FMC ACO

Accountable Care Organizations Public Reporting Information

ACO NAME & LOCATION

Florida Medical Clinic ACO, LLC
38135 Market Square
Zephyrhills, FL 33542

ACO PRIMARY CONTACT

Chandresh Saraiya, MD, FMC
Florida Medical Clinic, LLC
Chairman
813-712-1741
csaraiya@floridamedicalclinic.com

ORGANIZATIONAL INFORMATION

ACO Participants
Florida Medical Clinic, LLC
FMC Urgent Care, LLC

ACO PARTICIPANTS IN JOINT VENTURES BETWEEN ACO PROFESSIONALS AND HOSPITALS

FMC Urgent Care, LLC

Florida Medical Clinic, LLC

ACO GOVERNING BODY

Chandresh Saraiya, MD

Title/Position: Chairman

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

 

Joe Delatorre, CEO

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: Other Representative

Florida Medical Clinic, LLC

 

Joe Cozzolino, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

 

Rohitkumar Vyas, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

 

Juan Cevallos, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

 

Gerald Curley, DO

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

 

Belen Herrero, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

 

Richard Ina, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

 

Mitchell Forman, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC Urgent Care

FMC  Urgent Care, LLC

 

Joseph Gallagher

Title/Position: Medicare Beneficiary

Member’s Voting Power: 1

Membership Type: Medicare Beneficiary Representative

N/A

 

Paul Gerczuk, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

 

Matthew Hartlage, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

Florida Medical Clinic, LLC

KEY ACO CLINICAL AND ADMINISTRATIVE LEADERSHIP

Joe Delatorre, CEO
ACO Executive

Dr. Chandresh Saraiya,
Medical Director

Eddine Luma, Director HealthSync Operations
ACO QA/Compliance

ACO COMMITTEES & COMMITTEE LEADERSHIP

Quality and Performance Monitoring Committee

Parag Pitroda, MD
Chairman

Douglas Baska, DO

Nancy Finnerty, MD

Chandresh Saraiya, MD

Joel Sokolik, MD

Gabriel Somori, MD

Lauren Ruff, PA

Shifa Malik, MD

Compliance Committee

Eddine Luma, Director – HealthSync Operations
Chairperson

Kenny Caldwell, CFO

Joe Delatorre, CEO

Gus Taylor, CAO

Paula VanNorman, Sr. Director – Physician Offices

Community Relations Committee/Post-Acute Network Committee

Chandresh Saraiya, MD, FMC Medical Director
Chairman

Katherine North, Associate Director Hospital Medicine

Eddine Luma, Director of HealthSync Operations

Leigh Walker-Blankenship, Associate Director of HealthSync Operations

Florida Medical Clinic ACO Information

What is an ACO?

ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients.

The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings it achieves for the Medicare program.

Where can I learn more about ACOs?

CMS offers different learning opportunities for providers and organizations interested in learning more about ACOs. Visit the CMS Innovation Center website and Medicare Shared Savings Program website periodically to learn about the latest opportunities.

Visit the Medicare fee-for-service Frequently Asked Questions for more information on the Medicare Shared Savings Program.

______________________________________________________________________________________________________________

Shared Savings and Losses

Amount of Shared Savings/Losses

Second Agreement Period First Agreement Period
Performance Year 2022, N/A

Performance Year 2021, N/A

Performance Year 2020, N/A

Performance Year 2019, $5,124,344

Performance Year 2018, $4,680,146

Performance Year 2017, $4,615,423

Performance Year 2016, N/A

 Performance Year 2015, N/A

Performance Year 2014, N/A

Performance Year 2013, N/A

Note: Our ACO participated in multiple performance years during Calendar Year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Shared Savings Distribution

Second Agreement Period First Agreement Period
Performance Year 2022

Proportion invested in infrastructure: 10%
Proportion invested in redesigned care processes/resources: 10%
Proportion of distribution to ACO participants: 80%
A: PCP’s 70%
B: Hospitalist and Specialist 30%

Performance Year 2021

Proportion invested in infrastructure: 10%
Proportion invested in redesigned care processes/resources: 10%
Proportion of distribution to ACO participants: 80%
A: PCP’s 70%
B: Hospitalist and Specialist 30%

Performance Year 2020

Proportion invested in infrastructure: 10%
Proportion invested in redesigned care processes/resources: 10%
Proportion of distribution to ACO participants: 80%
A: PCP’s 70%
B: Hospitalist and Specialist 30%

Performance Year 2019

Proportion invested in infrastructure: 10%
Proportion invested in redesigned care processes/resources: 10%
Proportion of distribution to ACO participants: 80%
A: PCP’s 70%
B: Hospitalist and Specialist 30%

Performance Year 2018

Proportion invested in infrastructure: 10%
Proportion invested in redesigned care processes/resources: 10%
Proportion of distribution to ACO participants: 80%
A: PCP’s 70%
B: Hospitalist and Specialist 30%

Performance Year 2017

Proportion invested in infrastructure: 10%
Proportion invested in redesigned care processes/resources: 10%
Proportion of distribution to ACO participants: 80%
A: PCP’s 70%
B: Hospitalist and Specialist 30%

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

Performance Year 2013

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

Note: Our ACO participated in multiple performance years during Calendar Year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

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

QUALITY PERFORMANCE RESULTS

Click here to download the 2022 Quality Report PDF

Quality performance results are based on CMS Web Interface

Florida Medical Clinic ACO 2022 Quality Performance Results
Measure # Measure Name Collection Type Reported Performance Rate Current Year Mean Performance Rate (SSP ACOs)
Quality ID# 001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1] CMS Web Interface 7.3 10.71
Quality ID# 134 Preventative Care and Screening: Screening for Depression and Follow-up Plan CMS Web Interface 75.91 76.97
Quality ID# 236 Controlling High Blood Pressure CMS Web Interface 81.79 76.16
Quality ID# 318 Falls: Screening for Future Fall Risk CMS Web Interface 94.98 87.83
Quality ID# 110 Preventative Care and Screening: Influenza Immunization CMS Web Interface 89.74 77.34
Quality ID# 226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface 81.82 79.27
Quality ID# 113 Colorectal Cancer Screening CMS Web Interface 78.88 75.32
Quality ID# 112 Breast Cancer Screening CMS Web Interface 77.1 78.07
Quality ID# 438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface 82.17 86.37
Quality ID# 370 Depression Remission at Twelve Months CMS Web Interface 9.18 16.03
Quality ID# 321 CAHPS for MIPS [3] Survey Measure N/A N/A
Measure# 479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1] Administrative Claims 0.1443 0.1510
Measure# 484 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] Administrative Claims 29.9473 30.97
[1] A lower performance rate corresponds to higher quality.
[2] For PY 2022, the CMS Web Interface measures Quality ID #438 and Quality ID #370 do not have benchmarks, and therefore, were not scored.
[3] CAHPS for MIPS is a composite measure, so numerator, denominator, and performance rate values are not applicable (N/A). The CAHPS for MIPS composite score is calculated as the average number of points across scored Summary Survey Measures (SSMs) (86 FR 65256).

Shared Savings Program Accountable Care Organizations Performance Results 2013 – 2022

For more information on how to interpret scores on the above quality performance measures, see
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/downloads/MSSP-QM-Benchmarks.pdf

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