fianance |
Chris Pertierra, Chair |
|
Information and Technology |
Caridad Heidys Rodriguez, Chair |
|
Medical Standards and Quality |
Dr. Jose David Suarez, Chair |
|
Compliance Officer |
Manuel Lopez, JD, Chair |
|
Preventive Health |
Susan Fernandez, Chair |
Types of ACO participants, or combinations of participants, that formed the ACO:
- ACO professionals in a group practice arrangement
Shared Savings and Losses
Amount of Shared Savings/Losses
- 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
- 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
Quality Performance Results:
| 2019 Quality Performance Results: | ||
| ACO# | Measure Name | Rate |
| ACO-1 | CAHPS: Getting Timely Care, Appointments, and Information | 85.56 |
| ACO-2 | CAHPS: How Well Your Providers Communicate | 91.48 |
| ACO-3 | CAHPS: Patients’ Rating of Provider | 89.4 |
| ACO-4 | CAHPS: Access to Specialists | 81.37 |
| ACO-5 | CAHPS: Health Promotion and Education | 59.75 |
| ACO-6 | CAHPS: Shared Decision Making | 55.97 |
| ACO-7 | CAHPS: Health Status/Functional Status | 70.79 |
| ACO-34 | CAHPS: Stewardship of Patient Resources | 25.04 |
| ACO-45 | CAHPS: Courteous and Helpful Office Staff | 89.83 |
| ACO-46 | CAHPS: Care Coordination | 84.83 |
| ACO-8 | Risk Standardized, All Condition Readmission | 15.15 |
| ACO-38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 51.42 |
| ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91) | 1.78 |
| ACO-13 | Falls: Screening for Future Fall Risk | 85.33 |
| ACO-14 | Preventive Care and Screening: Influenza Immunization | 65.76 |
| ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 94.12 |
| ACO-18 | Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan | 87.45 |
| ACO-19 | Colorectal Cancer Screening | 76.23 |
| ACO-20 | Breast Cancer Screening | 82.21 |
| ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 81.09 |
| ACO-27 | Diabetes Mellitus: Hemoglobin A1c Poor Control | 27.14 |
| ACO-28 | Hypertension (HTN): Controlling High Blood Pressure | 73.7 |
| ACO-40 | Depression Remission at 12 months | - |
- 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).
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