CMS Global and Professional Direct Contracting

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Quality Partners in Care ACO Global and Professional Direct Contracting

Tenet Health
14201 N. Dallas Parkway
Dallas, TX 75254

HealthTexas Medical Group
2961 Mossrock
San Antonio, Texas 78230

Primary Contact Name Lee LaCroix
Primary Contact Phone Number (469) 893-6167
Primary Contact Email Address lee.lacroix@tenethealth.com

The Baptist Health System and HealthTexas Medical group is pleased to announce a collaborative partnership with the launch of a new Global and Professional Direct Contracting entity for the Centers for Medicare & Medicaid Services ("CMS") Global and Professional Direct Contracting Model. Together, we formed Quality Partners in Care ACO (QPIC ACO), a Global and Professional Direct Contracting Entity (DCE), or a group of healthcare providers who agree to work together to keep their patients healthy using proven methods, such as providing access to the right care, at the right time, and in the right setting. QPIC ACO has chosen to participate in the standard DCE under the Primary Care Capitation payment mechanism with voluntary alignment.

QPIC ACO assists its Medicare FFS beneficiaries by providing high quality coordinated care and works to keep members healthy, while treating them when sick or injured. If needed, a care management team will work with members to provide services such as chronic care management, as well as transitional care services by coordinating between the hospital system and the medical group, allowing for open communication & data sharing to reduce delays and duplication of services.

Click here to find a HealthTexas Medical Group provider.

Click here to find a Baptist Health System location.

Locations

GPDC Participants Speciality GPDC Participant in Joint Venture
GPDC Participant Providers
Physician Prime Care (HealthTexas Medical Group) Primary Care No
GPDC Preferred Providers
Adoration Hospice Care Texas, LLC dba Embrace Hospice Hospice No
Advance Hitech Nursing, Inc Home Health No
Alamo City Eye Physicians Ophthalmology No
Amedisys Hospice, L.L.C. Hospice No
Amedisys Texas LLC Home Health No
Be Healthy at Home, LLC Home Health No
Bridgemoor Transitional Care Skilled Nursing No
Brookdale Home Health Home Heath No
Brown and Brown Resources, Inc Home Health No
Cantex Home Health Home Health No
Cardiovascular & Hypertension Clinic of San Antonio Cardiology No
Compassus OP of Texas LLC Hospice No
Dominion Care Management Group Home Health No
Echo Hospice Hospice No
Elysian Hospice Hospice No
Foundation Bariatric Hospital of San Antonio Surgical Hospital No
Girling Health Care, Inc Home Heath No
Guiding Light Hospice, Inc Hospice No
KTS Partners, Inc. dba Capital Home Health Home Health No
Laboratory Corporation of America Reference Lab No
Laboratory Corporation of America Holdings Reference Lab No
Medina County Hospital District Skilled Nursing No
Morning House Ministries SNF No
New Bruanfels Cardiology Cardiovascular No
New Braunfels Regional Rehabilitation Hospital, Inc Rehab Hospital No
Odyssey Health Operating Hospice No
PAM Specialty Hospital of New Braunfels Long Term Acute Care No
PAM Specialty Hospital of New Braunfels Rehab Hospital No
PAM Specialty Hospital of San Antonio Medical Center, LLC Long Term Acute Care No
Paragon Infusion Care, Inc Infusion Center No
Paragon Infusion Centers (Bexar County) Infusion Center No
Regency IHS of San Antonio LLC Skilled Nursing No
San Antonio Eye Care Ophthalmology No
San Antonio Vascular & Endovascular Clinic Cardiovascular No
Signal Hospice Care, LLC Hospice No
South Texas Spinal Clinic Spine/Pain Center No
Touchstone Strategies Stone Oak2 LLC Skilled Nursing No
Uvalde County Hospital Authority Skilled Nursing No
Warm Springs Rehabilitation Hospital of Kyle, LLC Rehab Hospital No
Warm Springs Rehabilitation Hospital of San Antonio Rehab Hospital No
Warm Springs Rehabilitation Hospital of Thousand Oaks Rehab Hospital No
Warm Springs Rehabilitation Hospital of Westover Hills Rehab Hospital No
Warm Springs Specialty Hospital of San Antonio, LLC Long Term Acute Care No

GPDC Governing Body:

Member

Last Name

Member

First Name

Member

Title/Position

Member's Voting Power: expressed as a percentage or number Membership Type GPDC Participant Legal Business Name/DBA, if applicable
Ruffner Jeannine Board Chair 14.3% GPDC Participant Representative Physician Prime Care
Torres, MD Luis Physician Board Member 14.3% GPDC Participant Representative Physician Prime Care
Powell, MD Dan Physician Board Member 14.3% GPDC Participant Representative Physician Prime Care
Phillips Brady Board Member 14.3% Facility Participant Representative N/A
Handley Charles Board Member 14.3% Facility Participant Representative N/A
Day Lizette Board Member 14.3% Facility Participant Representative N/A
Cooper Connie Board Member 14.3% Medicare Beneficiary N/A

Key ACO clinical and administrative leadership:

  • GPDC Executive: Lee LaCroix
  • Medical Director: Dan Powell, MD
  • Compliance Officer: Lisa Crutchfield
  • Quality Assurance/Improvement Officer: Lizette Day

The DCE arrangement seeks waiver protection provided by CMS pursuant to Section 1115A(d)(1) of the Social Security Act (Act), namely that section 1877(a) of the Act (relating to Federal physician self-referral law) and sections 1128(b)(1) and (2) of the Act (relating to the Federal anti-kickback statue) are waived with respect to any startup arrangement between DCE and one or more DC Participant Providers or Preferred Providers or both, providing that conditions set forth in the Global and Professional Direct Contracting Program are met.