MSSP ACO – BHS

BHS Accountable Care LLC
Previous Names: N/A
19026 Stone Oak Pkwy
Suite 100
San Antonio, TX 78258

ACO Primary Contact
Primary Contact Name Robert Hensley
Primary Contact Phone Number 606-205-1203
Primary Contact Email Address Robert.hensley@tenethealth.com

Organizational Information

ACO participants:
 ACO Participants ACO Participant in Joint Venture (Enter Y or N)
M & M North, LLP  N
El Paso Wellness And Healthcare Center, PA  N
VHM Services Inc  N
Saint Vincent Physician Services Inc  N
BHS Physicians Network Inc  N
Greater Dallas Healthcare Enterprises  N
Tenet Florida Physician Services, LLC  N
Family Medicine & Aesthetics PA  N
I & B Medical Associates, Inc  N
Inpatient Healthcare Group, PLLC  N
Luis H Robles MD, PA  N
San Antonio Premier Internal Medicine, PLLC  N
Juarez & Juarez Family Medical Clinic, Inc  N
Westwind Medical Associates, PA  N
Valley House Calls, PLLC  N
Mercy Clinics MD, PA  N
John Patterson, Md, Pa  N
Perry Wolfe  N
 ACO Participants ACO Participant in Joint Venture (Enter Y or N)
Alma Lemez MD, PA  N
Borderland Medica, PA  N
Kellum Physician Partners, PA  N
Sun City Sports Medicine And Family Clinic, PA  N
West Boca Health Services, LLC  N
Leo Edwards  N
Kevin P Comfort, MD  N
Mariaelena Gonzalez-Sozer, MD PA  N
Westside Family Medicine  N
North San Antonio Healthcare Associates  N
South Alamo Medical Group  N
Community Family Medicine PA  N
San Antonio Preventive & Diagnostic Medicine  N
Andres S Enriquez, MD PA  N
San Antonio-MMC, PA  N
Carlos A Lozano MD, PA  N
Stone Oak Family Doctors, PA  N
Muneer E Assi DO, PA  N
Yolanda Marcos, MD PA  N
Segundo Abraham Briones MD, PA  N

ACO governing body:

Member Name: Title/Position Voting Power Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable
Clifford Alprin Physician/Chairman  9.09  ACO Partcipant Representative  North San Antonio Healthcare Associates
Kevin Comfort Physician  9.09  ACO Partcipant Representative  Kevin P. Comfort, MD
Carlos Lazono Physician  9.09  ACO Partcipant Representative  Carlos A Lozano, MD PA
Andres Physician  9.09  ACO Partcipant Representative  Andres S Enriquez, MD PA
Leo Edwards Physician  9.09  ACO Partcipant Representative  Leo Edwards
Edward Sargent Physician  9.09  ACO Participant Representative San Antonio Preventative & Diagnostic Medicine
Javier Bocanegra Physician  9.09  ACO Partcipant Representative  Community Family Medicine PA
Dale Worsham Beneficiary  9.09 ACO Participant Representative
Robert Hensley Executive Director  9.09  ACO Partcipant Representative   BHS Physician Network
Lynette Watkins CMO, Baptist Health System  9.09  ACO Partcipant Representative  BHS Physician Network

Key ACO clinical and administrative leadership:

Robert Hensley ACO Executive
Lynette Watkins Medical Director
Lisa Crutchfield Compliance Officer
Lizette Day Quality Assurance/Improvement Officer

Associated committees and committee leadership:
N/A

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

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

Shared Savings and Losses

Amount of Shared Savings/Losses

  • 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

  • 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

2018 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 85.52 86.14
ACO-2 CAHPS: How Well Your Providers Communicate 93.42 93.93
ACO-3 CAHPS: Patients' Rating of Provider 91.45 92.45
ACO-4 CAHPS: Access to Specialists 82.45 81.50
ACO-5 CAHPS: Health Promotion and Education 57.05 59.26
ACO-6 CAHPS: Shared Decision Making 62.53 61.94
ACO-7 CAHPS: Health Status/Functional Status 71.79 73.35
ACO-34 CAHPS: Stewardship of Patient Resources 21.41 26.26
ACO-8 Risk-Standardized, All Condition Readmission 15.47 14.98
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 19.17 18.59
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 35.64 37.01
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 79.50 76.75
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 59.96 59.00
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91) 2.03 1.98
ACO-11 Use of Certified EHR Technology 99.05 98.20
ACO-12 Medication Reconciliation 98.36 85.91
ACO-13 Falls: Screening for Future Fall Risk 83.07 79.73
ACO-44 Use of Imaging Studies for Low Back Pain 58.97 64.36
ACO-14 Preventive Care and Screening: Influenza Immunization 70.19 72.71
ACO-15 Pneumonia Vaccination Status for Older Adults 80.16 75.97
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 90.41 76.83
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 90.48 72.81
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 62.50 66.74
ACO-19 Colorectal Cancer Screening 77.47 68.27
ACO-20 Breast Cancer Screening 71.43 71.96
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 82.80 81.47
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 13.06 15.51
ACO-41 Diabetes: Eye Exam 50.52 52.42
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 75.34 73.10
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 88.17 88.92

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.

  • For 2018 Quality Performance Results Please Click Here
  • For 2017 Quality Performance Results Please Click Here
  • For 2016 Quality Performance Results Please Click Here
  • For 2015 Quality Performance Results Please Click Here
  • For 2014 Quality Performance Results Please Click Here
  • For 2013 Quality Performance Results Please Click Here

Note: In the Quality Performance Results file(s) above, search for “BHS Accountable Care LLC” or “Baptist Integrated Physician Partners” to view the quality performance results. This ACO can also be found by using the ACO ID A1242 in the public use files on data.cms.gov.

Payment Rule Waivers

No, our ACO does not use the SNF 3-Day Rule Waiver.