Primary Partner Care

Primary PartnerCare ACO Independent Practice Association, Inc.
Previous Legal Business Entity Name: Primary PartnerCare Associates IPA, Inc.
1010 Northern Boulevard, Suite 328
Great Neck, NY 11021

Primary Contact Name: Marion Davis, CEO
Primary Contact Phone Number: 516-233-2484
Primary Contact Email Address: mdavis@primarypartnercare.com

Organizational Information
ACO Participants – 2023

ACO Participants	ACO Participant in Joint Venture (Enter Y or N)
Antonio Corona	N
Benjamin Z. Arbesfeld, MD, PC	N
Ebenezer Odoom, MD, PC	N
Ihor Magun MD	N
Long Beach Family Medicine, PC	N
North Shore Gastroenterology Associates	N
Primary PartnerCare Physicians, PLLC	N
Scott V. Rankin M.D. P.C.	N
Woo Sup Kim MD PC	N

ACO Governing Body

Member			Member’s Voting Power (Percentage)	Membership Type	ACO Participant TIN Legal Business Name/DBA, if Applicable
First Name	Last Name	Title/Position
Harry	Jacob	Chief Medical Officer & Director	10%	ACO Physician	Primary PartnerCare Physicians, PLLC
Lawrence	Crafa	Treasurer & Director	10%	ACO Physician	Primary PartnerCare Physicians, PLLC
Leslie Sean	Ramsammy	Director	10%	ACO Physician	Primary PartnerCare Physicians, PLLC
William	Duke	Director	10%	ACO Physician	Primary PartnerCare Physicians, PLLC
Jack	Mann	Director	10%	ACO Physician	Primary PartnerCare Physicians, PLLC
James	Stallone	Director	10%	ACO Physician	Primary PartnerCare Physicians, PLLC
Aretha	Persaud	Director	10%	ACO Physician	Primary PartnerCare Physicians, PLLC
Donato	Balsamo	Director	10%	ACO Physician	Primary PartnerCare Physicians, PLLC
Marion	Davis	Chief Executive Officer & Director	10%	Other
Robert	Caldwell	Director	0%	Other
James	DeBonet	Director	10%	Beneficiary Representative

 

Key ACO Clinical and Administrative Leadership

ACO Executive: Marion Davis
Medical Director: Harry Jacob, MD
Compliance Officer: Charles Davis
Quality Assurance / Improvement Officer: James Stallone, DO

 

Associated Commitees and Committee Leadership

Committee Name	Committee Leader Name and Position
Quality Improvement	James Stallone, DO, Chair
Medical Management	Harry Jacob, MD, Chair
Credentialing/Recredentialing	Harry Jacob, MD, Chair
Advanced AfterCare	Ryan Cahill, DO, Chair

 

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

• • Networks of individual practices of ACO professionals

Shared Savings and Losses

Third Agreement Period

• • Performance Year 2021, $5,209,182
• • Performance Year 2020, $4,911,631

Second Agreement Period

• • Performance Year 2019, $5,527,430
• • Performance Year 2018, $7,383,593
• • Performance Year 2017, $4,979,555

First Agreement Period

• • Performance Year 2016, $0
• • Performance Year 2015, $0
• • Performance Year 2014, $0

 

Shared Savings Distribution

Third Agreement Period

• • Performance Year 2021
  • - Proportion invested in infrastructure: %
  • - Proportion invested in redesigned care processes/resources: %
  • - Proportion of distribution to ACO participants: %
• • Performance Year 2020
  • - Proportion invested in infrastructure: 35%
  • - Proportion invested in redesigned care processes/resources: 15%
  • - Proportion of distribution to ACO participants: 50%

Second Agreement Period

• • Performance Year 2019
  • - Proportion invested in infrastructure: 32%
  • - Proportion invested in redesigned care processes/resources: 18%
  • - Proportion of distribution to ACO participants: 50%
• • Performance Year 2018
  • - Proportion invested in infrastructure: 36%
  • - Proportion invested in redesigned care processes/resources: 14%
  • - Proportion of distribution to ACO participants: 50%
• • Performance Year 2017
  • - Proportion invested in infrastructure: 28%
  • - Proportion invested in redesigned care processes/resources: 22%
  • - Proportion of distribution to ACO participants: 50%

First Agreement Period

• • 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

Quality Performance Results

2021 Quality Performance Results:

NOTE: Quality Perfomance Results are based on the CMS Web Interface

Measure #	Measure Name	Rate	ACO Mean
001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control	4.29	12.46
134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	99.13	74.38
236	Controlling High Blood Pressure	94.76	74.87
318	Falls: Screening for Future Fall Risk	99.17	87.03
110	Preventative Care and Screening: Influenza Immunization	98.43	80.52
226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	100.00	80.97
113	Colorectal Cancer Screening	92.03	73.63
112	Breast Cancer Screening	88.36	75.11
438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	100.00	84.24
479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups	0.1511	0.1540
MCC1	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)	32.50	33.99
CAHPS-1	Getting Timely Care, Appointments, and Information	88.65	84.67
CAHPS-2	How Well Providers Communicate	95.67	93.56
CAHPS-3	Patient’s Rating of Provider	94.18	92.19
CAHPS-4	Access to Specialists	81.73	78.80
CAHPS-5	Health Promotion and Education	66.13	61.61
CAHPS-6	Shared Decision Making	66.68	60.89
CAHPS-7	Health Status and Functional Status	71.02	71.78
CAHPS-8	Care Coordination	88.01	85.66
CAHPS-9	Courteous and Helpful Office Staff	93.91	91.88
CAHPS-11	Stewardship of Patient Resources	27.70	24.71

Please note, the Quality ID#: 370 (Depression Remission at 12 Months) Quality Measure is not inclued in public reporting due to low sample size.

For previous years’ Financial and Quality Performance Results, please visit data.cms.gov

Payment Rule Waivers

• • No, our ACO does not use the SNF 3-Day Rule Waiver.
• • Yes, our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.

 

Fraud and Abuse Waivers

Primary PartnerCare ACO Independent Practice Association, Inc. (“ACO”) 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 ACO Board of Directors has made a bona fide determination that an arrangement with Quest Diagnostics 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, ACO is seeking ACO Participation Waiver protection for its arrangement with Quest Diagnostics 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.

 

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
1-877-487-2048.