CMS Global and Professional Direct Contracting
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.
| 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.