MSSP ACO – BHS

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

ACO Primary Contact
Primary Contact Name Hema Kissoon
Primary Contact Phone Number (561) 405-0071
Primary Contact Email Address Hema.Kissoon@tenethealth.com

Organizational Information

ACO Participants ACO Participant in Joint Venture
Abbott Medical Group PLLC N
Ali Hasan Mahmood MD PLC N
Alma Lemez MD PA N
American Internal Medicine PC N
Andres S Enriquez MD PA N
Anjali Kumar N
Azhar A Esho MD PC N
BHS Physician Network Inc N
Borderland Medica, P.A. N
Carlos A Lozano MD PA N
Centro San Vincente N
Commerce Primary Care, PC N
Community Family Medicine PA N
Cristo A. Calle MD, PA N
Debra Van Ort N
Do Gardi MD  PC N
Dr. Brajesh Bhatla, MD PA N
Dr. Leo K Edwards, Jr N
El Paso Wellness & Healthcare Center PA N
Elliott I. Greenspan, D.O., P.C. & Associates N
Emily D Smith MC PLLC N
Everett V Bryant MD PLLC N
Exclusive Physicians PLLC N
Family Medicine & Aesthetics PA N
Greater Dallas Healthcare Enterprises N
Health Centers Detroit Foundation Inc. N
Health First Medical Center PLC N
Health One Medical Center, Eastpointe LLC N
Heart & Vascular Institute PLLC N
Highland Park Medical Center, PLLC N
Hidal D Elia MD PC N
Home Visit M.D.,PLC N
I & B Medical Associates N
Inpatient Healthcare Group PL N
Integrated & Preventative Health Care Associates PLC N
Irina A. Minina MD PLLC N
Jaime L Silva M.D.,Pa. N
James J Glazier MD PC N
Jane K. Syriac MD P.C. N
Jibrail Kasperkhan, MD, PLLC N
Johanna J Verwilghen MD PLLC N
John Patterson, Md, Pa N
Jose J Silva MD PA N
Juarez & Juarez Family Medicine Clinic, INC. N
Kellum Physician Partners N
Kevin P. Comfort MD N
Laz Medical Group PC N
Luis H. Robles MD PA N
M & M North, LLP N
Marcos Reis MD N
Maria Elena Gonzalez-Sozer MD N
Mary Jo K Voelpel DO PC N
Medwin Family Medicine & Rehabilitation Pc N
Mercy Clinics MD PA N
Muneer E. Assi DO PA N
N. H. Shannon MD PA N
North San Antonio Healthcare Associates N
Perry Wolfe N
Pillay Internal Medicine Associates, PLLC N
Primary Medical Services PC N
Professional Plaza Clinic Corporation N
Project Vida Health Center N
Quality Medical Group PLC N
Raghad Lepley MD PC N
Rhonda Fleming, MD PA N
Robert T. Ching, DO, PA N
S Park-Davis Healthcare N
Saint Vincent Physician Services Inc N
San Antonio Premier Internal Medicine, PLLC N
San Antonio Preventative & Diagnostic Medicine N
San Antonio-Mmc, P.A. N
Schreiber Cardiology PC N
Segundo Abraham Briones MD, PA N
South Alamo Medical Group N
Stanley M Poleck DO PLLC N
Stone Oak Family Doctors, PA N
Sin City Sports Medicine And Family Clinic PA N
Sylmara E. Chatman M.D. P.C. N
Tenet Florida Physician Services, LLC N
Trinity Medical Center, P.C. N
University Physician Group N
Valley House Calls, PLLC N
VHM Services Inc N
VHS Physicians of Michigan N
Virginia Park Internal Medicine PC N
West Boca Health Services, Llc N
Westside Family Medicine N
Westwind Medical Associates PA N
Yolanda Marcos MD PA 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
Lozano Carlos Physician 11.11 ACO Participant Representative Carlos A. Lozano, MD
Alprin Clifford Physician 11.11 ACO Participant Representative North San Anotnio Healthcare Associates
Comfort Kevin Physician 11.11 ACO Participant Representative Kevin P. Comfort, MD
Enriquez Andres Physician 11.11 ACO Participant Representative Franklin Medical Center
Worsham Dale Beneficiary 11.11 ACO Participant Representative Medicare Beneficiary
Watkins Lynette CMO, Baptist Health System 11.11 ACO Participant Representative BHS Physician Network
Edwards Leo Physician 11.11 ACO Participant Representative Leo K. Edwards, MD
Perez-Enriquez Jose Physician 11.11 Mercy Clinics
Sargent Edward Physician 11.11 San Antonio Preventative & Diagnostic Medicine

Key ACO clinical and administrative leadership:

  • ACO Executive: Lizette Day
  • Medical Director: Lynette Watkins
  • 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 2019 $9,290,277
  • Second Agreement Period
    • 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

Shared Savings Distribution:

  • Third 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%
    • Second Agreement Period
      • 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

Quality Performance Results

2019 Quality Performance Results:

ACO # Measure Name Rate ACO Mean
ACO1 CAHPS: Getting Timely Care,  Appointments, and Information 84.3 85.86
ACO2 CAHPS: How Well Your Providers Communicate 93.96 94.11
ACO3 CAHPS: Patients’ Rating of Provider 91.83 92.69
ACO4 CAHPS: Access to Specialists 87.46 81.54
ACO5 CAHPS: Health Promotion and Education 65.81 60.44
ACO6 CAHPS: Shared Decision Making 59.99 62.78
ACO7 CAHPS: Health Status/Functional Status* 70.05 73.79
ACO34 CAHPS: Stewardship of Patient Resources 30.1 26.17
ACO45 CAHPS: Courteous and Helpful Office Staff 91.83 92.84
ACO46 CAHPS: Care Coordination 86.7 86.89
ACO8 Risk-Standardized,All Condition Readmission 15.01 14.86
ACO38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 59.85 58.15
ACO43 Ambulatory Sensitive Condition Acute Composite 1.91 1.87
ACO13 Falls: Screening for Future Fall Risk 85 84.04
ACO14 Preventive Care and Screening: Influenza Immunization 72.83 74.77
ACO17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 82.05 78.04
ACO18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 76.52 70.40
ACO19 Colorectal Cancer Screening 77.78 70.76
ACO20 Breast Cancer Screening 78.83 73.84
ACO42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 79.96 82.17
ACO40 Depression Remission at Twelve Months* 11.76 13.58
ACO27 Diabetes: Hemoglobin A1c Poor Control (>9%) 16.94 13.88
ACO28 Controlling High Blood Pressure 78.57 75.04

* Please note, the ACO-40 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.

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-day Rule Waiver:
    • No, our ACO does not use the SNF 3-Day Rule Waiver