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

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Organizational Information

ACO Participants - Legal Name

Participant in
Joint Venture

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
Business Name, if applicable

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
James Sawyer MD FACP, Co-Chair

Health Information and Data Committee

Jason Smith, Chair
Jeanette Schaublin, Co-Chair

Clinical Best Practices Committee

James Sawyer, MD, FACP, Chair
Darrell Bunch, DO, Co-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
Follow-up Plan
¹

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
Conditions for ACOs (MCC)
2

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.

 

[2] A lower performance rate corresponds to higher quality.

     

 

[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