Accountable Care Organization (ACO) Public Reporting (Pioneer)
ACO Name and Location:
Michigan Pioneer ACO
28411 Northwestern Highway, Suite 750
Southfield, MI 48034
ACO Primary Contact:
Roger Wiseman, ACO President
Rwiseman@dmc.org
248-595-8819, ext. 133
Organizational Information:
ACO Participants 2017:
Click here to expand ACO Participants.
Medical Group |
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ABBOTT MEDICAL GROUP |
ACCESS IPA |
AFZAL BEEMATH MD PC |
Ali Hasan Mahmood, MD, PLC |
Amity Internal Medicine PC |
ANGELA BULLY MD PLLC |
ANJALI KUMAR, MD |
ASHOK KUMAR BANSAL PC |
AZHAR ESHO, MD PC |
BELAMEDICA |
CARDIOVASCULAR CONSULTANTS |
CHARLES G GODOSHIAN MD PC |
CITY MEDICAL |
COMMERCE PRIMARY CARE PC |
CRYSTAL HOME HEALTHCARE |
DAVID CRISS MD |
Dearborn Heights Medical Center, P.C. |
DELAIR GARDI MD PC d/b/a HEART AND VASCULAR CONSULTANTS |
DETROIT MEDICAL SERVICES PLLC |
EDISON HEALTH CARE ASSOCIATES |
ELLIOTT I GREENSPAN DO PC & ASSOCIATES |
Enas Nakkash, MD |
EVERETT V BRYANT MD PLLC |
FAMILY MEDICAL CENTER PC |
FAMILY MEDICAL CLINIC |
Farm Brook Family Practice |
GHINWA NAKKASH MD PC |
Grand River Medical Associates PLLC |
Greenfield Medical Center of Dearborn, PC |
Healing Hands Family Health Center, PLLC |
HEALTH CENTERS DETROIT MEDICAL GROUP |
HEALTH FIRST MEDICAL CENTER |
HEALTH ONE MEDICAL CENTER EASTPOINTE PLLC |
HEART AND VASCULAR INSTITUTE PLLC |
HIGHLAND MILFORD FAMILY CLINIC |
HIGHLAND PARK MEDICAL CENTER PLLC |
Hila D. Elia, M.D., PC |
I&L PROFESSIONAL MEDICAL SERVICES |
INTEGRATED HEALTH CARE PROVIDERS |
INTERGRATED HEALTH CARE ASSOSCIATION |
JACKSON HEALTH SERVICES |
JANE K. SYRIAC, MD PC |
KENNETH J. DZIUBA, MD PC |
Laz Medical Group, P.C. |
LYLE GRANT MD |
MILFORD FAMILY PRACTICE |
OSTEOPATHIC CLINICAL CARDLOLOGY |
PARK FAMILY HEALTH CARE PC |
PILLAY INTERNAL MEDICINE ASSOCIATES PLLC |
POLECK PRACTICE |
PROFESSIONAL MEDICAL CENTER PC |
PROFESSIONAL PLAZA CLINIC CORP |
PROGRESSIVE HEALTH CARE PC |
Rosemary M Aquiler-Angeles, MD, PC |
SAMINA ANSAR GHAZI MD |
SOMERSET FAMILY MEDICINE |
Suezette Olaker, MD, PC |
SUSAN E HAROLD MD |
SYLMARA E CHATMAN MD |
THOMAS MAYS MD PC |
UNITED FAMILY MEDICAL ASSOCIATES |
UNIVERSITY PHYSICIAN GROUP |
UNIVERSITY PHYSICIAN GROUP d/b/a ROSA PARKS GERIATRIC CENTER |
VAN DYKE MEDICAL |
VHS Physicians of Michigan d/b/a DMC Medical Group |
Virginia Park Internal Medicine, PC |
VK SIDDIQUI MD PC |
Warren Family Medical Center |
No participants are involved in a joint venture between ACO professionals and hospitalsACO Governing Body:
- Dr. Richard Brown, Voting Member & Chair, ACO Participant,Park Family Health Care PC
- Dr. Safwan Badr, Voting Member & ACO Participant, Wayne State University Physician Group
- Dr. Reginald J. Eadie, Voting Member & Physician, President, DMC Detroit Receiving & Harper Hospitals
- Dr. Mahir Elder, Voting Member & ACO Participant, Heart and Vascular Institute PLLC
- Dr. Alka Jain, Voting Member & ACO Participant, Commerce Primary Care
- Dr. Jeet Pillay, Voting Member & ACO Participant, Pillay Internal Medicine Associates PLLC
- Dr. Suzanne White, Voting Member & Physician, Chief Medical Officer, Detroit Medical Center
- Ms. Paula Autry, Voting Member, ACO Supplier & President, DMC Sinai-Grace Hospital
- Ms. Vern Davis-Anthony, Voting Member & Medicare Beneficiary Representative
Key Clinical and Administrative Leadership:
Roger Wiseman, ACO President
Dr. Gregory Berger, Executive Medical Director
Michelle Castro, ACO Compliance Officer
Kelly Bida, Manager, Quality Assurance/Improvement Officer
Dr. Safwan Badr, Associate Medical Director
Chris Allen, Director of Health Plan Operations and Finance
Mara Duvall, Director of ACO Operations
Justin Williams, Manager, Care Management
Associated Committees and Committee Leadership:
MiPACO Performance Committee, Committee Co-Chair – Dr. Greg Naman
MiPACO Performance Committee, Committee Co-Chair – Dr. Safwan Badr
Compliance Committee, Committee Chair – Michelle Castro
Types of ACO Participants, or Combinations of Participants, that Formed the ACO:
- ACO professionally in a group practice arrangement;
- Networks of individual practices of ACO professionals;
- Partnerships or joint venture arrangements between hospitals and ACO professionals; and
- A hospital employing ACO professionals
Shared Savings and Losses:
- Amount of Shared Savings/Losses:
- Agreement period beginning 2012, Performance Year 1, 2012: $4,022,379
- Agreement period beginning 2012, Performance Year 2, 2013: $5,827,210
- Agreement period beginning 2012, Performance Year 3, 2014: $9,821,272
- Agreement period beginning 2012, Performance Year 4, 2015: $ *
How Shared Savings Are Distributed:
Those ACO Participating Physicians who hold Class B units received approximately 1% of the shared savings pursuant to their agreement with the ACO.
The remaining shared savings were used to reimburse Tenet Healthcare Corporation (Tenet), whose corporate affiliate is the largest Class A unit holder, for amounts advanced to the ACO through Tenet's corporate affiliate and used by the ACO to pay expenses incurred during the performance year and to reinvest in the ACO's operations--i.e., shared savings were expended to support the purposes of the Pioneer ACO program.
- Agreement period beginning 2012, Performance Year 1
- Proportion invested in infrastructure: 10.43%
- Proportion invested in redesigned care processes/resources: 29.56%
- Proportion of distribution to ACO participants: 21.36%
- Agreement period beginning 2012, Performance Year 2013
- Proportion invested in infrastructure: 10.22%
- Proportion invested in redesigned care processes/resources: 44.49%
- Proportion of distribution to ACO participants: 29.21%
- Agreement period beginning 2012, Performance Year 2014
- Proportion invested in infrastructure: 6.10%
- Proportion invested in redesigned care processes/resources: 28.83%
- Proportion of distribution to ACO participants: 24.65%
- Agreement period beginning 2012, Performance Year 2015
- Proportion invested in infrastructure: * %
- Proportion invested in redesigned care processes/resources: * %
- Proportion of distribution to ACO participants: * %
Payment Waiver Rules:
- Yes, our ACO utilizes the SNF 3-Day Rule Waiver
- Ambassador Nursing Center
- Hartford Nursing & Rehab Center
- Oakpointe Senior Care & Rehab Center
- Medilodge of Milford
- Notting Hill of West Bloomfield
2012 - 2014 Quality Performance Results Table | |||||||
---|---|---|---|---|---|---|---|
Measure number | Performance measure | 2012 reporting period | 2013 reporting period | 2014 reporting period | |||
ACO perfor- mance rate |
Pioneer Mean | ACO perfor- mance rate |
Pioneer Mean | ACO perfor- mance rate |
Pioneer Mean | ||
ACO-1 | Getting Timely Care, Appointments, and Information | 80.43 | 80.96 | 76.89 | 81.64 | 73.9 | 81.95 |
ACO-2 | How Well Your Doctors Communicate | 92.55 | 92.64 | 92.68 | 92.95 | 91.1 | 92.99 |
ACO-3 | Patients’ Rating of Doctor | 91.3 | 91.67 | 91.48 | 92.50 | 90.23 | 92.41 |
ACO-4 | Access to Specialists | 85.24 | 84.66 | 88.91 | 84.93 | 85.8 | 83.93 |
ACO-5 | Health Promotion and Education | 58.5 | 57.07 | 61.92 | 59.58 | 60.78 | 60.15 |
ACO-6 | Shared Decision Making | 72.25 | 74.36 | 69.75 | 73.99 | 69.07 | 74.63 |
ACO-7 | Health Status/Functional Status | 65.01 | 70.34 | 66.77 | 71.55 | 66.48 | 72.32 |
ACO-8 | Risk Standardized, All Condition Readmissions | 16.88 | 15.48 | 16.4 | 14.96 | 16.61 | 15.30 |
ACO-9 | ASC Admissions: COPD or Asthma in Older Adults | 1.61 | 1.07 | 1.48 | 1.11 | 1.45 | 1.06 |
ACO-10 | ASC Admission: Heart Failure | 0.96 | 1.03 | 1.23 | 1.16 | 1.1 | 1.11 |
ACO-11 | Percent of PCPs who Qualified for EHR Incentive Payment | 32.38 | 63.61 | 49.11 | 77.04 | 73.45 | 86.13 |
ACO-12 | Medication Reconciliation | 24.25 | 70.55 | 78.31 | 70.35 | 90.35 | 83.56 |
ACO-13 | Falls: Screening for Fall Risk | 37.93 | 35.64 | 72.62 | 59.52 | 88.83 | 64.61 |
ACO-14 | Influenza Immunization | 49.39 | 53.37 | 55.72 | 69.03 | 75.97 | 70.56 |
ACO-15 | Pneumococcal Vaccination | 37.52 | 57.26 | 61.02 | 72.06 | 75.49 | 77.00 |
ACO-16 | Adult Weight Screening and Follow-up | 45.1 | 53.12 | 52.23 | 65.07 | 82.37 | 67.90 |
ACO-17 | Tobacco Use Assessment and Cessation Intervention | 68.51 | 77.82 | 85.92 | 90.07 | 97.18 | 93.70 |
ACO-18 | Depression Screening | 32.16 | 23.62 | 43.02 | 49.80 | 74.03 | 59.67 |
ACO-19 | Colorectal Cancer Screening | 50.62 | 58.10 | 57.57 | 71.97 | 78.3 | 74.46 |
ACO-20 | Mammography Screening | 68.98 | 64.77 | 55.38 | 71.69 | 69.42 | 76.02 |
ACO-21 | Proportion of Adults who had blood pressure screened in past 2 years | 83.66 | 63.19 | 49.76 | 61.80 | 75.73 | 56.23 |
ACO-22 | Hemoglobin A1c Control (HbA1c) (<8 percent) | 40.28 | 64.73 | 60.72 | 75.42 | 72.33 | 75.23 |
ACO-23 | Low Density Lipoprotein (LDL) (<100 mg/dL) | 37.67 | 55.12 | 48.98 | 63.76 | 61.41 | 67.22 |
ACO-24 | Blood Pressure (BP) <140/90 | 46.35 | 67.08 | 62.3 | 77.20 | 70.87 | 78.58 |
ACO-25 | Tobacco Non Use | 49.48 | 66.61 | 68.4 | 75.39 | 84.71 | 82.30 |
ACO-26 | Aspirin Use | 62.82 | 78.52 | 54.3 | 83.86 | 82.19 | 88.22 |
ACO-27 | Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent) | 52.6 | 27.08 | 29.8 | 16.10 | 16.02 | 14.11 |
ACO-28 | Percent of beneficiaries with hypertension whose BP <140/90 | 44.93 | 63.94 | 60 | 74.23 | 74.21 | 74.98 |
ACO-29 | Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dl | 35.8 | 54.01 | 55.61 | 62.51 | 62.54 | 65.40 |
ACO-30 | Percent of beneficiaries with IVD who use Aspirin or other antithrombotic | 43.58 | 76.07 | 79 | 84.28 | 93.73 | 87.68 |
ACO-31 | Beta-Blocker Therapy for LVSD | 56.21 | 82.05 | 78.49 | 85.11 | 94.12 | 88.82 |
ACO-32 | Drug Therapy for Cholesterol Lowering LDL | 37.16 | 69.43 | 73.15 | 76.49 | 81.18 | 78.74 |
ACO-33 | ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD | 47.67 | 71.12 | 78.69 | 74.94 | 95.96 | 81.01 |
Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease, EHR = electronic health record, IVD = ischemic vascular disease, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.
2015 Quality Performance Results Table | |||
---|---|---|---|
Measure number |
scope="col" Measure Name |
2015 reporting period | |
ACO performance rate | Pioneer Mean | ||
ACO-1 | CAHPS: Getting Timely Care, Appointments, and Information | 78.76 | 81.61 |
ACO-2 | CAHPS: How Well Your Providers Communicate | 93.14 | 93.15 |
ACO-3 | CAHPS: Patients’ Rating of Provider | 90.84 | 92.35 |
ACO-4 | CAHPS: Access to Specialists | 84.4 | 83.87 |
ACO-5 | CAHPS: Health Promotion and Education | 59.39 | 61.74 |
ACO-6 | CAHPS: Shared Decision Making | 74.07 | 75.09 |
ACO-7 | CAHPS: Health Status/Functional Status | 70.26 | 72.34 |
ACO-34 | CAHPS: Stewardship of Patient Resources* | 25.99 | 25.53 |
ACO-8 | Risk Standardized, All Condition Readmission | 16.63 | 15.41 |
ACO-35 | Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)* Readmission | 22.52 | 18.94 |
ACO-36 | All-Cause Unplanned Admissions for Patients with Diabetes* | 69.99 | 57.14 |
ACO-37 | All-Cause Unplanned Admissions for Patients with Heart Failure* | 102.53 | 82.55 |
ACO-38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 82.23 | 66.32 |
ACO-9 | Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) | 1.73 | 1.15 |
ACO-10 | Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) | 1.08 | 1.05 |
ACO-11 | Percent of Primary Care Physicians who Successfully Meet Meaningful Use Requirements | 45.78 | 81.78 |
ACO-39 | Documentation of Current Medications in the Medical Record* | 70.68 | 72.33 |
ACO-13 | Falls: Screening for Future Fall Risk | 77.66 | 62.71 |
ACO-14 | Preventive Care and Screening: Influenza Immunization | 72.8 | 76.93 |
ACO-15 | Pneumonia Vaccination Status for Older Adults | 75.34 | 79.87 |
ACO-16 | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up | 80.72 | 65.45 |
ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 96.83 | 92.04 |
ACO-18 | Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan | 52.61 | 56.82 |
ACO-19 | Colorectal Cancer Screening | 72.83 | 75.24 |
ACO-20 | Breast Cancer Screening | 71.4 | 78.92 |
ACO-21 | Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented | 90.84 | 72.03 |
ACO-40 | Depression Remission at Twelve Months* | N/A | 4.09 |
ACO-27 | Diabetes Mellitus: Hemoglobin A1c Poor Control | 22.61 | 17.36 |
ACO-41 | Diabetes: Eye Exam* | 43.11 | 50.45 |
ACO-28 | Hypertension: Controlling High Blood Pressure | 74.25 | 74.94 |
ACO-30 | Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic | 90.49 | 87.41 |
ACO-31 | Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) | 91.07 | 89.18 |
ACO-33 | Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) | 94.59 | 82.78 |
CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease. *= Measure required beginning Reporting Year 2015. N/A= Reporting on the depression remission measure is not required for 2015, as indicated by N/A |
For more information on how to interpret scores on the above quality performance measures, see Medicare Shared Savings Program Quality Measure Benchmarks for the 2015 Reporting Year
For additional resources for Tenet’s Compliance Program please refer to: