Accountable Care Organization
UH Coordinated Care Organization
ACO Name and Location
University Hospitals Coordinated Care
Previous Names: N/A
3605 Warrensville Center Road
M/S MSC9214
Shaker Heights, OH 44122
ACO Primary Contact
Valerie Reese
216-286-9159
Valerie.Reese@UHhospitals.org
Organizational Information
| ACO Participants: | |
|---|---|
| ACO Participants | ACO Participant in Joint Venture |
| University Primary Care Practices, Inc. | Y |
| ACO governing body: | |||||
|---|---|---|---|---|---|
| Member | Member’s Voting Power – Ex- pressed as a percent- age or number |
Member- ship Type |
ACO Participant Legal Business Name/DBA, if Applicable | ||
| First Name | Last Name | Title/ Position |
|||
| Peter | Pronovost | Chief Quality & Clinical Transformation Officer/ Board Chair & Director |
1 | ACO partici- pant represen- tative |
University Hospitals Medical Practices |
| Michael | Szubski | Chief Financial & System Services Officer/ Director/Board Vice-Chair |
1 | ACO partici- pant represen- tative |
University Hospitals Medical Practices |
| Cathy | Annable | Medicare Beneficiary Repre- sentative / Director |
1 | Medicare benefi- ciary repre- sentative |
|
| Paul | Hinchey | Interim Chief Operation Officer, University Hospitals Health System/ Director |
0 | Non- voting Comm- unity Stake- holder |
|
| Sean | Hoynes | Director | 1 | ACO partici- pant represen- tative |
University Hospitals Medical Practices |
| Karen | Monheim | Director | 1 | ACO partici- pant represen- tative |
University Hospitals Medical Practices |
| Brian | Monter | Director | 0 | Non- voting Comm- unity Stake- holder |
|
| Mark | Plush | Medicare Beneficiary Repre- sentative / Director |
1 | Medicare benefi- ciary repre- sentative |
|
| Kamaleswary | Ravichandran | Director | 1 | ACO partici- pant represen- tative |
University Hospitals Medical Practices |
| Paul | Tait | Chief Strategic Officer |
1 | ACO partici- pant represen- tative |
University Hospitals Medical Practices |
| George | Topalsky | Vice President, Primary Care Institute / Director | 1 | ACO partici- pant represen- tative |
University Hospitals Medical Practices |
| Key ACO clinical and administrative leadership: | |
|---|---|
| Title | Name |
| ACO Executive | Valerie Reese |
| Medical Director | George Topalsky |
| Chief Compliance Officer | LaVonne Pulliam |
| Quality Assurance/Improvement Officer | Tomasina Green |
| Associated committees and committee leadership: | |
|---|---|
| Committee Name | Committee Leader Name and Position |
| Finance & Operations Committee | Peter Pronovost, Board Chair |
| Quality & Care Optimization Committee | Peter Pronovost, Board Chair |
| Patient Engagement Committee | Peter Pronovost, Board Chair |
Types of ACO Participants, or Combinations of Participants, That Formed the ACO:
- Partnerships or joint venture arrangements between hospitals and ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses
- Third Agreement Period
- Performance Year 2022, $12,154,861.02
- Performance Year 2021, $7,729,833.80
- Performance Year 2020, $8,866,320.33
- Performance Year 2019, $9,193,207.35
- Second Agreement Period
- Performance Year 2018, $0
- Performance Year 2017, $0
- Performance Year 2016, $0
- First Agreement Period
- Performance Year 2015, $5,584,001
- Performance Year 2014, $0
- 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 2022
- Proportion invested in infrastructure: 32%
- Proportion invested in redesigned care processes/resources: 18%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2021
- Proportion invested in infrastructure: 32%
- Proportion invested in redesigned care processes/resources: 18%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2020
- Proportion invested in infrastructure: 32%
- Proportion invested in redesigned care processes/resources: 18%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2019
- Proportion invested in infrastructure: 32%
- Proportion invested in redesigned care processes/resources: 18%
- Proportion of distribution to ACO participants: 50%
- Performance Year 2022
- Second Agreement Period
- Performance Year 2018
- 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 2017
- 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 2016
- 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 2018
- First Agreement Period
- Performance Year 2015
- Proportion invested in infrastructure: 32%
- Proportion invested in redesigned care processes/resources: 18%
- Proportion of distribution to ACO participants: 50%
- 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
- Performance Year 2015
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.
2022 Quality Performance Results:
| Measure # | Measure Name | Collection Type | Rate | ACO Mean |
|---|---|---|---|---|
| Measure #001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1] | CMS Web Interface | 7.57 | 10.71 |
| Measure #134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 86.28 | 76.97 |
| Measure #236 | Controlling High Blood Pressure | CMS Web Interface | 81.03 | 76.16 |
| Measure #318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 97.37 | 87.83 |
| Measure #110 | Preventative Care and Screening: Influenza Immunization | CMS Web Interface | 81.70 | 77.34 |
| Measure #226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 80.43 | 79.27 |
| Measure #113 | Colorectal Cancer Screening | CMS Web Interface | 75.00 | 75.32 |
| Measure #112 | Breast Cancer Screening | CMS Web Interface | 86.21 | 78.07 |
| Measure #438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 81.57 | 86.37 |
| Measure #370 | Depression Remission at Twelve Months | CMS Web Interface | 11.54 | 16.03 |
| Measure #321 | CAHPS for MIPS [3] | CMS Web Interface | N/A | N/A |
| Measure #479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Group [1] | Administrative Claims | 0.1599 | 0.1510 |
| Measure #484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] | Administrative Claims | 35.72 | 30.97 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | CAHPS for MIPS Survey | 85.95 | 83.96 |
| CAHPS-2 | How Well Providers Communicate | CAHPS for MIPS Survey | 94.19 | 93.47 |
| CAHPS-3 | Patient’s Rating of Provider | CAHPS for MIPS Survey | 92.37 | 92.06 |
| CAHPS-4 | Access to Specialists | CAHPS for MIPS Survey | 74.59 | 77.00 |
| CAHPS-5 | Health Promotion and Education | CAHPS for MIPS Survey | 69.16 | 62.68 |
| CAHPS-6 | Shared Decision Making | CAHPS for MIPS Survey | 62.95 | 60.97 |
| CAHPS-7 | Health Status and Functional Status | CAHPS for MIPS Survey | 76.24 | 73.06 |
| CAHPS-8 | Care Coordination | CAHPS for MIPS Survey | 85.61 | 85.46 |
| CAHPS-9 | Courteous and Helpful Office Staff | CAHPS for MIPS Survey | 91.39 | 91.97 |
| CAHPS-11 | Stewardship of Patient Resources | CAHPS for MIPS Survey | 27.99 | 25.62 |
For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.
Payment Rule Waivers
- Waiver for Payment for Telehealth Services:
- Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR §425.612(f) and 42 CFR §425.613.