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 N
GPDC Preferred Providers
Alamo City Eye Physicians Ophthalmology N
Elysian Hospice Hospice N
Cantex Home Health Home Health N
Uvalde County Hospital Authority Skilled Nursing N
Dominion Care Management Group Home Health N
Compassus OP of Texas LLC Hospice N
Advance Hitech Nursing, Inc Home Health N
Brown and Brown Resources, Inc Home Health N
Laboratory Corporation of America Holdings Reference Lab N
Laboratory Corporation of America Reference Lab N
Regency IHS of San Antonio LLC Skilled Nursing N
Cardiovascular & Hypertension Clinic of San Antonio Cardiology N
San Antonio Eye Care Ophthalmology N
Brookdale Home Health Home Heath N
Girling Health Care, Inc Home Heath N
Odyssey Health Operating Hospice N
Guiding Light Hospice, Inc Hospice N
Signal Hospice Care, LLC Hospice N
Echo Hospice Hospice N
Morning House Ministries SNF N
San Antonio Vascular & Endovascular Clinic Cardiovascular N

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.