Prime Care Managers
ACO Public Reporting
PRIME CARE MANAGERS / ACO ID: A3280
ACO Name & Location
Prime Care Managers Accountable Care Organization
4002 Technology Center, Longview TX 75605
Primary ACO Contact
|
Primary Contact Name |
John D. Ford |
|
Contact Phone Number |
903-247-0484 |
|
Contact Email Address |
This email address is being protected from spambots. You need JavaScript enabled to view it. |
Organizational Information
ACO Participants - Legal Name |
Participant in
|
|---|---|
|
Associated Clinicians of East Texas |
Y |
|
Collom and Carney Clinic Association |
Y |
|
Darren J. Arnecke, M.D., P.A. |
N |
|
East Texas Clinic Association |
N |
|
Family Medical Associates, P.A. |
N |
|
Marshall Family Practice Associates, PLLC |
N |
|
Oge Family Medical Clinic, PLLC |
N |
|
Pulmonary & Internal Medicine of Texarkana |
N |
|
Phynet, Inc. |
Y |
|
Tyler Internal Medicine Associates, P.A. |
N |
|
Whelchel Primary Care Medicine, P.A. |
N |
ACO Governing Body
|
Member |
Voting Power Expressed as a percentage |
Membership Type |
ACO Participant Legal |
||
|
First Name |
Last Name |
Title/Position |
|||
|
John |
Ford |
Chairman |
23% |
Stakeholder |
|
|
Darrell |
Bunch, D.O. |
Voting Member |
25% |
ACO Participant / Rep. |
PhyNet, Inc. |
|
James |
Sawyer, M.D. |
Voting Member |
25% |
ACO Participant / Rep. |
Associated Clinicians of East Texas |
|
James |
Logan, M.D. |
Voting Member |
25% |
ACO Participant / Rep. |
Marshall Family Practice Associates |
|
James |
Mauldin |
Voting Member |
2% |
Medicare Beneficiary / Rep. |
|
Key ACO Clinical & Administrative Leadership
ACO Executive: John Ford
Medical Director: James Sawyer, M.D., FACP
Compliance Officer: Jeanette Schaublin
Quality Assurance/Improvement Officer: Jeanette Schaublin
Associated Committees and Committee Leadership
Committee Name |
Committee Leader Name & Position |
|
Executive Committee |
John Ford, Chair |
|
Quality Improvement and Assurance Committee |
Darrell Bunch DO, Chair |
|
Health Information and Data Committee |
Jason Smith, Chair |
|
Clinical Best Practices Committee |
James Sawyer, MD, FACP, Chair |
|
IT/Compliance Committee |
Jason Smith, Chair |
Types of ACO Participants, or Combinations of Participants, That Formed the ACO
▪︎ Networks of individual practices of ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses:
§ Second Agreement Period
o Performance Year 2021, $ 4,441,132.86
o Performance Year 2020, $ 3,997,054.67
§ First Agreement Period
o Performance Year 2019, $ 2,929,207.96
o Performance Year 2018, $ 0.00
o Performance Year 2017, $ 0.00
Shared Savings Distribution:
§ Second Agreement Period
o Performance Year 2021
- Proportion invested in infrastructure: 27%
- Proportion invested in redesigned care processes/resources: 7%
- Proportion of distribution to ACO participants: 66%
o Performance Year 2020
- Proportion invested in infrastructure: 27%
- Proportion invested in redesigned care processes/resources: 7%
- Proportion of distribution to ACO participants: 66%
§ First Agreement Period
o Performance Year 2019
- Proportion invested in infrastructure: 30%
- Proportion invested in redesigned care processes/resources: 10%
- Proportion of distribution to ACO participants: 60%
o Performance Year 2017-2018
- Proportion invested in infrastructure: N/A%
- Proportion invested in redesigned care processes/resources: N/A%
- Proportion of distribution to ACO participants: N/A
2021 Quality Performance Results:
Quality performance results are based on CMS Web Interface
|
Measure # |
Measure Name |
Rate |
ACO Mean |
|
001 |
Diabetes: Hemoglobin A1c (HbA1c) Poor Control2 |
11.22 |
12.46 |
|
134
|
Preventative Care and Screening: Screening for Depression and |
64.47 |
74.38 |
|
236
|
Preventative Care and Screening: Screening for Depression and Follow-up Plan |
63.79 |
74.87 |
|
318 |
Falls: Screening for Future Fall Risk |
88.60 |
87.03 |
|
110 |
Preventative Care and Screening: Influenza Immunization |
85.29 |
80.52 |
|
226 |
Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention |
67.50 |
80.97 |
|
113 |
Colorectal Cancer Screening |
74.50 |
73.63 |
|
112 |
Breast Cancer Screening |
72.95 |
75.11 |
|
438 |
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease ¹ |
83.31 |
84.24 |
|
370 |
Depression Remission at Twelve Months ¹’⁴ |
27.66 |
15.50 |
|
321 |
CAHPS for MIPS3 |
N/A |
N/A |
|
479 |
Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2 |
0.1553 |
0.1540 |
|
MCC1 |
All-Cause Unplanned Admissions for Patients with Multiple Chronic |
30.95 |
33.99 |
|
[1] For PY 2021, measures #134, #438, and #370 do not have CMS Web Interface benchmarks and are not scored as a result. |
|
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|
[2] A lower performance rate corresponds to higher quality. |
|
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|
[3] CAHPS for MIPS is a composite measure, so numerator, denominator, and performance rate values are not applicable (N/A). See CAHPS for MIPS for details on performance. [4] # 370 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. |
||||
2021 Quality Performance Results:
CAHPS for MIPS
|
Measure # |
Measure Name |
Rate |
ACO Mean |
|
CAHPS-1 |
Getting Timely Care, Appointments, and Information |
88.81 |
84.67 |
|
CAHPS-2 |
How Well Providers Communicate |
92.52 |
93.56 |
|
CAHPS-3 |
Patient’s Rating of Provider |
90.76 |
92.19 |
|
CAHPS-4 |
Access to Specialists |
79.75 |
78.80 |
|
CAHPS-5 |
Health Promotion and Education |
51.31 |
61.61 |
|
CAHPS-6 |
Shared Decision Making |
57.20 |
60.89 |
|
CAHPS-7 |
Health Status and Functional Status |
68.72 |
71.78 |
|
CAHPS-8 |
Care Coordination |
85.58 |
85.66 |
|
CAHPS-9 |
Courteous and Helpful Office Staff |
92.01 |
91.88 |
|
CAHPS-11 |
Stewardship of Patient Resources |
29.75 |
24.71 |
• For Previous Years’ Financial and Quality Performance Results, Please Visit: https://data.cms.gov/
Payment Rule Waivers
■ ACO Payment Rule Waiver:
○ N/A
Fraud and Abuse Waivers
■ ACO Participation Waiver:
○ N/A