Shared Savings Program ACO Public Reporting

ACO Name and Location

RGV ACO Health Providers, LLC
Previous Names: N/A
303 North D Salinas Blvd
Donna, TX 78537

ACO Primary Contact

Primary Contact Name

Jose F. Peña, MD, FACP, FACHE, CHCQM, CRC

Primary Contact Phone Number

956-969-0120

Primary Contact Email Address

jpena@rgvacollc.com

Organizational Information

ACO participants:


ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Passaic Primary Care Physicians, LLC

N

Guillermo I. Rocha, MD, PA

N

Melva Palacios, MD and Chris Casso, MD, PA

N

Internal Medicine And Geriatrics Practice, Inc.

N

Centro Medico Iberoamericano, Inc.

N

Medical Group of North Jersey, LLC

N

Donna Medical Clinic, PA

N

Center For Adult Medicine And Preventive Care, Inc.

N

Rey Medicine, PC

N

Pedro J. Peñalo, MD, PA

N

Elite Premier Medical Care, LLC

N

Alejandro Arizmendi, MD, PLLC

N

Center for Med Care, PC

N

Rio Grande Valley Adult & Internal Medicine Specialists, PA

N

Family Health Center of Mission, PLLC

N

Nelson R. Kalaf, MD, PA

N

Melecia Fuentes, MD, PA

N

Valley Medical Arts Clinic, PA

N

Rio Grande Medicine, Inc.

N

Michael WM Mann, MD, PA

N

Abreu Adult Clinic, PA

N

Alfonso Ochoa, MD, PA

N

Mid Valley Adult Specialists, PA

N

Jose T. Sandoval, MD, PA

N

Bandera Family Health Care, PA

N

Solo Doc, 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

 

 

 

Peña

Jose

Chairman;    Voting Member

1

ACO Participant Representative

Donna Medical Clinic, PA

McDougal

Pedro

Voting Member

1

ACO Participant Representative

RGV Adult & Internal Medicine Specialists, PA

Peñalo

Pedro

Voting Member

1

ACO Participant Representative

Pedro J. Peñalo, MD, PA

Soto

Jose

Voting Member

1

Medicare Beneficiary Representative

N/A

Johnson

Jere

Voting Member

1

ACO Participant Representative

Family Health Center of Mission, PLLC

Rocha

Guillermo

Voting Member

1

ACO Participant Representative

Guillermo I. Rocha, MD, PA

Moquete

Manuel

Voting Member

1

Other: New Jersey Medical Director

N/A

Arizmendi

Alejandro

Voting Member

1

ACO Participant Representative

Alejandro Arizmendi, MD, PLLC

Key ACO clinical and administrative leadership:


Jose F. Peña, MD

ACO Executive

Pedro J. Peñalo, MD

Medical Director

Pedro E. McDougal, MD

Medical Director

Alejandro Arizmendi, MD

Medical Director

Manuel Moquete, MD

Medical Director

Cassandra Treviño, PA-C

Compliance Officer

Pedro J. Peñalo, MD

Quality Assurance/Improvement Officer

Associated committees and committee leadership:


Committee Name

Committee Leader Name and Position

Beneficiary Engagement Committee

Jose Soto, Chair

Quality Assurance and Performance Improvement Committee

Pedro J. Peñalo, MD, Chair

Utilization Committee

Jose F. Peña, MD, Chair

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

  • Networks of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2017, $9,427,971
    • Performance Year 2016, $10,027,046
  • First Agreement Period
    • Performance Year 2015, $12,619,152
    • Performance Year 2014, $7,528,797
    • Performance Year 2013, $11,900,756

Shared Savings Distribution

  • Second Agreement Period
    • Performance Year 2017
      • Proportion invested in infrastructure: 16%
      • Proportion invested in redesigned care processes/resources: 12%
      • Proportion of distribution to ACO participants: 72%
    • Performance Year 2016
      • Proportion invested in infrastructure: 28%
      • Proportion invested in redesigned care processes/resources: 4%
      • Proportion of distribution to ACO participants: 68%
  • First Agreement Period
    • Performance Year 2015
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 65%
    • Performance Year 2014
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 65%
    • Performance Year 2013
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 65%

Quality Performance Results

2017 Quality Performance Results:


ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

73.05

80.60

ACO-2

CAHPS: How Well Your Providers Communicate

90.41

93.13

ACO-3

CAHPS: Patients’ Rating of Provider

90.47

92.31

ACO-4

CAHPS: Access to Specialists

82.54

83.32

ACO-5

CAHPS: Health Promotion and Education

70.57

62.30

ACO-6

CAHPS: Shared Decision Making

79.56

75.85

ACO-7

CAHPS: Health Status/Functional Status

70.89

73.05

ACO-34

CAHPS: Stewardship of Patient Resources

31.03

25.68

ACO-8

Risk Standardized, All Condition Readmission

14.95

15.01

ACO-35

Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)

18.46

18.46

ACO-36

All-Cause Unplanned Admissions for Patients with Diabetes

49.58

53.95

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

72.48

79.16

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

57.19

61.74

ACO-43

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

1.37

1.93

ACO-11

Use of Certified EHR Technology

100.00

98.48

ACO-12

Medication Reconciliation

99.49

75.32

ACO-13

Falls: Screening for Future Fall Risk

99.50

74.38

ACO-44

Imaging Studies for Low Back Pain

52.00

67.32

ACO-14

Preventive Care and Screening: Influenza Immunization

97.36

72.52

ACO-15

Pneumonia Vaccination Status for Older Adults

94.20

72.92

ACO-16

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up

96.18

70.69

ACO-17

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

99.50

90.48

ACO-18

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

93.71

61.98

ACO-19

Colorectal Cancer Screening

87.58

64.58

ACO-20

Breast Cancer Screening

84.53

70.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

92.07

79.89

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

9.49

16.74

ACO-41

Diabetes: Eye Exam

77.63

50.37

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

86.31

71.47

ACO-30

Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

96.69

86.86

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

Note: In the Quality Performance Results file(s) above, search for “RGV ACO Health Providers, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A85439 in the public use files on data.cms.gov.

Payment Rule Waivers

  • Yes, our ACO does use the SNF 3-Day Rule Waiver.