Primary Partner Care

Medicare Shared Savings Program ACO

Accountable Care Organization (ACO) Name and Location
Primary PartnerCare ACO Independent Practice Association, Inc.
1010 Northern Boulevard, Suite 314
Great Neck, NY 11021
ACO Primary Contact
Marion Davis, CEO
516-233-2483
mdavis@primarypartnercare.com
Primary PartnerCare Associates IPA, Inc Composition
The ACO consists of primary care physicians. It was not formed as a partnership or joint venture with hospitals.
Primary PartnerCare Associates IPA Participants
Alan Antonelli, M.D., P.C.
Alan Seymour
Amityville Medical Care P.C.
Antonio Corona
Bay Family Medicine, PLLC
Bay Shore Medical Care PC
Benjamin Z. Arbesfeld, MD, PC
Brian Vogel
Brij M. Sharma, M.D., P.C.
Carefirst Family Medical, PC
Complete Health Medical P.C.
DBM Medical, PLLC
Dr. Bellamy Brook D.O. P.C.
Dulce M. Almanzar, M.D., Pc
Eastern Long Island Family Medicine PC
Eldad S Benmen
Frank J Parasmo Jr MD
Fredric J Mintz MD PC
George Lowy MD PC
Glen Oaks Internal Medicine PC
Harry S. Jacob M.D.
Health Edge Medical Care PLLC
Howard Knoll
Ida Messana MD PLLC
Internal Medicine and Geriatrics Associates PLLC
Internal Medicine Associates Llc
Island Family Medical Practice, PC
James A Stallone DO
James A. Higgins, D.O.
James W Ferguson, MD LLC
JEMTEL Medical PC
JH Halio MD
John R Fernandez MD PLLC
John Sciales
Joseph A. Mackey, M.D.
Joseph Dic DO
Kings Park Medicine PC
Kumar Mandal Md Pc
Lawrence Family Medical Practice, P.C.
Leslie Sean Ramsammy MD PC
Lisa Marx, DO, PLLC
Long Beach Family Medicine
Long Island Health and Wellness Family Medicine PC
Long Island Medical Care Services, PC
Mahendra G. Shah
Marc A Singer MD FACC
Maria Deiparine Sygaco
Mark A. Shapiro M.D.
Mid Island Internal Medicine, Pllc
Mitchell I Weinstein, D.O., P.C.
MJ Meltzer MD & DG Kassan MD
Mumtaz Mohidin, MD
North Ocean Family Medicine
Octavian G. Austriacu DO, PC
Pedro J. Roque MD PLLC
Persaud Medical PLLC
Peter J Kurzweil
Pierre G. Collin
Preferred Health Medical Care PC
Queens Village Primary Medical Care
Robert L Carlin, MD PC
Robert L Carlin, MD PC
Rosanne M. Cebelenski, DO PC
Ryan M. Cahill, D.O., P.C.
Scott Bloom MD PC
Setauket Primary Medical Care, P.C.
Shoba Menon MD
Skender Murtezani, M.D. PLLC
Smithtown Medical Specialists, PC
Smithtown Primary Medical Care, P.C.
South Island Family Medical, LLC
South Shore Family Practice DO PC
Stuart W Haber MD PC
Sylvester Ozoude
Termini Medical Care, P.C.
Thomas P. Mathew MD PC
Vicente H Salvador
Weymin Hago
William G Johnson MD PC
William H Simon
William M Duke MD
Yin-Lee Chin Md Pc
Yuan T. Hwang MD and Matthew M. Lin, M.D., P.C.

Primary PartnerCare Associates IPA, Inc. Board of Directors

Harry S. Jacob, MD ACO Physician, Chairman Nassau Voting
Daniel Kassan, MD ACO Physician, Director Nassau Voting
Ida Messana, MD ACO Physician, Director Queens Voting
William Duke, MD ACO Physician, Director Queens Voting
James Stallone, DO ACO Physician, Director Suffolk Voting
James A. Higgins, DO ACO Physician, Director Suffolk Voting
Marion Davis ACO Executive N/A Voting
James DeBonet ACO Patient Representative N/A Voting
Primary PartnerCare Associates IPA Committees/Leadership
Harry S. Jacob, MD, Chief Executive Medical Officer
Quality Improvement Committee, Harry S. Jacob, MD, Chair
Clinical Management Committee, Daniel Kassan, MD, Chair
Patient Advisory Committee, Ida Messana, MD, Chair
Credentialing Committee, Vacant, Chair
Aggregate Amount of Shared Savings/Losses
N/A – ACO not yet eligible for Shared Savings/Losses
Distribution of Shared Savings
N/A – ACO not yet eligible for Shared Savings/Losses
REQUIRED PUBLIC DISCLOSURE FOR THE ACO PARTICIPATION WAIVER
Primary PartnerCare Associates IPA, Inc. is a Medicare Shared Savings Program ACO. The Secretary of the Department of Health and Human Services has provided four waivers of federal fraud and abuse laws in connection with the Medicare Shared Savings Program. The Primary PartnerCare Associates IPA Board of Directors has made a bona fide determination that an arrangement with Quest Diagnostics Incorporated as described below is reasonably related to the purpose of the Medicare Shared Savings Program, and has authorized such arrangement. The collaboration is related to the purposes of the Medicare Shared Savings Program because it promotes accountability for the quality, cost and overall care for a Medicare population by managing and coordinating care for Medicare beneficiaries, and encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for Medicare beneficiaries. Specifically, Primary PartnerCare Associates IPA, Inc. is seeking ACO Participation Waiver protection for its arrangement with Quest Diagnostics Incorporated for a grant to:

 

  •     • Promote evidence-based medicine and patient engagement
  •     • Meet the requirements for reporting quality and cost measures coordinating care
  •     • Establish clinical and administrative systems
  •     • Meet the clinical integration requirements of the Medicare Shared Savings Program
  •     • Evaluate the health needs of the ACO’s aligned population
  •     • Communicate clinical knowledge and evidence based medicine to Medicare beneficiaries
  •     • Develop standards for beneficiary access and communication, including beneficiary access to medical records

 

Quality Performance Results Table 2015
Measure Number Performance Measure 2015 reporting period
ACO Performance rate Mean performance
rate for all ACOs
ACO #1 CAHPS: Getting Timely Care, Appointments, and Information 78.75 80.61
ACO #2 CAHPS: How Well Your Doctors Communicate 92.18 92.65
ACO #3 CAHPS: Patients’ Rating of Provider 91.14 91.94
ACO #4 CAHPS: Access to Specialists 81.93 83.61
ACO #5 CAHPS: Health Promotion and Education 62.27 59.06
ACO #6 CAHPS: Shared Decision Making 75.16 75.17
ACO #7 CAHPS: Health Status/Functional Status 72.16 72.30
ACO #34 CAHPS: Stewardship of Patient Resources 24.68 26.87
ACO #8 Risk Standardized, All Condition Readmission 15.60 14.86
ACO #35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 18.67 18.07
ACO #36 All-Cause Unplanned Admissions for Patients with Diabetes 58.65 54.60
ACO #37 All-Cause Unplanned Admissions for Patients with Heart Failure 76.80 76.96
ACO #38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 68.77 62.92
ACO #9 Ambulatory Sensitive Condition Admissions: Chronic Obstructive
Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)
1.09 1.11
ACO #10 Ambulatory Sensitive Conditions Admissions: Heart Failure
(AHRQ Prevention Quality Indicator (PQI) #8)
1.02 1.04
ACO #11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 46.03 76.22
ACO #39 Documentation of Current Medications in the Medical Record 100.00 84.07
ACO #13 Falls: Screening for Future Fall Risk 77.05 56.46
ACO #14 Preventive Care and Screening: Influenza Immunization 89.45 62.03
ACO #15 Pneumonia Vaccination Status for Older Adults 70.56 63.73
ACO #16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 97.58 71.15
ACO #17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 97.98 90.16
ACO #18 Preventive Care and Screening: Screening for Clinical Depression
and Follow-Up Plan
70.16 42.25
ACO #19 Colorectal Cancer Screening 78.23 60.06
ACO #20 Breast Cancer Screening 68.55 65.67
ACO #21 Preventive Care and Screening: Screening for High
Blood Pressure and Follow-Up Documented
97.18 70.04
ACO #40 Depression Remission at Twelve Months N/A 6.11
ACO #27 Diabetes Mellitus: Hemoglobin A1c Poor Control 14.17 20.38
ACO #41 Diabetes: Eye Exam 70.08 41.05
ACO #28 Hypertension: Controlling High Blood Pressure 71.37 69.62
ACO #30 Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic 92.34 83.82
ACO #31 Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 96.49 87.22
ACO #33 Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin
Reception Blocker (ARB) Therapy – for patients with CAD and
Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)
93.39 77.73

Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease, PCP = primary care physician,
EHR = electronic health record, IVD = ischemic vascular disease, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

Quality Performance Results Table 2012-2014

Measure Number Performance Measure 2012 reporting period 2013 reporting period 2014 reporting period
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 Not in Operations Not in Operations 82.35 80.13
ACO #2 How Well Your Doctors Communicate Not in Operations Not in Operations 93.71 92.37
ACO #3 Patients’ Rating of Doctor Not in Operations Not in Operations 92.77 91.58
ACO #4 Access to Specialists Not in Operations Not in Operations 84.33 83.97
ACO #5 Health Promotion and Education Not in Operations Not in Operations 54.24 58.29
ACO #6 Shared Decision Making Not in Operations Not in Operations 72.56 74.60
ACO #7 Health Status / Functional Status Not in Operations Not in Operations 69.21 71.10
ACO #8 Risk Standardized, All Condition Readmissions Not in Operations Not in Operations 15.61 15.15
ACO #9 ASC Admissions: COPD or Asthma in Older Adults Not in Operations Not in Operations 1.3 1.08
ACO #10 ASC Admission: Heart Failure Not in Operations Not in Operations .97 1.19
ACO #11 Percent of PCPs who Qualified for EHR Incentive Payment Not in Operations Not in Operations 31.25 76.71
ACO #12 Medication Reconciliation Not in Operations Not in Operations 97.99 82.61
ACO #13 Falls: Screening for Fall Risk Not in Operations Not in Operations 40.86 45.60
ACO #14 Influenza Immunization Not in Operations Not in Operations 75.04 57.51
ACO #15 Pneumococcal Vaccination Not in Operations Not in Operations 48.21 55.03
ACO #16 Adult Weight Screening and Follow-up Not in Operations Not in Operations 50.95 66.75
ACO #17 Tobacco Use Assessment and Cessation Intervention Not in Operations Not in Operations 79.64 86.79
ACO #18 Depression Screening Not in Operations Not in Operations 36.53 39.27
ACO #19 Colorectal Cancer Screening Not in Operations Not in Operations 63.79 56.14
ACO #20 Mammography Screening Not in Operations Not in Operations 64.17 61.41
ACO #21 Proportion of Adults who had blood pressure screened in past 2 years Not in Operations Not in Operations 80.46 60.24
ACO #22 Hemoglohin A1c Control (HbA1c) Not in Operations Not in Operations 25.81 25.41
ACO #23 Low Density Lipoprotein (LDL) Not in Operations Not in Operations N/A N/A
ACO #24 Blood Pressure (BP) <140/90 Not in Operations Not in Operations 18.89 25.41
ACO #25 Tobacco Non-Use Not in Operations Not in Operations 26.04 25.41
ACO #26 Aspirin Use Not in Operations Not in Operations In dispute N/A
ACO #27 Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 precent) Not in Operations Not in Operations In dispute In dispute
ACO #28 Percent of beneficiaries with hypertension whose BP <140/90 Not in Operations Not in Operations In dispute In dispute
ACO #29 Percent of beneficiaries with IVD having complete lipid profile and LDL control <100mg/dl Not in Operations Not in Operations N/A N/A
ACO #30 Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dl Not in Operations Not in Operations In dispute In dispute
ACO #31 Beta-Blocker Therapy for LVSD Not in Operations Not in Operations In dispute In dispute
ACO #32 Drug Therapy for Lowering LDL Cholesterol Not in Operations Not in Operations N/A N/A
ACO #33 ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD Not in Operations Not in Operations In dispute N/A

Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease, PCP = primary care physician,
EHR = electronic health record, IVD = ischemic vascular disease, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

For general questions or additional information about Accountable Care Organizations, please visit www.Medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.