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ACO Public Reporting

ACO Name and Location

  PrimeCare Managers, LLC

  4002 Technology Center, Longview TX 75605

ACO Primary Contact

  John D. Ford

  903-247-0484

  [email protected]

Organizational Information

ACO Participants

ACO Participant in Joint Venture

Associated Clinicians Of East Texas/DBA: DIAGNOSTIC CLINIC OF LONGVIEW

Yes

COLLOM & CARNEY CLINIC ASSOCIATION/ DBA: COLLOM & CARNEY CLINIC

Yes

Darren Arnecke

No

DARREN J. ARNECKE M.D.,P.A.

No

East Texas Clinic Association

No

Family Medical Associates, PA

No

FAMILY MEDICAL GROUP OF TEXARKANA

No

LONGVIEW OUTPATIENT PHYSICAL THERAPY LLC/DBA: CENTRE OF REHABILITATION EXCELLENCE

Yes

Marshall Family Practice Associates Pllc

No

ONESOURCE HOME CARE INC /DBA: PrimeCare Home Health

Yes

Phynet Inc.

Yes

PRIME CARE HOSPICE LLC

Yes

Whelchel Primary Care Medicine, P.A.

No

ACO Governing Body

First Name Last Name Title / Position Voting Power Membership Type ACO Participant Legal Business Name
Darrell Bunch DO/Board Officer 25% ACO Participant Representative Phynet Inc.
Gergory Richter MD Voting member 8% ACO Participant Representative COLLOM & CARNEY CLINIC ASSOCIATION/DBA: COLLOM & CARNEY CLINIC
James Sawyer MD Voting member 10% ACO Participant Representative Associated Clinicians Of East Texas/DBA: DIAGNOSTIC CLINIC OF LONGVIEW
James Logan MD Voting member 8% ACO Participant Representative Marshall Family Practice Associates, PLLC
John Ford Board Chair 23% Community Stakeholder Representative N/A
Kathleen Harris MD Voting member 8% ACO Participant Representative Associated Clinicians Of East Texas/DBA: DIAGNOSTIC CLINIC OF LONGVIEW
Kyle Jones FNPC Voting Member 8% ACO Participant Representative COLLOM & CARNEY CLINIC ASSOCIATION/DBA: COLLOM & CARNEY CLINIC
Lee Thomas Medicare FFS beneficiary 2% Medicare Beneficiary Representative N/A
Micheal Morris MD Voting member 8% ACO Participant Representative Associated Clinicians Of East Texas/DBA: DIAGNOSTIC CLINIC OF LONGVIEW

Associated Committees and Committee Leadership:

Committee Name Committee Leader Name and Position
ACO Compliance Committee Jason Smith, Co-Chair
ACO Compliance Committee Jeanette Schaublin LVN, CCID, Officer
ACO Compliance Committee John Ford, Chair
Clinical Best Practices Committee Jeanette Schaublin LVN, CCID, Co-Chair
Clinical Best Practices Committee Darrell Bunch, DO, Co-Chair
Clinical Best Practices Committee James Sawyer, MD, FACP, Chair
Executive Committee Roger Hall, Co-Chair
Executive Committee Bert Ratay, Co-Chair
Executive Committee John Ford, Chair
Health Information and Data Committee Jason Smith, Chair
Health Information and Data Committee Jeanette Schaublin LVN, CCID, Co-Chair
Health Information and Data Committee Levi Hensly, Co-Chair
IT/Data Compliance Committee Levi Hensly, Co-Chair
IT/Data Compliance Committee Valerie Topp, Co-Chair
IT/Data Compliance Committee Jason Smith, Chair
Quality Improvement and Assurance Committee Jeanette Schaublin LVN, CCID, Officer
Quality Improvement and Assurance Committee James Sawyer MD FACP, Co-Chair

Types of ACO Participants, or Combinations of Participants, that formed the ACO

  • Networks of individual practices of ACO professionals
  • Partnerships or joint venture arrangements between integrated care networks and ACO professionals

Shared Savings and Losses
Amount of Shared Savings/Losses:

  • Third Agreement Period

    Performance Year 2025, N/A
    Performance Year 2024, $5,940,415.60

  • Second Agreement Period

    Performance Year 2023, $7,998,546.23
    Performance Year 2022, $4,180,487.00
    Performance Year 2021, $4,441,132.86
    Performance Year 2020, $3,997,054.67

  • First Agreement Period

    Performance Year 2019, $2,929,207.96
    Performance Year 2018, $0.00
    Performance Year 2017, N/A

Shared Savings and Losses

  • Third Agreement Period

    Performance Year 2025

    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A

    Performance Year 2024

    • Proportion invested in infrastructure: 12%
    • Proportion invested in redesigned care processes/resources: 8%
    • Proportion of distribution to ACO participants: 80%
  • Second Agreement Period

    Performance Year 2023

    • Proportion invested in infrastructure: 27%
    • Proportion invested in redesigned care processes/resources: 7%
    • Proportion of distribution to ACO participants: 66%

    Performance Year 2022

    • Proportion invested in infrastructure: 27%
    • Proportion invested in redesigned care processes/resources: 7%
    • Proportion of distribution to ACO participants: 66%

    Performance Year 2021

    • Proportion invested in infrastructure: 27%
    • Proportion invested in redesigned care processes/resources: 7%
    • Proportion of distribution to ACO participants: 66%

    Performance Year 2020

    • Proportion invested in infrastructure: 30%
    • Proportion invested in redesigned care processes/resources: 10%
    • Proportion of distribution to ACO participants: 60%
  • First Agreement Period

    Performance Year 2019

    • Proportion invested in infrastructure: 30%
    • Proportion invested in redesigned care processes/resources: 10%
    • Proportion of distribution to ACO participants: 60%

     Performance Year 2018

    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A

    Performance Year 2017

    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A


2024 Quality Performance Results:

Quality performance results are based on Web Interface collection type.

Measure # Measure Name Collection Type Reported Performance Rate Current Year Mean (SSP ACOs)
110 Preventative Care and Screening: Influenza Immunization CMS Web Interface 95.13
112 Breast Cancer Screening CMS Web Interface 90.26
113 Colorectal Cancer Screening CMS Web Interface 77.03
134 Preventative Care and Screening: Screening for Depression and Follow-up Plan CMS Web Interface 94.88
226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface 93.75
236 Controlling High Blood Pressure CMS Web Interface 83.2
318 Falls: Screening for Future Fall Risk CMS Web Interface 93.12
370 Depression Remission at Twelve Months CMS Web Interface 8
438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface 93.51
479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups Administrative Claims 0.1522
001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control CMS Web Interface 4.75
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS Survey 87.17
CAHPS-2 How Well Providers Communicate CAHPS for MIPS Survey 95.16
CAHPS-3 Patient’s Rating of Provider CAHPS for MIPS Survey 92.42
CAHPS-4 Access to Specialists CAHPS for MIPS Survey 82.3
CAHPS-5 Health Promotion and Education CAHPS for MIPS Survey 58.32
CAHPS-6 Shared Decision Making CAHPS for MIPS Survey 59.27
CAHPS-7 Health Status and Functional Status CAHPS for MIPS Survey 73.86
CAHPS-8 Care Coordination CAHPS for MIPS Survey 86.63
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS Survey 94.25
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS Survey 33.34

For previous years’ Financial and Quality Performance Results, please visit: Data.cms.gov

Payment Rule Waivers

  • Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.

Fraud and Abuse Waivers

  •  ACO Participation Waiver:

The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement.

  • Parties to the arrangement: Prime Care Managers, LLC (ACO) and One Source Home Care, LLC dba Prime Care Managers Home Health (Home Health Agency) Prime Care Managers, LLC (ACO) and Prime Care Hospice, LLC.
    Prime Care Managers, LLC (ACO) and Longview Outpatient Physical Therapy, LLC(C
    • Date of arrangement: 06/12/2024
    • Items, services, goods, or facility provided: Provides home health, hospice, and outpatient therapy services to support care transitions, symptom management, rehabilitation, and quality of life for ACO patients across settings.