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UMass Memorial Medicare Accountable Care Organization (ACO)

UMass Memorial ACO Focuses on Quality Care

Participating in the Medicare ACO is our commitment to providing the Worcester and Central Massachusetts region with quality, personalized and innovative care. Our Medicare ACO leverages our resources to focus on providing Medicare patients (also called Medicare Fee-for-Service beneficiaries) with the best possible experience of timely, appropriate and high-quality health care services.

  • Providing personalized care coordination services across the health continuum
  • Facilitating more effective physician visits and communication among your doctors and providers
  • Providing you with targeted health information and wellness programs that focus on disease prevention
  • Helping you coordinate timely appointments, manage medications and determine appropriate follow-up care
  • Improving the efficiency of your health care

Learn more below, or call our toll-free number at 844-549-0213.

For additional resources: Please visit www.medicare.gov or call 800-MEDICARE (800-633-4227) or (TTY users should call 877-486-2048) for general questions or additional information about Accountable Care Organizations. 

The Health Policy Commission (HPC) Accountable Care Organization (ACO) Certification Program

We are honored to receive ACO Certification from the Massachusetts Health Policy Commission.  This program is designed to accelerate care delivery transformation in Massachusetts and promote a high quality, efficient health system. The purpose of the HPC Accountable Care Organization ACO certification program is to complement existing local and national care transformation and payment reform efforts, encourage value-based care delivery, and promote investments by all payers in high-quality and cost-effective care across the continuum. 

Beneficiary Notices: 

ACO Name and Location      

UMASS Memorial Accountable Care Organization, INC.

One Biotech Park
365 Plantation Street, 3rd Floor
Worcester, MA 01605

ACO Primary Contact

Caryn Sweeney
508-334-1364
UMMACOprimarypubliccontact@umassmemorial.org

Organizational Information

ACO Participants:

ACO Participants

ACO Participant in Joint Venture

Aesclepion Healthcare LLC

N

Associates in Otolaryngology Head and Neck Surgery, PC

N

Athol Memorial Hospital, Inc

N

Benjamin Grajales, MD

N

Center for Digestive Wellness PC

N

Centmass Imaging, Inc

N

Chair City Family Medicine, PC

N

Charles A. Birbara, MD

N

Charlton Family Practice

N

Christopher I Bechara MD PC

N

Community Health Connections, Inc

N

Community Healthlink, Inc

N

Community Neuroscience Services, LLC

N

Complete Family Medicine, PLLC

N

Curewell Gastroenterology, PC

N

D'Ambrosio Eye Care, Inc

N

Daniel H Ervin, DO, PC

N

Edward M. Kennedy Community Health Center, Inc

N

Family Foot Care Center PC

N

Family Health Center of Worcester, Inc

N

Family Medical & Maternity Care PC

N

Focused Primary Care, PC

N

Gardner Family Medicine, Inc

N

Glen Bombardier

N

Greater Boston Medical Associates, Inc

N

Harrington Memorial Hospital, Inc

N

Heart Rhythm Specialists of Central Massachusetts, PC

N

Henry Heywood Memorial Hospital

N

Heywood Medical Group, Inc

N

Holyoke Medical Center, Inc

N

Hugh Cooper

N

James M. Shenko, MD, PC

N

John Howland

N

Lawrence M Dubuske MD

N

Leominster Dermatology LLP

N

Leominster Medical Associates

N

Longview Orthopaedic Center, LLC

N

Marlboro Internal Medicine, PC

N

Marlborough Hospital Corp

N

Mass Lung & Allergy PC

N

Medpractice PC

N

Mercy Family Practice PC

N

Mountain View Family Practice, PC

N

Nancy D. Berube, MD PC

N

New England Hospitalists, PC

N

North Quabbin Family Physicians, PC

N

North Worcester Gastroenterology, PC

N

Northeast Allergy, Asthma & Immunology, PC

N

Partners in Internal Medicine, PC

N

Paul Dufault

N

Primary Physician Partners

N

R. Leslie Shelton, MD, PC

N

Richard V. Montilla, MD, PC

N

Robert Byrne

N

Robert Fishman

N

Stephen Child

N

Stephen Weedon

N

Sturbridge Professional Services, PC

N

Tad Baum, MD, PC

N

Tricia Vorderstrasse MD PC

N

UMass Memorial HealthAlliance Clinton Hospital, Inc

N

UMass Memorial Medical Center, Inc

N

UMass Memorial Medical Group, Inc

N

Urology Central

N

Vedere Pathology, PC N

Vitreo-Retinal Associates PC

N

Vladas Litani, MD

N

Wachusett Radiology Inc

N

Western Mass Physician Associates, Inc

N

William Brodkin

N

William Friedman

N

Worcester Eye Consultants, PC

N

Worcester Physicians and Nurses Services LLC

N

Zbigniew Dombek, MD

N

ACO Governing Body:

Member

First Name

Member

Last Name

Member

Title/Position

Member's Voting Power (Expressed as a percentage)

Membership Type

ACO Participant Legal Business Name, if applicable

Eric 

Dickson, MD

Chairman
Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.; UMass Memorial Medical Center, Inc.

John 

Greenwood

President
Voting Member

5.88%

Other - ACO President

UMass Memorial Accountable Care Organization, Inc.

Barbara 

Kupfer

Voting Member

5.88%

Medicare Beneficiary Representative

N/A

Debra 

Twehous, MD

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc

Edward 

Moore

Voting Member

5.88%

ACO Participant Representative

Harrington Memorial Hospital, Inc., Harrington Physician Services Inc.

Francesco 

Aiello, MD

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Francis 

Sweeney, MD

Voting Member

5.88%

ACO Participant Representative

Heywood Medical Group, Inc., Henry Heywood Memorial Hospital

Jennifer 

Reidy, MD

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Jordan 

Eisenstock, MD

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc

Steve Roach Voting Member 5.88% ACO Participant Representative HealthAlliance-Clinton Hospital and Marlborough Hospital

Justin 

Precourt, RN

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Center, Inc.

Lalita 

Matta, MD

Voting Member

5.88%

ACO Participant Representative

Lalita Matta MD

Matthew 

Trainor, MD

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc

Robert 

Fishman, DO

Voting Member

5.88%

ACO Participant Representative

Robert Fishman, DO

Stephen 

Kerrigan

Voting Member

5.88%

ACO Participant Representative

Edward M. Kennedy Community Health Center, Inc.

Joahd Touré, MD Voting Member 5.88% ACO Participant Representative UMass Memorial Medical Group, Inc.

Stephen 

Tosi, MD

Voting Member

5.88%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

 

Key ACO Clinical and Administrative Leadership:

  • ACO Executive: John Greenwood
  • Medical Director: Thomas Scornavacca, DO
  • Compliance Officer: Jennifer Heil
  • Quality Assurance/Improvement Officer: Tracey Wilkie

Associated Committees and Committee Leadership:

Committee Name

Committee Leader Name and Position

 

">

Finance Committee

Jeanne Shirshac, Chair

Quality Improvement Committee

Kastoori Iyengar, MD, Chair

Utilization/Care Management Committee

Thomas Scornavacca, DO, Chair

Compliance Committee

Jennifer Heil, Chair

Governance Committee

John Greenwood, Chair

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

  • ACO professionals in a group practice arrangement
  • Hospital employing ACO professionals
  • Networks of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Third Agreement Period

    • Performance Year 2022, $5,181,428

  • Second Agreement Period

    • Performance Year 2021, $0

    • Performance Year 2020, $6,732,247

    • Performance Year 2019, $0

    • Performance Year 2018, $0

  • First Agreement Period

    • Performance Year 2017, $9,105,746

    • Performance Year 2016, $0

    • Performance Year 2015, $0

Shared Savings Distribution:

  • Third Agreement Period

    • Performance Year 2022

    • Proportion invested in infrastructure: 25%

    • Proportion invested in redesigned care processes/resources: 25%

    • Proportion of distribution to ACO participants: 50%
       

  • Second Agreement Period

o   Performance Year 2021

  •  Proportion invested in infrastructure: N/A
  •  Proportion invested in redesigned care processes/resources: N/A
  •  Proportion of distribution to ACO participants: N/A

o   Performance Year 2020

  • Proportion invested in infrastructure: 21%
  • Proportion invested in redesigned care processes/resources: 29%
  • Proportion of distribution to ACO participants: 50%

o   Performance Year 2019

  • Proportion invested in infrastructure: N/A
  • Proportion invested in redesigned care processes/resources: N/A
  • Proportion of distribution to ACO participants: N/A

o   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

 

  • First Agreement Period​

    • Performance Year 2017

  • Proportion invested in infrastructure: 26%
  • Proportion invested in redesigned care processes/resources: 24%
  • Proportion of distribution to ACO participants: 50%

o   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

o   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

Quality Performance Results

2022 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]

Web Interface

6.23

 

10.71

 

Measure #: 134

Preventative Care and Screening: Screening for Depression and Follow-up Plan

Web Interface

79.72

76.97

Measure #: 236

Controlling High Blood Pressure

Web Interface

78.59

76.16

Measure #: 318

Falls: Screening for Future Fall Risk

Web Interface

94.51

87.83

Measure #: 110

Preventative Care and Screening: Influenza Immunization

Web Interface

81.06

77.34

Measure #: :226

Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention

Web Interface

83.33

79.27

Measure #: 113

Colorectal Cancer Screening

Web Interface

78.3

75.32

Measure #: 112

Breast Cancer Screening

Web Interface

83.33

 

78.07

 

Measure #: 438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

Web Interface

89.87

 

86.37

 

Measure #: 370

Depression Remission at Twelve Months

Web Interface

7.14

 

16.03

 

Measure #: 479

Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1]

 

Administrative Claims

0.1595

 

0.1510

 

Measure #: 484

Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1]

Administrative Claims

35.11

 

30.97

 

CAHPS-1

 

Getting Timely Care, Appointments, and Information

CAHPS for MIPS Survey

86.70

 

83.96

 

CAHPS-2

 

How Well Providers Communicate

CAHPS for MIPS Survey

92.60

 

93.47

 

CAHPS-3

 

Patient’s Rating of Provider

CAHPS for MIPS Survey

91.76

 

92.06

 

CAHPS-4

 

Access to Specialists

CAHPS for MIPS Survey

80.57

 

77.00

 

CAHPS-5

 

Health Promotion and Education

CAHPS for MIPS Survey

68.65

 

62.68

 

CAHPS-6

 

Shared Decision Making

CAHPS for MIPS Survey

64.18

 

60.97

 

CAHPS-7

 

Health Status and Functional Status

CAHPS for MIPS Survey

74.20

 

73.06

 

CAHPS-8

 

Care Coordination

CAHPS for MIPS Survey

85.29

 

85.46

 

CAHPS-9

 

Courteous and Helpful Office Staff

CAHPS for MIPS Survey

91.85

 

91.97

 

CAHPS-11

 

Stewardship of Patient Resources

CAHPS for MIPS Survey

30.56

 

25.62

 

For previous years’ Financial and Quality Performance Results, please visit: data.cms.gov