Public Reporting Information

ACO Name and Location

Pacific Accountable Care, LLC
Previous Names: N/A
15611 Pomerado Road
Suite 400
Poway, California 92064

 

ACO Primary Contact

Primary Contact Name

Claudia Hernandez

Primary Contact Phone Number

844-544-4054

Primary Contact Email Address

admin@pacificaccountablecare.com

 

Organizational Information

 

ACO Participants:

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

ALFREDO QUINONEZ M.D., INC
N
ANDRES ZIMMERMANN
N
ARCH HEALTH PARTNERS
N
BRUCE J SACHS MD PROFESSIONAL CORPORATION
N
CARLSBAD VILLAGE FAMILY PRACTICE MEDICAL ASSOCIATES INC
N
CLINICAS DE SALUD DEL PUEBLO INC
N
GRAYBILL MEDICAL GROUP INC
N
IMPERIAL VALLEY MULTI-SPECIALTY MEDICAL GROUP INC
N
JOHN H CLANCY DO AND TARA LEIGH CLANCY DO MEDICAL CORPORATION
N
JOSEPH CASTREJON MD PC
N
MARCELO R. RIVERA MD INC
N

MARCELO RIVERA 

N
MELISSA HURD MEDICAL CORPORATION N
MICHELLE GONZALES MD PC
N
MINIMALLY INVASIVE SURGEONS OF NORTH COUNTY INC
N
NEIL L. HALIM, MD INC.
N
PALOMAR HEALTH
N
PERRIN CURRAN
N
SHAFI KHALID MD PC
N

VISTA COMMUNITY CLINIC

N

WARING COURT PEDIATRIC AND ADULT MEDICAL GROUP 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

Balikian, M.D.

Philip

Manager

1

ACO Participant Representative

Arch Health Partners

Curran, M.D. Perrin Manager 1 ACO Participant Representative Perrin Curran

Lee

Joon

Manager

1

ACO Participant Representative

Palomar Health

Maletz, M.D.  Louis Manager 1 ACO Participant Representative Arch Health Partners
Paz, M.D. Alejandro Manager 1 ACO Participant Representative Graybill Medical Group Inc.
Rivera, M.D. Marcelo Manager 1 ACO Participant Representative Marcelo Rivera
Rodriguez, M.D. George Manager 1 ACO Participant Representative Graybill Medical Group Inc.
Wells, M.D. Todd Manager 1 ACO Participant Representative Arch Health Partners
Leahy Mary Ellen Manager 1 Medicare Beneficiary Representative N/A
Vacant   Manager 1 ACO Participant Representative Vacant

 

Key ACO Clinical and Administrative Leadership:

Joon Lee

ACO Executive

Louis Maletz, MD

Medical Director

Heather Stamps

Compliance Officer

Fritz Steen, RN Quality Assurance/Improvement Officer

 

Associated Committees and Committee Leadership:

Committee Name

Committee Leader Name and Position

Nominations Committee

Belinda Dure-Smith, MD

Quality Improvement Committee Louis Maletz, MD
Finance Committee Amanda Pape, CFO
Network Strategy Committee Louis Maletz, MD

 

Types of ACO participants, or Combinations of Participants, that Formed the ACO:

  • Partnerships or joint venture arrangements between hospitals and ACO professionals
  • Networks of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2020, $ 2,721,004.10
  • First Agreement Period
    • Performance Year 2019, $ 0
    • Performance Year 2018, $ 0
    • Performance Year 2017, $ 2,630,942
       
  • Shared Savings Distribution:

  • Second Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 50%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 35%
  • First 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: 50%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 35%

Quality Performance Results

2020 Quality Performance Results:

 

ACO #

Measure Name

Rate

ACO Mean

ACO-13

Falls: Screening for Future Fall Risk

45.75

84.97

ACO-14

Preventive Care and Screening Influenza Immunization

52.64

76.03

ACO-17

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

51.35

81.67

ACO-18

Preventive Care and Screening: Screening for Depression and Follow-up Plan

33.27

71.46

ACO-19

Colorectal Cancer Screening

36.33

72.59

ACO-20

Breast Cancer Screening

38.16

74.05

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

35.80

14.70

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

62.13

72.87

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

84.09

83.37

ACO-43

Ambulatory Sensitive Condition Acute Composite (AHRQ*Prevention Quality Indicators (PQI#91))

0.65

0.95

 

Due to COVID-19 Pandemic, ACO-9 and ACO-38 have reverted to pay-for-reporting measures for Performance “Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.”

 

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov

 

Payment Rule Waivers

 

  • 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.

 

 

 

 

 

 
 

 

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