Wellforce Medicare ACO

ACO Name and Location Wellforce Medicare ACO, LLC 800 District Avenue, Suite 520 Burlington, MA 01803

ACO Primary Contact Kathleen Garland 978.942.2220 katheen.garland@tuftsmedicine.org

 

ACO participants

ACO Participants	ACO Participants in Joint Venture (Y or N)
ADULT PRIMARY CARE PLLC	N
AJAJ ANAND MD PC	N
ALEXANDRA ARGASINSKI	N
ANDREW M ROMANOWSKY MD LLC	N
APEX MEDICAL ASSOCIALTES, LLC	N
BENJAMIN HENKLE M D LLC	N
BLUE HILLS MEDICAL ASSOCIATES	N
BREWSTER MEDICAL ASSOCIATES, PC	N
CAPE COD PRIMARY CARE LLC	N
CARLOS DEL RIO	N
CHELMSFORD FAMILY PRACTICE, PC	N
CHELMSFORD PRIMARY CARE LLC	N
CHRISOPHER COAKLEY	N
CLARA LENNOX	N
CNV MW (NEW ENGLAND NEPHROLOGY HOME CARE ASSOCIATES)	N
CONGENIAL HEALTHCARE, LLC	N
COMPREHENSIVE PRIMARY CARE	N
DAMIAN FOLCH	N
DAVID SCHROEDER (WELLESLEY INTERNAL MEDICINE, D. SCHEIN)	N
DAVID SCHROEDER MD PC (WELLESLEY INTERNAL MEDICINE, D. SCHROEDER)	N
DAVID SIDEBOTTOM	N
DR. HE'S PRIMARY CARE FOR ADULTS INC	N
DRUM HILL PRIMARY CARE LLC	N
DUTTON FAMILY CARE ASSOCIATES LLP	N
ERIC JOHNSON M.D., P.C.	N
FOUAD N. AOUDE MD PC	N
GLOBAL CARE MEDICAL GROUP PC	N
HALLMARK HEALTH MEDICAL ASSOCIATES INC	N
HALWARD BLEGEN	N
HASS FAMILY MEDICINE CAPE COD	N
HEART CENTER OF METROWEST, INC.	N
JACK CHANG MD PC	N
JAY KRASNER (WAYSIDE HEALTH ASSOCIATES)	N
JOSHI MEDICAL SERVICES, PC	N
KAREN-GAIL BRANDSE, MD AND ASSOCIATES	N
KEVIN MALONE DO PC	N
KEVIN TOMANY MD PC	N
KUNWAR SINGH	N
LAWRENCE P JOHNSON MD PC	N
LGH MEDICAL GROUP, INC.	N
LGH MERRIMACK VALLEY CARDIOLOGY ASSOCIATES, LLC	N
LGH PROFESSIONAL SERVICES LLC	N
LGH WOMANHEALTH, INC.	N
LOWELL COMMUNITY HEALTH CENTER, INC.	N
LOWELL FAMILY MEDICAL CARE PC	N
MASS MEDICAL GROUP LLC	N
MASSACHUSETTS ENT ASSOCIATES INC	N
MASSACHUSETTS EYE ASSOCIATES PC	N
MEDICAL ASSOCIATES OF NEW ENGLAND	N
MEDICAL HEALTHCARE SPECIALISTS, P.C.	N
MELROSE INTERNAL MEDICINE ASSOC PC	N
MELROSE MEDICAL ASSOCIATES	N
MERRIMACK RADIOLOGY CRA LLC	N
MICHAEL C ZASLOW, M.D. P.C.	N
MILL CITY MEDICAL GROUP LTD	N
MYSTIC MEDICAL GROUP, INC.	N
NASSER NABI MD PC	N
NATICK GENERAL PRACTICE, P.C.	N
NESC LPHO LLC	N
NEW ENGLAND FOOT & ANKLE PC	N
NEW ENGLAND HERNIA CENTER LLC	N
NEW ENGLAND NEPHROLOGY HOME CARE ASSOCIATES	N
NORTHEAST MEDICAL GROUP INC	N
ORTHOPAEDIC SURGICAL ASSOCIATES OF LOWELL, P.C.	N
PAT CHIRASEVEENUPRAPUND (PAT CHIRA,MD)	N
PATHOLOGY ASSOCIATES OF LOWELL PC	N
PAULINE CHAO	N
PELHAM HEALTHCARE ASSOCIATES PLLC	N
PETER D. ROMAN, MD, PC	N
PLEASANT LAKE MANAGEMENT, CO, P.C.	N
PLYMOUTH CARVER PRIMARY CARE, PC	N
PRAMODHYA CHIRASEVINUPRAPHAND (PRAMODHYA CHIRA,MD)	N
PRATT MEDICAL GROUP, INC.	N
PRECISION SURGICAL SPECIALISTS OF LOWELL PC	N
PRISM MEDICAL ASSOCIATES, LLC	N
PULMONARY & PRIMARY CARE ASSOC. OF PLYMOUTH, P.C.	N
PULMONARY ASSOCIATES OF METROWEST, PC	N
QUINCY PRIMARY HEALTHCARE, PC	N
REGAL MEDICAL GROUP (BOROUGHS MEDICAL & WELLNESS CENTER)	N
RIVERSIDE MEDICAL GROUP PC	N
RIVERSIDE SURGICAL ASSOCIATES, PC	N
ROBERT F. COMMITO MD PC	N
ROBERT F KELLIHER MD	N
RONALD SEN	N
SALIL K. MIDHA. MD. PC	N
SAVITHA GOWDA, MD PC (NORWOOD MEDICAL ASSOCIATES, PC )	N
SEPULVEDA & ASSOCIATES PC	N
NANCY LANDRY PLLC (SOMERVILLE FAMILY PRACTICE)	N
SOUTH SHORE NEPHROLOGY, P.C.	N
ST MARY'S INTERNAL MEDICINE PC	N
STEPHEN LOUIE, M.D. (STEPHEN W. LOUIE, M.D.)	N
STEPHEN MURPHY (STEPHEN P MURPHY MD PC)	N
STONY BROOK PRIMARY CARE LLC	N
SUBURBAN CARDIOLOGY AND INTERNAL MEDICINE, PC	N
THARWAT A HANNA, MD PC	N
TLB II, P.C. (CAPE COD MEDICAL CENTER)	N
TODAY'S WELLNESS PLLC	N
TUFTS MEDICAL CENTER COMMUNITY CARE INC	N
VASCULAR ASSOCIATES OF THE MERRIMACK VALLEY PC	N
VHM SERVICES INC (METROWEST PHYSICIAN SERVICES)	N
WALPOLE MEDICAL CENTER, PC	N
WAYSIDE HEALTH ASSOCIATES (JAY KRASNER, MD)	N
WESTFORD VEIN AESTHETIC SOLUTIONS LLC	N
WOBURN NEPHROLOGY ASSOCIATES PC	N
YARMOUTH MEDICAL CENTER, LLC	N
ZAHEER AHMED	N
ZEUS CORPORATION	N
ZHANG MEDICAL ASSOCIATES, PLLC	N

ACO governing body

Member	Member's Voting Power Expressed as a percentage or number	Membership Type	ACO Legal Business Name/DBA if applicable
Alain Chaoui, MD	11.111%	ACO Participant	Congenial Healthcare
Michele Crage, MD	11.111%	ACO Participant	Woburn Nephrology Associates
David Criss, MD	11.111%	ACO Participant	Melrose Internal Medicine
Karen Freund, MD	11.111%	ACO Participant	Pratt Medical Group
William Galvin, MD	11.111%	ACO Participant	Circle Health OB/GYN
Carolyn O'Donnell	11.111%	Medicare Beneficiary Representative	N/A
Tushar Patel, MD	11.111%	ACO Participant	Riverside Medical Group
Peter Roman, MD	11.111%	ACO Participant	Peter D Roman MC PC
Daniel Driscoll, MD	11.111%	ACO Participant	Tufts Medical Center Community Care, Inc.

Key ACO clinical and administrative leadership

Kathy Garland
ACO Executive

Frank Osborn, MD
Medical Director

Jim Gagnon
Quality Assurance / Improvement Officer

Associated committees and committee leadership:

Committee Name	Committee Leader Name and Position
ACO Finance Committee	David Criss, MD, ACO Finance Committee Chair
Clinical Performance & Quality Committee	Frank Osborn, MD, as Clinical Performance and Quality Committee Chair

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

• Wellforce Medicare ACO, LLC is a Network of individual practices of ACO professionals.

Shared savings and losses

Amount of Shared Savings / Losses

• Fourth Agreement Period -
  • Performance Year 2023: $15,001,147
• Third Agreement Period
  • Performance Year 2022: $28,100,000
• Second Agreement Period
  • Performance Year 2021: $6,096,128
• First Agreement Period
  • Performance Year 2020: $6,045,355

Shared savings distribution

• Fourth Agreement Period -
  • Performance Year 2023: $15.0 million
    • Proportion invested in infrastructure: 37%
    • Proportion invested in redesigned care processes/resources:  3.25%
    • Proportion of distribution to ACO participants: 59.74%
       
• Third Agreement Period
  • Performance Year 2022: $28.1 million
    • Proportion invested in infrastructure: 20.6%
    • Proportion invested in redesigned care processes/resources: 12.5%
    • Proportion of distribution to ACO participants: 49.8%
• Second Agreement Period
  • Performance Year 2021
    • Proportion invested in infrastructure: 22.3%
    • Proportion invested in redesigned care processes/resources: 19.4%
    • Proportion of distribution to ACO participants: 58.3%
• First Agreement Period
  • Performance Year 2020
    • Proportion invested in infrastructure: 18.5%
    • Proportion invested in redesigned care processes/resources: 19.8%
    • Proportion of distribution to ACO participants: 61.7%

Quality performance results

2023 Quality Performance Results:

Measure #	Measure Name	Collection Type	Reported Performance Rate	Current Year Mean Performance Rate (SSP ACOs)
001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control2	CMS Web Interface	11.54	9.84
134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	CMS Web Interface	78.14	80.97
236	Controlling High Blood Pressure	CMS Web Interface	87.69	77.80
318	Falls: Screening for Future Fall Risk	CMS Web Interface	91.64	89.42
110	Preventative Care and Screening: Influenza Immunization	CMS Web Interface	70.91	70.76
226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	CMS Web Interface	90.48	79.29
113	Colorectal Cancer Screening	CMS Web Interface	81.27	77.14
112	Breast Cancer Screening	CMS Web Interface	89.43	80.36
438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	CMS Web Interface	93.67	87.05
370	Depression Remission at Twelve Months	CMS Web Interface	5.36	16.58
321	CAHPS for MIPS [3]	N/A	7.87	6.25
479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1]	N/A	0.1733	0.1553
484	Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1]	N/A	-	35.39

 

---

 

2022 Quality Performance Results:

Measure #	Measure Name	Collection Type	Reported Performance Rate	Current Year Mean Performance Rate (SSP ACOs)
001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control2	CMS Web Interface	9.49	10.71
134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	CMS Web Interface	65.20	76.97
236	Controlling High Blood Pressure	CMS Web Interface	83.47	83.47
318	Falls: Screening for Future Fall Risk	CMS Web Interface	85.20	87.83
110	Preventative Care and Screening: Influenza Immunization	CMS Web Interface	78.68	77.34
226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	CMS Web Interface	61.11	79.27
113	Colorectal Cancer Screening	CMS Web Interface	78.20	75.32
112	Breast Cancer Screening	CMS Web Interface	77.51	78.07
438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	CMS Web Interface	90.78	86.37
370	Depression Remission at Twelve Months	CMS Web Interface	6.06	16.03
321	CAHPS for MIPS [3]	N/A	N/A	N/A
479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1]	CMS Web Interface	0.1715	0.1510
484	Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1]	CMS Web Interface	37.17	30.97

 

---

 

2021 Quality Performance Results:

Measure #	Measure Name	Reported Performance Rate	Current Year Mean Performance Rate (SSP ACOs)
001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control2	8.42	12.46
134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	79.34	74.38
236	Controlling High Blood Pressure	88.93	74.87
318	Falls: Screening for Future Fall Risk	94.4	87.03
110	Preventative Care and Screening: Influenza Immunization	85.9	80.52
226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	97.06	80.97
113	Colorectal Cancer Screening	75.19	73.63
112	Breast Cancer Screening	77.7	75.11
438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	91.71	84.24
370	Depression Remission at Twelve Months	N/A	N/A
321	CAHPS for MIPS3	N/A	N/A
479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2	0.1625	0.154
MCC1	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2	41.6	33.99

 

Please note, the Quality ID #: 370 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size

 

---

 

2020 Quality Performance Results:

ACO Quality Measure Number	Measure Name	Rate	ACO Mean
ACO-43	Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))	1.53	0.95
ACO-13	Falls: Screening for Future Fall Risk	90.30	84.97
ACO-14	Preventive Care and Screening: Influenza Immunization	83.11	76.03
ACO-17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	100.00	81.67
ACO-18	Preventive Care and Screening: Screening for Depression and Follow-up Plan	74.17	71.46
ACO-19	Colorectal Cancer Screening	72.18	72.59
ACO-20	Breast Cancer Screening	80.90	74.05
ACO-42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	93.25	83.37
ACO-27	Diabetes Mellitus: Hemoglobin A1c Poor Control	9.76	14.70
ACO-28	Hypertension (HTN): Controlling High Blood Pressure	86.06	72.87

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

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