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UMass Memorial Medicare Accountable Care Organization (ACO)

Our doctors work hard to provide you with high-quality care, but it can be a challenge to manage all of patients’ health care needs and information. That’s why we have developed the UMass Memorial Medicare Accountable Care Organization (ACO).

An ACO is a group of doctors, hospitals and health care providers that work together to provide you with better, more coordinated care. Our doctors and hospitals in the UMass Memorial ACO communicate with you and with each other to make sure that you get the care you need when you’re sick and the support you need to stay healthy and well.

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. 

ACO Name and Location

  UMASS Memorial Accountable Care Organization, INC.
  One Biotech Park
  365 Plantation Street, 3rd Floor
  Worcester, MA 01605

 

ACO Primary Contact

Primary Contact Name

Anthony Berry

Primary Contact Phone Number

(508) 793-5394

Primary Contact Email Address

Anthony.Berry@umassmemorial.org

 

Organizational Information

ACO participants:

ACO Participants

ACO Participant in Joint Venture

 

 

Vasuki Radhakrishnan

N

Primary Physician Partners

N

Raymond Sauls

N

Marlboro Internal Medicine, PC

N

Kevin Delacey

N

Deborah Sullivan

N

Paul Dufault

N

Glen Bombardier

N

William Dunn

N

Elizabeth Erban

N

Zbigniew Dombek, M.D.

N

Steven Rozak

N

John Howland

N

Edwin Young

N

HUGH COOPER

N

UMass Memorial Health Care, Inc., HealthAlliance Hospitals, Inc.

N

Harrington Memorial Hospital, Inc.

N

Henry Heywood Memorial Hospital

N

Marlborough Hospital Corp

N

Athol Memorial Hospital

N

Family Health Center of Worcester, Inc.

N

Charles A. Birbara, M.D.

N

Wachusett Radiology Inc

N

Edward M. Kennedy Community Health Center, Inc.

N

Community Healthlink, Inc.

N

Leominster Medical Associates

N

Cardiology Internists of Leominster Inc.

N

Lawrence M Dubuske MD

N

Associates in Otolaryngology Head and Neck Surgery, P.C.

N

Wachusett Emergency Physicians, PC.

N

UMass Memorial Medical Group, Inc.

N

North Quabbin Family Physicians, PC

N

Charlton Family Practice

N

D'Ambrosio Eye Care, Inc.

N

GREATER BOSTON MEDICAL ASSOCIATES, INC.

N

Heywood Medical Group, Inc..

N

Western Mass Physician Associates, Inc.

N

UMass Memorial Medical Center, Inc.

N

Community Health Connections, Inc.

N

R. Leslie Shelton, M.D., P.C.

N

Tad Baum, M.D., PC

N

Family Foot Care Center Pc

N

John Murphy

N

Robert Fishman

N

Benjamin Grajales, M.D.

N

John Bogdasarian

N

William Friedman

N

Vladas Litani, MD

N

Stephen Weedon

N

William Brodkin

N

Harrington Physician Services Inc

N

Edward Kamens

N

Urology Central

N

Lawrence Dubuske

N

Boulevard Medical Group Inc

N

Mercy Family Practice PC

N

Christopher I Bechara Md Pc

N

Partners in Internal Medicine, PC

N

James M. Shenko, M.D., PC

N

Holyoke Medical Center, Inc.

N

Heart Rhythm Specialists of Central Massachusetts, PC

N

Curewell Gastroenterology, PC.

N

Mass Lung & Allergy PC

N

New England Hospitalists, PC

N

Iris Sullivan, M.D., PC

N

North Worcester Gastroenterology, P.C.

N

NORTHEAST ALLERGY, ASTHMA & IMMUNOLOGY, PC

N

Mountain View Family Practice, Pc

N

Dr. He's Primary Care for Adults Inc.

N

Vitreo-Retinal Associates PC.

N

Longview Orthopaedic Center, LLC

N

Daniel H Ervin, DO, PC

N

Sturbridge Professional Services, P.c.

N

Robert Byrne

N

Aesclepion Healthcare LLC

N

Central Mass Pulmonary Pc

N

Regal Medical Group

N

Tak Medical Group, PC

N

Richard V. Montilla, MD, PC.

N

Center for Digestive Wellness PC

N

Community Neuroscience Services, LLC

N

Nancy D. Berube, Md Pc

N

Chair City Family Medicine, PC

N

Stephen Child

N

Tricia Vorderstrasse Md Pc

N

UMass Memorial Radiology Phys Serv

N

Family Medical & Maternity Care P.C.

N

Gardner Family Medicine, Inc.

N

Worcester Eye Consultants, PC

N

Leominster Dermatology LLP

N

CRYSTAL LAKE PATHOLOGY PC

N

MEDPRACTICE PC

N

CENTMASS IMAGING, INC.

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

Dickson

Eric

Chairman

1

ACO Participant Representative

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

Greenwood

John

President

1

Other - ACO President

UMass Memorial Accountable Care Organization, Inc.

Kupfer

Barbara

Voting Member

1

Medicare Beneficiary Representative

N/A

Tosi, MD

Stephen

Voting Member

1

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Gustafson

Michael

Voting Member

1

ACO Participant Representative

UMass Memorial Medical Center, Inc.

Brown

Douglas

Voting Member

1

ACO Participant Representative

Marlborough Hospital Corp.; UMass Memorial Health Care, Inc., HealthAlliance Hospitals, Inc.

Twehous

Debra

Voting Member

1

ACO Participant Representative

UMass Memorial Medical Group, Inc

Corbett, MD

William

Voting Member

1

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Kerrigan

Stephen

Voting Member

1

ACO Participant Representative

Edward M. Kennedy Community Health Center, Inc.

Reidy

Jennifer

Voting Member

1

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Matta

Lalita

Voting Member

1

ACO Participant Representative

Lalita Matta MD

Fishman

Robert

Voting Member

1

ACO Participant Representative

Robert Fishman, DO

Aiello

Francesco

Voting Member

1

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Eisenstock

Jordan

Voting Member

1

ACO Participant Representative

UMass Memorial Medical Group, Inc

Trainor

Matthew

Voting Member

1

ACO Participant Representative

UMass Memorial Medical Group, Inc

Moore

Edward

Voting Member

1

ACO Participant Representative

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

Sweeney

Francis

Voting Member

1

ACO Participant Representative

Heywood Medical Group, Inc., Henry Heywood Memorial Hospital

 

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

Gertrude Manchester, 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:

  • Performance Year Second Agreement Period
    • 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:

  • Second Agreement Period
    • 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
    • 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%
    • 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 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

2019 Quality Performance Results:

ACO #

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

87.56

85.86

ACO-2

CAHPS: How Well Your Providers Communicate

94.04

94.11

ACO-3

CAHPS: Patients’ Rating of Provider

92.37

92.69

ACO-4

CAHPS: Access to Specialists

78.65

81.54

ACO-5

CAHPS: Health Promotion and Education

65.08

60.44

ACO-6

CAHPS: Shared Decision Making

58.55

62.78

ACO-7

CAHPS: Health Status/Functional Status

78.02

73.79

ACO-34

CAHPS: Stewardship of Patient Resources

24.93

26.17

ACO-45

CAHPS: Courteous and Helpful Office Staff

94.07

92.84

ACO-46

CAHPS: Care Coordination

86.64

86.89

ACO-8

Risk Standardized, All Condition Readmission

15.75

14.86

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

66.04

58.15

ACO-43

Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))

2.13

1.87

ACO-13

Falls: Screening for Future Fall Risk

95.38

84.04

ACO-14

Preventive Care and Screening: Influenza Immunization

70.25

74.77

ACO-17

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

73.08

78.04

ACO-18

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

65.49

70.40

ACO-19

Colorectal Cancer Screening

80.14

70.76

ACO-20

Breast Cancer Screening

80.35

73.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

87.97

82.17

ACO-40

Depression Remission at Twelve Months

1.12

13.58

ACO-27

Diabetes: Hemoglobin A1c Poor Control (>9%)

12.82

13.88

ACO-28

Controlling High Blood Pressure

74.25

75.04

 

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.

.

  • Waiver for Payment for Telehealth Services:
    • No, our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613

Beneficiary Incentive Program

·No, our ACO does not use the Beneficiary Incentive Program (BIP) established under 42 CFR §425.304(c).