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

 

Emilio Dominguez, MD

Title/Position: Voting Member

Member’s Voting Power: 1

Membership Type: ACO Participant Representative, FMC

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

KEY ACO CLINICAL AND ADMINISTRATIVE LEADERSHIP

Joe Delatorre, CEO
ACO Executive

Dr. Chandresh Saraiya,
Medical Director

Eddine Luma, Compliance Officer
ACO QA/Improvement Officer

Dr. Emilio Dominguez,
Chief Medical Director

ACO COMMITTEES & COMMITTEE LEADERSHIP

Quality and Performance Monitoring Committee

Nancy Finnerty, MD
Chairman

Douglas Baska, DO

Crete Fisher, MD

Joseph Hubaykah, MD

Tracy Mckay, MD

Richard McDonough, MD

Parag Pitroda, MD

Chandresh Saraiya, MD

Joel Sokolik, MD

Gabriel Somori, MD

Compliance Committee

Eddine Luma, Assoc. Director of Clinical Transformation & Compliance & HIPAA Privacy Officer
Chairperson

Christian Alvarez, CFO

Samantha Champagnie, Senior Director

Joe Delatorre, CEO

Emilio Dominguez, MD

Gus Taylor, CAO

Paula VanNorman, Sr. Director of Physician Offices

Community Relations Committee

Chandresh Saraiya, MD, FMC
Chairman

Leigh Walker-Blankenship, ACO Manager, FMC

Sirisha Chalasani, MD, FMC

Ana Z. Torres Alvarez, ACO RN Care Manager, FMC

Heather Tomberlin, ACO LPN Care Manager, FMC

James Judkins, ACO LPN Care Manager, FMC

Traci Belle Simpson, ACO RN Care Manager, FMC

Tanja Cogan, BSW, FMC

Evan Smith, Encompass Home Health

Alysia Dunwoody, RN, Encompass Home Health

Michael Dougherty, RN, Encompass Home Health

Kathy Kondolf-Harmmer, Administrator, Heartland of Zephyrhills

Adam Timer, Heartland of Zephyrhills

Donna Coulter, DON, Royal Oaks

Jake Mitchell, Administrator, Royal Oaks

Rosemary Hartzner, Admissions Director, Royal Oaks

Payton Baker, Heritage Park

Lido Capogrosso, Admissions Director, Heritage Park

Pamela Cafra, Zephyrhills Health & Rehab

Karen Alvarez, CARES Home Health

Rey Basila, PT, Administrator, Mission Home Care

Geri Burke, Care Patrol

Crete Fisher, MD, FMC

Reginald Villaruel, RN, Director of Nursing, Mission Home Care

Florida Medical Clinic ACO Information

ACO Information

TYPES OF ACO PARTICIPANTS THAT FORMED THE ACO

A network of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

Second Agreement Period First Agreement Period
Performance Year 2019, $5,124,344

Performance Year 2018, $4,680,146

Performance Year 2017, $4,615,423

Performance Year 2016, $0

 Performance Year 2015, $0

Performance Year 2014, $0

Performance Year 2013, $0

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 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

Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR 425.612.

QUALITY PERFORMANCE RESULTS

Click here to view 2019 Quality Report PDF

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

Click here to view 2018 Quality Report PDF

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

Click here to view 2017 Quality Report PDF

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

Click here to view 2016 Quality Report PDF

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

Click here to view 2015 Quality Report PDF

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

Shared Savings Program Accountable Care Organizations Performance Results 2013 – 2019

PREVIOUS YEARS QUALITY PERFORMANCE RESULTS

2012 Reporting Period 2013 Reporting Period 2014 Reporting Period
Measure number Performance Measure ACO Performance Rate Mean Performance Rate for All ACOs ACO Performance Rate Mean Performance Rate for All ACOs ACO Performance Rate Mean Performance Rate for All ACOs
ACO #1 Getting Timely Care, Appointments, and Information 78.12 81.69 78.7 81.48 77.59 80.13
ACO #2 How Well Your Doctors Communicate 88.73 92.84 91.72 92.96 91.46 92.39
ACO #3 Patients’ Rating of Doctor 88.12 91.86 90.02 92.06 91.43 91.58
ACO #4 Access to Specialists 88.07 85.11 87.91 85.12 86.84 83.97
ACO #5 Health Promotion and Education 56.87 56.61 59.86 58.38 58.8 58.29
ACO #6 Shared Decision Making 72.57 73.99 75.57 74.53 75.06 74.6
ACO #7 Health Status/Functional Status 68.58 70.35 71.08 71.12 71.42 71.1
ACO #8 Risk Standardized, All Condition Readmissions 14.78 15.42 14.57 14.9 14.99 15.15
ACO #9 ASC Admissions: COPD or Asthma in Older Adults 0.9 1.13 1.07 1.17 0.85 1.08
ACO #10 ASC Admission: Heart Failure 1.33 1.09 1.26 1.2 1.26 1.19
ACO #11 Percent of PCPs who Qualified for EHR Incentive Payment 92.11% 25.70% 86.00% 66.21% 94.64% 76.71%
ACO #12 Medication Reconciliation 0.19 72.37 24.59 73.56 69.29 82.61
ACO #13 Falls: Screening for Fall Risk 2.3 28.27 45.67 39.57 58.54 45.6
ACO #14 Influenza Immunization 60.76 50.58 68.66 56.93 69.36 57.51
ACO #15 Pneumococcal Vaccination 47.39 48.62 64.82 54.76 58.01 55.03
ACO #16 Adult Weight Screening and Follow-up 81.04 53.91 71.29 61.61 86.2 66.75
ACO #17 Tobacco Use Assessment and Cessation Intervention 96.18 80.12 97.84 84.01 97.83 86.79
ACO #18 Depression Screening 0.23 22.48 38.75 31.19 56.2 39.27
ACO #19 Colorectal Cancer Screening 50.69 50.21 74.58 59.3 65.62 56.14
ACO #20 Mammography Screening 52.72 62.23 59.08 62.05 70.07 61.41
ACO #21 Proportion of Adults who had blood pressure screened in past 2 years 0 71.56 50.2 74.25 51.05 60.24
ACO #22 Hemoglobin A1c Control (HbA1c) (<8 percent) 80.74 N/A 86.33 N/A 82.73 N/A
ACO #23 Low Density Lipoprotein (LDL) (<100 mg/dL) 57.31 N/A 63.31 N/A N/A N/A
ACO #24 Blood Pressure (BP) <140/90 73.09 N/A 74.34 N/A 66.91 N/A
ACO #25 Tobacco Non Use 88.86 N/A 90.17 N/A 88.08 N/A
ACO #26 Asprin Use 72.86 N/A 86.42 N/A 86.14 N/A
ACO #27 Percent of Beneficiaries with Diabetes whose HbA1c in poor control (>9 percent) 13.92% 25.94% 7.43% 22.11% 8.74% 20.35%
ACO #28 Percent of Beneficiaries with Hypertension whose BP <140/90 71.28% 63.22% 80.19% 67.79% 64.32% 68.02%
ACO #29 Percent of Beneficiaries with IVD with complete lipid profile and LDL control <100mg/dl 59.04% 52.02% 64.90% 55.44% N/A N/A
ACO #30 Percent of Beneficiaries with IVD who use Asprin ir other Antithrombotic 79.08% 72.60% 84.76% 76.35% 86.49% 80.79%
ACO #31 Beta-Blocker Therapy for LVSD 70.83 79.60 90.79 79.82 88.89 82.71%
ACO #32 Drug Therapy for Lowering LDL Cholesterol 78.95 N/A 82.41 N/A N/A N/A
ACO #33 ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

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