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UMass Memorial Medicare Accountable Care Organization (ACO)

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. 

The Health Policy Commission (HPC) Accountable Care Organization (ACO) Certification Program

We are honored to receive ACO Certification from the Massachusetts Health Policy Commission.  This program is designed to accelerate care delivery transformation in Massachusetts and promote a high quality, efficient health system. The purpose of the HPC Accountable Care Organization ACO certification program is to complement existing local and national care transformation and payment reform efforts, encourage value-based care delivery, and promote investments by all payers in high-quality and cost-effective care across the continuum. 

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

   Caryn Sweeney
   508-334-1364
   UMMACOprimarypubliccontact@umassmemorial.org

Organizational Information

ACO Participants:

ACO Participants

ACO Participant in Joint Venture

Aesclepion Healthcare LLC

N

Associates in Otolaryngology Head and Neck Surgery, PC

N

Athol Memorial Hospital, Inc

N

Benjamin Grajales, MD

N

Cardiology Internists of Leominster Inc

N

Center for Digestive Wellness PC

N

Centmass Imaging, Inc

N

Chair City Family Medicine, PC

N

Charles A. Birbara, MD

N

Charlton Family Practice

N

Christopher I Bechara MD PC

N

Community Health Connections, Inc

N

Community Healthlink, Inc

N

Community Neuroscience Services, LLC

N

Curewell Gastroenterology, PC

N

D'Ambrosio Eye Care, Inc

N

Daniel H Ervin, DO, PC

N

Edward Kamens

N

Edward M. Kennedy Community Health Center, Inc

N

Family Foot Care Center PC

N

Family Health Center of Worcester, Inc

N

Family Medical & Maternity Care PC

N

Gardner Family Medicine, Inc

N

Glen Bombardier

N

Greater Boston Medical Associates, Inc

N

Harrington Memorial Hospital, Inc

N

Harrington Physician Services Inc

N

Heart Rhythm Specialists of Central Massachusetts, PC

N

Henry Heywood Memorial Hospital

N

Heywood Medical Group, Inc

N

Holyoke Medical Center, Inc

N

Hugh Cooper

N

James M. Shenko, MD, PC

N

John Howland

N

Lawrence M Dubuske MD

N

Leominster Dermatology LLP

N

Leominster Medical Associates

N

Longview Orthopaedic Center, LLC

N

Marlboro Internal Medicine, PC

N

Marlborough Hospital Corp

N

Mass Lung & Allergy PC

N

Medpractice PC

N

Mercy Family Practice PC

N

Mountain View Family Practice, PC

N

Nancy D. Berube, MD PC

N

New England Hospitalists, PC

N

North Quabbin Family Physicians, PC

N

North Worcester Gastroenterology, PC

N

Northeast Allergy, Asthma & Immunology, PC

N

Partners in Internal Medicine, PC

N

Paul Dufault

N

Primary Physician Partners

N 

R. Leslie Shelton, MD, PC

N

Richard V. Montilla, MD, PC

N

Robert Byrne

N

Robert Fishman

N

Stephen Child

N

Stephen Weedon

N

Sturbridge Professional Services, PC

N

Tad Baum, MD, PC

N

Tak Medical Group, PC

N

Tricia Vorderstrasse MD PC

N

UMass Memorial HealthAlliance Clinton Hospital, Inc

N

UMass Memorial Medical Center, Inc

N

UMass Memorial Medical Group, Inc

N

Urology Central

N

Vitreo-Retinal Associates PC

N

Vladas Litani, MD

N

Wachusett Radiology Inc

N

Western Mass Physician Associates, Inc

N

William Brodkin

N

William Dunn

N

William Friedman

N

Worcester Eye Consultants, PC

N

Worcester Physicians and Nurses Services LLC

N

Zbigniew Dombek, MD

N

 

ACO Governing Body:

Member

First Name

Member

Last Name

Member

Title/Position

Member's Voting Power (Expressed as a percentage)

Membership Type

ACO Participant Legal Business Name, if applicable

Dickson, MD

Eric

Chairman

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.; UMass Memorial Medical Center, Inc.

Greenwood

John

President

5.88%

Other - ACO President

UMass Memorial Accountable Care Organization, Inc.

Kupfer

Barbara

Voting Member

5.88%

Medicare Beneficiary Representative

N/A

Tosi, MD

Stephen

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Gustafson, MD

Michael

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Center, Inc.

Brown

Douglas

Voting Member

5.88%

ACO Participant Representative

Marlborough Hospital Corp.; UMass Memorial Health Care, Inc., HealthAlliance Hospitals, Inc.

Twehous, MD

Debra

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc

Corbett, MD

William

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Kerrigan

Stephen

Voting Member

5.88%

ACO Participant Representative

Edward M. Kennedy Community Health Center, Inc.

Reidy, MD

Jennifer

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Matta, MD

Lalita

Voting Member

5.88%

ACO Participant Representative

Lalita Matta MD

Fishman, DO

Robert

Voting Member

5.88%

ACO Participant Representative

Robert Fishman, DO

Aiello, MD

Francesco

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Eisenstock, MD

Jordan

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc

Trainor, MD

Matthew

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc

Moore

Edward

Voting Member

5.88%

ACO Participant Representative

Harrington Memorial Hospital, Inc., Harrington Physician Services Inc.

Sweeney, MD

Francis

Voting Member

5.88%

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

Thomas Scornavacca, DO, 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 2021, $0
  • Performance Year 2020, $6,732,247
  • 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 2021
    • 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 2020
    • Proportion invested in infrastructure: 21%
    • Proportion invested in redesigned care processes/resources: 29%
    • Proportion of distribution to ACO participants: 50%
  • 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

 

Quality Performance Results

2021 Quality Performance Results:
Quality performance results are based on CMS Web Interface.

Measure # 

Measure Name

Rate

ACO Mean

001

Diabetes: Hemoglobin A1c (HbA1c) Poor Control2

8.36

12.46

134

Preventative Care and Screening: Screening for Depression and Follow-up Plan

72.62

74.38

236

Controlling High Blood Pressure

80.40

74.87

318

Falls: Screening for Future Fall Risk 

97.04

87.03

110

Preventative Care and Screening: Influenza Immunization

85.24

80.52

226

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

82.61

80.97

113

Colorectal Cancer Screening

81.48

73.63

112

Breast Cancer Screening

84.12

75.11

438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

84.62

84.24

479

Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2

0.1669

0.1540

MCC1

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2

40.34

33.99

CAHPS-1

Getting Timely Care, Appointments, and Information

86.22

84.67

CAHPS-2

How Well Providers Communicate

93.70

93.56

CAHPS-3

Patient’s Rating of Provider

91.47

92.19

CAHPS-4

Access to Specialists

79.22

78.80

CAHPS-5

Health Promotion and Education

64.63

61.61

CAHPS-6

Shared Decision Making

60.86

60.89

CAHPS-7

Health Status and Functional Status

75.03

71.78

CAHPS-8

Care Coordination

83.83

85.66

CAHPS-9

Courteous and Helpful Office Staff

91.34

91.88

CAHPS-11

Stewardship of Patient Resources

20.66

24.71

 

Please note, the Quality ID #: 370 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.”

For previous years’ Financial and Quality Performance Results, please visit: data.cms.gov

 

 

 

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