MSSP ACO – BHS

BHS Accountable Care LLC
19026 Stone Oak Pkwy
Suite 100
San Antonio, TX 78258

ACO Primary Contact
Primary Contact Name Lizette Day
Primary Contact Phone Number (210) 202-9958
Primary Contact Email Address Lizette.Day@tenethealth.com

Organizational Information

ACO Participants ACO Participant in Joint Venture
Perry Wolfe N
Segundo Abraham Briones MD PA N
SUN CITY SPORTS MEDICINE AND FAMILY CLINIC PA N
VHM Services Inc N
Andres S Enriquez MD PA N
COMMUNITY FAMILY MEDICINE PA N
Muneer E. Assi DO PA N
SAN ANTONIO PREVENTIVE & DIAGNOSTIC MEDICINE N
North San Antonio Healthcare Associates N
WESTWIND MEDICAL ASSOCIATES PA N
LEO EDWARDS N
Tenet Florida Physician Services, LLC N
Stone Oak Family Doctors, PA N
YOLANDA MARCOS MD PA N
MARIAELENA GONZALEZ-SOZER MD PA N
ALMA LEMEZ MD PA N
EL PASO WELLNESS AND HEALTHCARE CENTER P.A. N
Bhs Physicians Network Inc N
Carlos A Lozano MD PA N
JUAREZ & JUAREZ FAMILY MEDICAL CLINIC, INC. N
West Boca Health Services, Llc N
Kevin P. Comfort MD N
BORDERLAND MEDICA, P.A. N
Saint Vincent Physician Services Inc N
San Antonio-Mmc, P.A. 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/DBA, if applicable
Alprin Clifford Physician Board Chair 12.50% ACO Participant Representative North San Antonio Healthcare Associates
Comfort Kevin Physician Board Member 12.50% ACO Participant Representative Kevin P. Comfort, MD
Lozano Carlos Physician Board Member 12.50% ACO Participant Representative Carlos A. Lozano, MD
Enriquez Andres Physician Board Member 12.50% ACO Participant Representative Andres S Enriquez Md Pa
Alves Patrice Physician Board Member 12.50% ACO Participant Representative San Antonio Preventive & Diagnostic Medicine
Edwards Leo Physician Board Member 12.50% ACO Participant Representative Dr. Leo K. Edwards, Jr
Bocanegra Javier Physician Board Member 12.50% ACO Participant Representative Community Family Medicine
Lara Steve Sr. Director Physician Practice Operations 0% Facility Participant Representative N/A
Petroff Peter Board Member 12.5% Medicare Beneficiary N/A

Key ACO clinical and administrative leadership:

  • ACO Executive: Lizette Day
  • Medical Director: Clifford Alprin
  • Compliance Officer: Lisa Crutchfield
  • Quality Assurance/Improvement Officer: Lizette Day

Associated committees and committee leadership:

Committee Name Committee Leader Name and Position
N/A N/A

 

Types of ACO participants, or combinations of participants, that formed the ACO:

ACO professionals in a group practice arrangement
Networks of individual practices of ACO professionals
Partnerships or joint venture arrangements between hospitals and ACO professionals
Hospital employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Third Agreement Period
    • Performance Year 2020, $9,993,608
    • Performance Year 2019, $9,290,277
  • Second Agreement Period
    • Performance Year 2019, $9,290,277
    • Performance Year 2018, $9,666,039
    • Performance Year 2017, $17,479,903
    • Performance Year 2016, $12,479,101
  • First Agreement Period
    • Performance Year 2015, $2,708,375
    • Performance Year 2014, $2,816,277
    • Performance Year 2013, $0

Note: Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Shared Savings Distribution:

  • Third Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
    • Performance year 2019
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
  • Second Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
    • Performance Year 2018
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
    • Performance Year 2017
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
    • Performance Year 2016
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
  • First Agreement Period
    • 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 2014
      • 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 2013
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources N/A
      • Proportion of distribution to ACO participants: N/A

Note: Our ACO participated in multiple performance years during Calendar Year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Quality Performance Results

2020 Quality Performance Results:

ACO # Measure Name Rate ACO Mean
ACO8 Risk-Standardized, All Condition Readmission 15.20 15.07
ACO38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 46.21 49.50
ACO43 Ambulatory Sensitive Condition Acute Composite 0.84 0.95
ACO13 Falls: Screening for Future Fall Risk 83.40 84.97
ACO14 Preventive Care and Screening: Influenza Immunization 75.68 76.03
ACO17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 70.59 81.67
ACO18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 78.55 71.46
ACO19 Colorectal Cancer Screening 81.88 72.59
ACO20 Breast Cancer Screening 81.45 74.05
ACO42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 84.56 83.37
ACO27 Diabetes: Hemoglobin A1c Poor Control (>9%) 11.81 14.70
ACO28 Controlling High Blood Pressure 71.79 72.87

* Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.”

For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.