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
Kathleen.Garland [at] lowellgeneral.org
ACO Participants
| ACO Participants |
ACO Participants in Joint Venture (Y or N) |
| Ajay Anand MD PC | N |
| Alexandra Argasinski, MD | N |
| Andrew M Romanowsky MD LLC | N |
| Apex Medical Associaltes, LLC | N |
| Benjamin Henkle MD LLC | N |
| Blue Hills Medical Associates | N |
| Regal Medical Group (Boroughs Medical & Wellness Center) | N |
| Brewster Medical Associates, PC | N |
| Tlb 11, PC (Cape Cod Medical Center) | N |
| Cape Cod Primary Care, LLC | N |
| Carlos Del Rio, MD PC | N |
| Chelmsford Family Practice, PC | N |
| Chelmsford Primary Care LLC | N |
| Christopher E. Coakley, M.D | N |
| Clara Lennox | N |
| Congenial Healthcare, LLC | N |
| Comprehensive Primary Care LLC | N |
| Damian Folch | N |
| David Sidebottom | N |
| Dineli, A Professional Corporation | N |
| Droidmd P LLC | 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 |
| George P Meltsakos PC | N |
| Global Care Medical Group PC | N |
| Hallmark Health Medical Associates, Inc. | N |
| Halward Blegen, M.D. | N |
| Heart Center Of Metrowest | N |
| Jack Chang MD PC | 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. MD | N |
| Lawrence P Johnson MD PC | N |
| Lgh Medical Group, Inc. | N |
| Lgh Merrimack Valley Cardiology Associates, LLC | N |
| Lgh Professional Services LLC | N |
| Circle Health Obgyn LLC | N |
| Lowell Community Health Center, Inc. | N |
| Lowell Family Medical Care PC | N |
| Main Street Family Practice | N |
| Maria Gorbovitsky, M.D., P.C. | N |
| Mass Medical Group LLC | N |
| Massachusetts Ent Associates Inc | N |
| Massachusetts Eye Associates PC | N |
| Medical Associates Of New England, LLC | N |
| Medical Healthcare Specialists,P.C. | N |
| Melrose Internal Medicine | N |
| Melrose Medical Associates | N |
| Merrimack Radiology Cra LLC | N |
| Michael Zaslow Md | N |
| Middleton Family Medicine | N |
| Mill City Medical Group Ltd | N |
| Mystic Medical Group | N |
| Nasser Nabi Md, Facc, Fccp, PC | N |
| Natick General Practice, P.C. | N |
| Nesc Lpho LLC | N |
| New England Foot & Ankle PC | N |
| New England Hernia Center LLC | N |
| Cnv Mw (New England Nephrology Home Care Associates) | N |
| Nonnie Estella | N |
| Northeast Medical Group Inc | N |
| Savitha Gowda, M.D, P.C (Norwood Medical Associates, PC) | N |
| Orthopaedic Surgical Associates Of Lowell, P.C. | N |
| Pat Chiraseveenuprapund (Pat Chira, Md) | N |
| Pathology Associates Of Lowell PC | N |
| Pauline Chao, M.D. | 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 |
| Pondville Medical Associates, LLC | N |
| Pramod 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 |
| Pulmonay Associates Of Metrowest | N |
| Quincy Primary Healthcare, PC | N |
| Reading Family Medicine, PC | N |
| Riverside Medical Group PC | N |
| Riverside Surgical Associates, PC | N |
| Robert F. Commito Md PC | N |
| Robert R. Moore, M.D., Ph. D., P.C. | N |
| Ronald Sen, MD | N |
| St. Mary’s Internal Medicine, PC (Saint Mary's Internal Medicine) | N |
| Salil K. Midha. Md. PC | N |
| Sepulveda & Associates PC | N |
| Sivaram Yamajala, MD LLC | N |
| Nancy Landry PLLC Dba Somerville Family Practice | N |
| South Shore Nephrology, P.C. | N |
| Stephen P Murphy MD PC | N |
| Stephen W. Louie, M.D. | N |
| Stony Brook Primary Care LLC | N |
| Suburban Cardiology And Internal Medicine, PC | N |
| Tharwat Mikhael Hanna, M.D. | N |
| Tufts Medical Center Community Care | N |
| Vascular Associates Of The Merrimack Valley PC | N |
| Jay Krasner (Wayside Health Associates) | N |
| David Schroeder | N |
| David Schroeder, MD, PC (David M. Shein) | N |
| Westford Vein Aesthetic Solutions LLC | N |
| Woburn Nephrology Associates | N |
| Yarmouth Medical Center, LLC | N |
| Yun K. Lam, M.D., P.C. | 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 |
| Michele Crage, MD | 1 | ACO Participant | Woburn Nephrology Associates |
| David Criss, MD | 1 | ACO Participant | Melrose Internal Medicine |
| Daniel Driscoll, MD | 1 | ACO Participant | Tufts Medical Center Community Care, Quincy |
| Karen Freund, MD | 1 | ACO Participant | Pratt Medical Group |
| Peter Roman, MD | 1 | ACO Participant | Peter D Roman MC PC |
| William Galvin, MD | 1 | ACO Participant | Circle Health OB/GYN |
| Barbara Clifford, FNP | 1 | Medicare Beneficiary Representative | N/A |
| Carolyn O'Donnell | 1 | Medicare Beneficiary Representative | N/A |
Key ACO Clinical and Administrative Leadership:
- ACO Executive: Nate Gagne
- Medical Director: Frank Osborn, MD
- Compliance Officer: Nicole Huff
- Quality Assurance / Improvement Officer: Candace Perry
Associated Committees and Committee Leadership:
Committee Name |
|
||
|
ACO Finance & Funds Flow Committee |
Mark Gilchrist, MD, ACO Finance & Funds Flow Committee Chair |
||
|
Clinical Performance & Quality Committee |
Kelli Kennedy, 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
-
Second Agreement Period
-
Performance Year 2021: $6,096,128
-
-
First Agreement Period
-
Performance Year 2020: $6,045,355
-
Shared Savings Distribution
- 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%
- Performance Year 2021
- 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%
- Performance Year 2020
Quality Performance Results
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