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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
440-496-8252
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 percentage or number		 Membership Type ACO Participant Legal Business Name/DBA, if Applicable
First Name Last Name Title/
Position
Brad Bond Treasurer & Director 11.12% ACO parti­ci­pant represen­tative University Hospitals Primary Care Practices, Inc.
Brent Carson Vice Chair & Director 11.11% ACO parti­ci­pant represen­tative University Hospitals Primary Care Practices, Inc.
Brian Monter Director 0% Non-voting Community Stakeholder N/A
George Topalsky CMO & Director 11.11% ACO parti­ci­pant represen­tative University Hospitals Primary Care Practices, Inc.
Kamaleswary Ravichandran Director 11.11% ACO parti­ci­pant represen­tative University Hospitals Primary Care Practices, Inc.
Karen Monheim Director 11.11% ACO parti­ci­pant represen­tative University Hospitals Primary Care Practices, Inc.
Mark Plush Director 11.11% Medicare beneficiary representative N/A
Paul Hinchey Director 0% Non-voting Community Stakeholder N/A
Peter Pronovost Board Chair & Director 11.11% ACO parti­ci­pant represen­tative University Hospitals Primary Care Practices, Inc.
Rick Cicero Director 11.11% ACO parti­ci­pant represen­tative University Hospitals Primary Care Practices, Inc.
Sean Hoynes Director 11.11% ACO parti­ci­pant represen­tative University Hospitals Primary Care Practices, Inc.
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 2023, $18,097,943.83
    • 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 2023
      • Proportion invested in infrastructure: 32%
      • Proportion invested in redesigned care processes/resources: 18%
      • Proportion of distribution to ACO participants: 50%
    • 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%
  • 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
  • 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

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.

2023 Quality Performance Results:

Quality performance results are based on CMS Web Interface
Measure # Measure Name Collection Type Rate ACO Mean
Measure #001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1] CMS Web Interface 7.53 9.84
Measure #110 Preventative Care and Screening: Influenza Immunization CMS Web Interface 67.34 70.76
Measure #112 Breast Cancer Screening CMS Web Interface 88.52 80.36
Measure #113 Colorectal Cancer Screening CMS Web Interface 82.97 77.14
Measure #134 Preventative Care and Screening: Screening for Depression and Follow-up Plan CMS Web Interface 89.92 80.97
Measure #226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface 70.31 79.29
Measure #236 Controlling High Blood Pressure CMS Web Interface 76.73 77.80
Measure #318 Falls: Screening for Future Fall Risk CMS Web Interface 97.06 89.42
Measure #370 Depression Remission at Twelve Months CMS Web Interface 0 16.58
Measure #438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface 82.71 87.05
Measure #479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Group [1] Administrative Claims 0.16 0.16
Measure #484 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] Administrative Claims 35.40 35.39
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS Survey 85.19 83.68
CAHPS-2 How Well Providers Communicate CAHPS for MIPS Survey 94.47 93.69
CAHPS-3 Patient’s Rating of Provider CAHPS for MIPS Survey 93.22 92.14
CAHPS-4 Access to Specialists CAHPS for MIPS Survey 72.23 75.97
CAHPS-5 Health Promotion and Education CAHPS for MIPS Survey 65.04 63.93
CAHPS-6 Shared Decision Making CAHPS for MIPS Survey 63.84 61.60
CAHPS-7 Health Status and Functional Status CAHPS for MIPS Survey 76.35 74.12
CAHPS-8 Care Coordination CAHPS for MIPS Survey 84.98 85.77
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS Survey 91.29 92.31
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS Survey 19.88 26.69

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

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
    • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.
  • 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.