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

 

Committee Leader Name and Position

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%
  • 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

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