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 [at] 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 |
| DINELI, A PROFESSIONAL CORPORATION | N |
| DR. HE'S PRIMARY CARE FOR ADULTS INC | 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 | 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 |
| MARIA L GORBOVITSKY MD 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 |
| READING FAMILY MEDICINE, 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 |
| ROBERT R. MOORE, MD PHD PC | 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 |
| WELLESLEY INTERNAL MEDICINE (D. SCHEIN) | N |
| WELLESLEY INTERNAL MEDICINE (D. SCHROEDER) | N |
| WESTFORD VEIN AESTHETIC SOLUTIONS LLC | N |
| WOBURN NEPHROLOGY ASSOCIATES PC | N |
| YARMOUTH MEDICAL CENTER, LLC | N |
| YUN LAM (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 | 12.5 | ACO Participant | Woburn Nephrology Associates |
| David Criss, MD | 12.5 | ACO Participant | Melrose Internal Medicine |
| Daniel Driscoll, MD | 12.5 | ACO Participant | Tufts Medical Center Community Care, Quincy |
| Karen Freund, MD | 12.5 | ACO Participant | Pratt Medical Group |
| Peter Roman, MD | 12.5 | ACO Participant | Peter D Roman MC PC |
| William Galvin, MD | 12.5 | ACO Participant | Circle Health OB/GYN |
| Barbara Clifford, FNP | 12.5 | Medicare Beneficiary Representative | N/A |
| Carolyn O'Donnell | 12.5 | 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: Jim Gagnon
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 |
TBD |
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