ACO Name and Location

Doctors ACO, LLC
2005 Prince Avenue
Athens, Georgia 30606

ACO Primary Contact

Primary Contact Name

Amy Thompson

Primary Contact Phone Number

678-231-8056

Primary Contact Email Address

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Organizational Information

ACO participants:

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

SARAH V. MCBEE, M.D., P.C.

N

East Metro Internal Medicine

N

Ugochukwu Nwokoro

N

Madison Family Medicine, LLP

N

Athens Gastroenterology Center,Pc

N

Angella Samuels

N

Ramanjaneyulu Dronavalli

N

Oza & Oza MDs Inc

N

Pankaj Kumar, M.D., LLC

N

SUSAN LEIGH JONES MD LLC

N

Progressive Internal Medicine, Inc.

N

Beena S Patel,Md, Pc

N

Frank J Dipalma Dpm Ltd

N

Anil Desai

N

Pamela Hall

N

Gary Kinsey

N

George Cleland

N

Commerce Adult And Pediatrics Medicine

N

Faith Healthcare Services, Inc.

N

Tmb Medical Associates, P.C.

N

Anil H. Jhangiani M.D., LLC

N

MANAN I. SHAH, MD, PC

N

ATLANTA MEDICAL AND AESTHETIC CENTER INC.

N

WALTON PULMONARY & SLEEP MEDICINE PC

N

Daniel Whitmer

N

Ronald Kahn

N

Mound Family Practice Assoc Inc

N

Clem Kirkland, M.D., Inc.

N

Ronald Kahn

N

Beavercreek Family Care Associates, LTD.

N

North Georgia Nephrology Consultants Llc

N

N. Agrawal, M.D., PC.

N

Beena Patel

N

MADISON MEDICAL ASSOCIATES, P.C

N

Rohit Desai

N

Arthritis & Rheumatology Center, PC

N

HEALTH ASSOCIATES OF GEORGIA, INC.

N

ATHENS MEDICAL ASSOCIATES, P.C.

N

MIGUEL E. COSSIO, MD PC

N

ATHENS NEIGHBORHOOD HEALTH CENTER INC

N

R.V. Dronavalli, M.D., P.C.

N

Atlanta Prime Med

N

GEORGIA CLINIC, P.C.

N

Rohit Desai

N

Athens Family Medicine, Inc

N

Dr. B. Abraham, PC

N

Maysville Family Practice, Inc

N

Magnolia Medical Clinic, Pc

N

Rockdale Newton Hematology Oncology

N

Athens Heart Center

N

PRINCE AVENUE PRIMARY CARE, L.L.C.

N

Elbert County Internal Medicine Llc

N

Jing Dong, M.D. PC

N

Sreeroop Sen MD LLC

N

Center For Family Medicine, LLC

N

Pamela Hall, MD PC

N

Dayton Internal Medicine Clinic, Inc.

N

Gwinnett Digestive Clinic

N

Our Family Health Center

N

 

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

Agrawal

Subodh

Chairman/President

1

ACO participant representative

Athens Heart Center

Haver

Paul

Vice Chairman/Chief Medical Officer

1

ACO participant representative

Athens Family Medicine, Inc

Shah

Manan

Treasurer/Compliance Officer

1

ACO participant representative

Manan I. Shah, MD, PC

Desai

Rohit

Secretary

1

ACO participant representative

Rohit Desai/DBA Stone Mountain Family Medicine

Cossio

Miguel

Physician

1

ACO participant representative

Miguel E. Cossio, MD PC

Parikh

Naresh

Physician

1

ACO participant representative

Georgia Clinic, P.C.

Indrakrisnan

Indran

Physician

1

ACO participant representative

Gwinnett Digestive Clinic

Bansal

Rajendra

Physician

1

Community Stakeholder representative

Community Stakeholder representative

Beacham

Ronald

Medicare Beneficiary

1

Medicare beneficiary representative

Medicare beneficiary representative

 

Key ACO Clinical and Administrative Leadership:

David Klebonis

ACO Executive

Paul Haver

Medical Director

Louis Morgenier

Compliance Officer

David Klebonis

Quality Assurance/Improvement Officer

 

Associated Committees and Committee Leadership:

Committee Name

Committee Leader Name and Position

Board of Managing Members

Dr. Subodh Agrawal, Chairman

Executive Committee

Dr. Rajendra Bansal, Chairman

Medical Committee

Dr. Paul Haver, Medical Director/Chairman

Health Analytics and Policy/Quality Improvement Committee

Dr. Naresh Parikh, Chairman

Compliance/Performance/Quality/Audit & Risk Management Committee

Mr. David Klebonis, Chairman

Physician Engagement and Continuing Education Committee

Dr. Rohit Desai, Chairman

Patient Engagement and Education Committee

Dr. Paul Haver, Chairman

Shared Savings, Finance, and Compensation Committee

Dr. Rajendra Bansal, Chairman

Information Technology Committee

Dr. Rohit Desai, Chairman

 

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
  • Federally Qualified Health Center (FQHC)
  • Rural Health Clinic (RHC)

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2016, $4,177,582
    • Performance Year 2015, $0

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2016
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 30%
      • Proportion of distribution to ACO participants: 40%
    • Performance Year 2015
      • 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

2016 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

78.15

79.9

ACO-2

CAHPS: How Well Your Providers Communicate

92.73

92.63

ACO-3

CAHPS: Patients' Rating of Provider

90.36

91.93

ACO-4

CAHPS: Access to Specialists

89.05

83.52

ACO-5

CAHPS: Health Promotion and Education

59.83

60

ACO-6

CAHPS: Shared Decision Making

78.59

75.28

ACO-7

CAHPS: Health Status/Functional Status

70.79

71.82

ACO-34

CAHPS: Stewardship of Patient Resources

35.26

27.52

ACO-8

Risk-Standardized, All Condition Readmission

14.6

14.7

ACO-35

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

16.33

18.17

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

45.71

53.2

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

65.09

75.23

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

48.42

59.81

ACO-9

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

10.69

9.27

ACO-10

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

11.21

14.53

ACO-11

Percent of PCPs who Successfully Meet Meaningful Use Requirements

55.56

82.72

ACO-39

Documentation of Current Medications in the Medical Record

95.44

87.54

ACO-13

Falls: Screening for Future Fall Risk

69.33

64.04

ACO-14

Preventive Care and Screening: Influenza Immunization

73.77

68.32

ACO-15

Pneumonia Vaccination Status for Older Adults

60.13

69.21

ACO-16

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

90.15

74.45

ACO-17

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

95.97

90.98

ACO-18

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

66.27

53.63

ACO-19

Colorectal Cancer Screening

60.42

61.52

ACO-20

Breast Cancer Screening

62.99

67.61

ACO-21

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

95.59

76.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

75.46

77.72

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

18.33

18.24

ACO-41

Diabetes: Eye Exam  

46.64

44.94

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

70.5

70.52

ACO-30

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

90.95

85.05

ACO-31

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

96.72

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%)

86.52

79.67

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.  

Note: In the Quality Performance Results file(s) above, search for “Doctors ACO, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A81088 in the public use files on data.cms.gov.

Payment Rule Waivers

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

REQUIRED PUBLIC DISCLOSURE FOR THE ACO PARTICIPATION WAIVER

Doctors ACO, LLC is a Medicare Shared Savings Program ACO. The Secretary of the Department of Health and Human Services has provided four waivers of federal fraud and abuse laws in connection with the Medicare Shared Savings Program. The Doctors ACO, LLC Board of Directors has made a bona fide determination that an arrangement with Quest Diagnostics Incorporated as described below is reasonably related to the purpose of the Medicare Shared Savings Program, and has authorized such arrangement. The collaboration is related to the purposes of the Medicare Shared Savings Program because it promotes accountability for the quality, cost and overall care for a Medicare population by managing and coordinating care for Medicare beneficiaries, and encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for Medicare beneficiaries. Specifically, Doctors ACO, LLC is seeking ACO Participation Waiver protection for its arrangement with Quest Diagnostics Incorporated for a grant to:

  • Promote evidence-based medicine and patient engagement
  • Meet the requirements for reporting quality and cost measures coordinating care
  • Establish clinical and administrative systems
  • Meet the clinical integration requirements of the Medicare Shared Savings Program
  • Evaluate the health needs of the ACO’s aligned population
  • Communicate clinical knowledge and evidence-based medicine to Medicare beneficiaries
  • Develop standards for beneficiary access and communication, including beneficiary access to medical records

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