UMass Memorial Medicare Accountable Care Organization (ACO)
Our doctors work hard to provide you with high-quality care, but it can be a challenge to manage all of patients’ health care needs and information. That’s why we have developed the UMass Memorial Medicare Accountable Care Organization (ACO).
An ACO is a group of doctors, hospitals and health care providers that work together to provide you with better, more coordinated care. Our doctors and hospitals in the UMass Memorial ACO communicate with you and with each other to make sure that you get the care you need when you’re sick and the support you need to stay healthy and well.
UMass Memorial ACO Focuses on Quality Care
Participating in the Medicare ACO is our commitment to providing the Worcester and Central Massachusetts region with quality, personalized and innovative care. Our Medicare ACO leverages our resources to focus on providing Medicare patients (also called Medicare Fee-for-Service beneficiaries) with the best possible experience of timely, appropriate and high-quality health care services.
- Providing personalized care coordination services across the health continuum
- Facilitating more effective physician visits and communication among your doctors and providers
- Providing you with targeted health information and wellness programs that focus on disease prevention
- Helping you coordinate timely appointments, manage medications and determine appropriate follow-up care
- Improving the efficiency of your health care
Learn more below, or call our toll-free number at 844-549-0213.
For additional resources: Please visit www.medicare.gov or call 800-MEDICARE (800-633-4227 or (TTY users should call 877-486-2048)) for general questions or additional information about Accountable Care Organizations.
Beneficiary Notices:
ACO Name and Location
UMASS Memorial Accountable Care Organization, INC.
One Biotech Park
365 Plantation Street, 3rd Floor
Worcester, MA 01605
ACO Primary Contact
|
Anthony Berry |
|
(508) 793-5394 |
Organizational Information
ACO Participants:
|
ACO Participants |
ACO Participant in Joint Venture |
|
Vasuki Radhakrishnan |
N |
|
Primary Physician Partners |
N |
|
Raymond Sauls |
N |
|
Marlboro Internal Medicine, PC |
N |
|
Kevin Delacey |
N |
|
Deborah Sullivan |
N |
|
Paul Dufault |
N |
|
Glen Bombardier |
N |
|
William Dunn |
N |
|
Elizabeth Erban |
N |
|
Zbigniew Dombek, M.D. |
N |
|
Steven Rozak |
N |
|
John Howland |
N |
|
Edwin Young |
N |
|
HUGH COOPER |
N |
|
UMass Memorial Health Care, Inc., HealthAlliance Hospitals, Inc. |
N |
|
Harrington Memorial Hospital, Inc. |
N |
|
Henry Heywood Memorial Hospital |
N |
|
Marlborough Hospital Corp |
N |
|
Athol Memorial Hospital |
N |
|
Family Health Center of Worcester, Inc. |
N |
|
Charles A. Birbara, M.D. |
N |
|
Wachusett Radiology Inc |
N |
|
Edward M. Kennedy Community Health Center, Inc. |
N |
|
Community Healthlink, Inc. |
N |
|
Leominster Medical Associates |
N |
|
Cardiology Internists of Leominster Inc. |
N |
|
Lawrence M Dubuske MD |
N |
|
Associates in Otolaryngology Head and Neck Surgery, P.C. |
N |
|
Wachusett Emergency Physicians, PC. |
N |
|
UMass Memorial Medical Group, Inc. |
N |
|
North Quabbin Family Physicians, PC |
N |
|
Charlton Family Practice |
N |
|
D'Ambrosio Eye Care, Inc. |
N |
|
GREATER BOSTON MEDICAL ASSOCIATES, INC. |
N |
|
Heywood Medical Group, Inc.. |
N |
|
Western Mass Physician Associates, Inc. |
N |
|
UMass Memorial Medical Center, Inc. |
N |
|
Community Health Connections, Inc. |
N |
|
R. Leslie Shelton, M.D., P.C. |
N |
|
Tad Baum, M.D., PC |
N |
|
Family Foot Care Center Pc |
N |
|
Robert Fishman |
N |
|
Benjamin Grajales, M.D. |
N |
|
John Bogdasarian |
N |
|
William Friedman |
N |
|
Vladas Litani, MD |
N |
|
Stephen Weedon |
N |
|
William Brodkin |
N |
|
Harrington Physician Services Inc |
N |
|
Edward Kamens |
N |
|
Urology Central |
N |
|
Boulevard Medical Group Inc |
N |
|
Mercy Family Practice PC |
N |
|
Christopher I Bechara Md Pc |
N |
|
Partners in Internal Medicine, PC |
N |
|
James M. Shenko, M.D., PC |
N |
|
Holyoke Medical Center, Inc. |
N |
|
Heart Rhythm Specialists of Central Massachusetts, PC |
N |
|
Curewell Gastroenterology, PC. |
N |
|
Mass Lung & Allergy PC |
N |
|
New England Hospitalists, PC |
N |
|
Iris Sullivan, M.D., PC |
N |
|
North Worcester Gastroenterology, P.C. |
N |
|
NORTHEAST ALLERGY, ASTHMA & IMMUNOLOGY, PC |
N |
|
Mountain View Family Practice, Pc |
N |
|
Dr. He's Primary Care for Adults Inc. |
N |
|
Vitreo-Retinal Associates PC. |
N |
|
Longview Orthopaedic Center, LLC |
N |
|
Daniel H Ervin, DO, PC |
N |
|
Sturbridge Professional Services, P.c. |
N |
|
Robert Byrne |
N |
|
Aesclepion Healthcare LLC |
N |
|
Tak Medical Group, PC |
N |
|
Richard V. Montilla, MD, PC. |
N |
|
Center for Digestive Wellness PC |
N |
|
Community Neuroscience Services, LLC |
N |
|
Nancy D. Berube, Md Pc |
N |
|
Chair City Family Medicine, PC |
N |
|
Stephen Child |
N |
|
Tricia Vorderstrasse Md Pc |
N |
|
UMass Memorial Radiology Phys Serv |
N |
|
Family Medical & Maternity Care P.C. |
N |
|
Gardner Family Medicine, Inc. |
N |
|
Worcester Eye Consultants, PC |
N |
|
Leominster Dermatology LLP |
N |
|
CRYSTAL LAKE PATHOLOGY PC |
N |
|
MEDPRACTICE PC |
N |
|
CENTMASS IMAGING, INC. |
N |
|
Worcester Physicians and Nurses Services LLC |
N |
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 |
|
Dickson |
Eric |
Chairman |
1 |
ACO Participant Representative |
UMass Memorial Medical Group, Inc.; UMass Memorial Medical Center, Inc. |
|
Greenwood |
John |
President |
1 |
Other - ACO President |
UMass Memorial Accountable Care Organization, Inc. |
|
Kupfer |
Barbara |
Voting Member |
1 |
Medicare Beneficiary Representative |
N/A |
|
Tosi, MD |
Stephen |
Voting Member |
1 |
ACO Participant Representative |
UMass Memorial Medical Group, Inc. |
|
Gustafson |
Michael |
Voting Member |
1 |
ACO Participant Representative |
UMass Memorial Medical Center, Inc. |
|
Brown |
Douglas |
Voting Member |
1 |
ACO Participant Representative |
Marlborough Hospital Corp.; UMass Memorial Health Care, Inc., HealthAlliance Hospitals, Inc. |
|
Twehous |
Debra |
Voting Member |
1 |
ACO Participant Representative |
UMass Memorial Medical Group, Inc |
|
Corbett, MD |
William |
Voting Member |
1 |
ACO Participant Representative |
UMass Memorial Medical Group, Inc. |
|
Kerrigan |
Stephen |
Voting Member |
1 |
ACO Participant Representative |
Edward M. Kennedy Community Health Center, Inc. |
|
Reidy |
Jennifer |
Voting Member |
1 |
ACO Participant Representative |
UMass Memorial Medical Group, Inc. |
|
Matta |
Lalita |
Voting Member |
1 |
ACO Participant Representative |
Lalita Matta MD |
|
Fishman |
Robert |
Voting Member |
1 |
ACO Participant Representative |
Robert Fishman, DO |
|
Aiello |
Francesco |
Voting Member |
1 |
ACO Participant Representative |
UMass Memorial Medical Group, Inc. |
|
Eisenstock |
Jordan |
Voting Member |
1 |
ACO Participant Representative |
UMass Memorial Medical Group, Inc |
|
Trainor |
Matthew |
Voting Member |
1 |
ACO Participant Representative |
UMass Memorial Medical Group, Inc |
|
Moore |
Edward |
Voting Member |
1 |
ACO Participant Representative |
Harrington Memorial Hospital, Inc., Harrington Physician Services Inc. |
|
Sweeney |
Francis |
Voting Member |
1 |
ACO Participant Representative |
Heywood Medical Group, Inc., Henry Heywood Memorial Hospital |
Key ACO Clinical and Administrative Leadership:
ACO Executive: John Greenwood
Medical Director: Thomas Scornavacca, DO
Compliance Officer: Jennifer Heil
Quality Assurance/Improvement Officer: Tracey Wilkie
Associated Committees and Committee Leadership:
|
Committee Name |
Committee Leader Name and Position |
|
Finance Committee |
Jeanne Shirshac, Chair |
|
Quality Improvement Committee |
Gertrude Manchester, MD, Chair |
|
Utilization/Care Management Committee |
Thomas Scornavacca, DO, Chair |
|
Compliance Committee |
Jennifer Heil, Chair |
|
Governance Committee |
John Greenwood, Chair |
Types of ACO Participants, or Combinations of Participants, that Formed the ACO:
- ACO professionals in a group practice arrangement
- Hospital employing ACO professionals
- Networks of individual practices of ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses:
- Second Agreement Period
- Performance Year 2019, $0
- Performance Year 2018, $0
- First Agreement Period
- Performance Year 2017, $9,105,746
- Performance Year 2016, $0
- Performance Year 2015, $0
Shared Savings Distribution:
-
Second Agreement Period
-
Performance Year 2019
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2018
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
-
- First Agreement Period
- Performance Year 2017
- Proportion invested in infrastructure: 26%
- Proportion invested in redesigned care processes/resources: 24%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2016
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- 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
- Performance Year 2017
Quality Performance Results
2019 Quality Performance Results:
|
ACO Quality Measure Number |
Measure Name |
Rate |
ACO Mean |
|
ACO-1 |
CAHPS: Getting Timely Care, Appointments, and Information |
87.56 |
85.86 |
|
ACO-2 |
CAHPS: How Well Your Providers Communicate |
94.04 |
94.11 |
|
ACO-3 |
CAHPS: Patients’ Rating of Provider |
92.37 |
92.69 |
|
ACO-4 |
CAHPS: Access to Specialists |
78.65 |
81.54 |
|
ACO-5 |
CAHPS: Health Promotion and Education |
65.08 |
60.44 |
|
ACO-6 |
CAHPS: Shared Decision Making |
58.55 |
62.78 |
|
ACO-7 |
CAHPS: Health Status/Functional Status |
78.02 |
73.79 |
|
ACO-34 |
CAHPS: Stewardship of Patient Resources |
24.93 |
26.17 |
|
ACO-45 |
CAHPS: Courteous and Helpful Office Staff |
94.07 |
92.84 |
|
ACO-46 |
CAHPS: Care Coordination |
86.64 |
86.89 |
|
ACO-8 |
Risk Standardized, All Condition Readmission |
15.75 |
14.86 |
|
ACO-38 |
All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions |
66.04 |
58.15 |
|
ACO-43 |
Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) |
2.13 |
1.87 |
|
ACO-13 |
Falls: Screening for Future Fall Risk |
95.38 |
84.04 |
|
ACO-14 |
Preventive Care and Screening: Influenza Immunization |
70.25 |
74.77 |
|
ACO-17 |
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention |
73.08 |
78.04 |
|
ACO-18 |
Preventive Care and Screening: Screening for Depression and Follow-up Plan |
65.49 |
70.40 |
|
ACO-19 |
Colorectal Cancer Screening |
80.14 |
70.76 |
|
ACO-20 |
Breast Cancer Screening |
80.35 |
73.84 |
|
ACO-42 |
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease |
87.97 |
82.17 |
|
ACO-40 |
Depression Remission at Twelve Months |
1.12 |
13.58 |
|
ACO-27 |
Diabetes: Hemoglobin A1c Poor Control (>9%) |
12.82 |
13.88 |
|
ACO-28 |
Controlling High Blood Pressure |
74.25 |
75.04 |
For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov.
Payment Rule Waivers
- Skilled Nursing Facility (SNF) 3-day Rule Waiver:
- No, our ACO does not use the SNF 3-Day Rule Waiver
- Waiver for Payment for Telehealth Services:
- No, our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613
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