Medicare ACO

The purpose of this document is to provide ACOs participating in the Shared Savings Program with a public reporting template, pre-populated with ACO-specific information obtained from CMS records. Information to populate the template is obtained from ACO reported information submitted to the ACO Management System (ACO-MS). ACOs participating in the Shared Savings Program are required to publicly report ACO organizational information and performance results on a designated webpage, per 42 CFR § 425.308.

ACO Name and Location

St Joseph Regional Health Partners ACO
Previous Names: N/A
2801 Franciscan Dr
Bryan, TX 77802

ACO Primary Contact

Primary Contact Name	Reyann Davis
Primary Contact Phone Number	979-774-2114
Primary Contact Email Address	[email protected]

Organizational Information

ACO participants:

ACO Participants	ACO Participant in Joint Venture (Enter Y or N)
Julie Lim	N
Kuppusamy Ragupathi, MD	N
Bcs Abundant Life Family Practice PA	N
Remon Fino, MD, PA	N
Steve Opersteny	N
Owens Interventional Pain Management PLLC	N
St. Joseph Regional Health Center	Y
Mark B. Lindsay, MD	N
Bryan Radiology Associates	N
James M. Kirby and Joseph J. Fedorchik	N
Central Texas Heart Center	N
Paul Roquet, MD, PA	N
Brazos Lung Associates, LLP	N
Central Texas Digestive Disease Association PA	N
Charles K. Peirce, MD, PA	N
Stephen L. Hand, OD, PA	N
Kelly W. Lobb	N
Ricardo S. Lemos, MD, PA	N

ACO governing body:

Member			Member's Voting Power –Expressed as a percentage or number	Membership Type -	ACO Participant Legal Business Name/DBA, if Applicable
Last Name	First Name	Title/Position		Membership Type -	ACO Participant Legal Business Name/DBA, if Applicable
Steines	Michael	MD, Voting Member	1	Participant Representative	St. Joseph Health Medical Group
Parsi	Kia	MD, Chair	1	Participant Representative	St. Joseph Health Medical Group
Campbell	James	MD, Voting Member	1	Participant Representative	Bryan Radiology Associates
White	Brad	MD, Voting Member	1	Participant Representative	St. Joseph Health Medical Group
Ficklen	David	MD, Voting Member	1	Participant Representative	St. Joseph Health Medical Group
Damian	David	MD, Voting Member	1	Participant Representative	St. Joseph Health Medical Group
Cheng	Clint	MD, Voting Member	1	Participant Representative	St. Joseph Health Medical Group
Colato	Fernando	MD, Voting Member	1	Participant Representative	Central Texas Heart Center
Waer	Amy	MD, Voting Member	1	Community Stakeholder Representative	Texas A&M University Health Science Center

Key ACO clinical and administrative leadership:

Reyann Davis	ACO Executive
Kia Parsi	Medical Director
Christi Knox	Compliance Officer
Sarah Habeeb	Quality Assurance/Improvement Officer

Associated committees and committee leadership:

Committee Name	Committee Leader Name and Position
St. Joseph Health Partners ACO Patient and Family Advisory Council	Gail Lazarine, Director of Patient Experience

Types of ACO participants, or combinations of participants, that formed the ACO:

Critical Access Hospital (CAH) billing under Method II
Hospital employing ACO professionals
Networks of individual practices of ACO professionals
Rural Health Clinic (RHC)

Shared Savings and Losses

Amount of Shared Savings/Losses

First Agreement Period
- Performance Year 2014, $0
- Performance Year 2015, $0
- Performance Year 2016, $0
Second Agreement Period
- Performance Year 2017, $0
- Performance Year 2018, $0
- Performance Year 2019, $0

Shared Savings Distribution:

First Agreement Period
- Performance Year 2016
  - 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 2015
  - 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 2014
  - Proportion invested in infrastructure: N/A
  - Proportion invested in redesigned care processes/resources: N/A
  - Proportion of distribution to ACO participants: N/A

Second Agreement Period
- Performance Year 2019
  - 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 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

Quality Performance Results

2019 Quality Performance Results:

ACO #	Measure Name	Rate	ACO Mean
ACO-1	CAHPS: Getting Timely Care, Appointments, and Information	91.78	85.86
ACO-2	CAHPS: How Well Your Providers Communicate	96.93	94.11
ACO-3	CAHPS: Patients’ Rating of Provider	95.01	92.69
ACO-4	CAHPS: Access to Specialists	81.14	81.54
ACO-5	CAHPS: Health Promotion and Education	56.11	60.44
ACO-6	CAHPS: Shared Decision Making	66.99	62.78
ACO-7	CAHPS: Health Status/Functional Status	74.53	73.79
ACO-34	CAHPS: Stewardship of Patient Resources	30.98	26.17
ACO-45	CAHPS: Courteous and Helpful Office Staff	95.41	92.84
ACO-46	CAHPS: Care Coordination	91.53	86.89
ACO-8	Risk Standardized, All Condition Readmission	14.90	14.86
ACO-38	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions	57.50	58.15
ACO-43	Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91)	1.90	1.87
ACO-13	Falls: Screening for Future Fall Risk	82.96	84.04
ACO-14	Preventive Care and Screening: Influenza Immunization	66.53	74.77
ACO-17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	52.63	78.04
ACO-18	Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan	72.03	70.40
ACO-19	Colorectal Cancer Screening	76.26	70.76
ACO-20	Breast Cancer Screening	75.18	73.84
ACO-42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	75.18	82.17
ACO-40	Depression Remission at Twelve Months	8.75	13.58
ACO-27	Diabetes Mellitus: Hemoglobin A1c Poor Control	14.52	13.88
ACO-28	Hypertension (HTN): Controlling High Blood Pressure	70.36	75.04

For Previous Year's 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.
Waiver for Payment for Telehealth Services:
- Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613