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

 

Committee Leader Name and Position

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%
  • 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