Accountable Care Organization (ACO) Name and Location
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
ACO Primary Contact
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) |
|---|---|
| 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 MD, PC | N |
| Woo Sup Kim MD PC | N |
ACO Governing Body
| First Name | Last Name | Title/Position | Member’s Voting Power (Percentage) | Membership Type | ACO Participant TIN Legal Business Name/DBA,if Applicable |
|---|---|---|---|---|---|
| Harry | Jacob | Chief Medical Officer & Director | 14.29% | ACO Physician | Primary PartnerCare Physicians, PLLC |
| Lawrence | Crafa | Treasurer & Director | 14.29% | ACO Physician | Primary PartnerCarePhysicians, PLLC |
| James | Stallone | Director | 14.29% | ACO Physician | Primary PartnerCarePhysicians, PLLC |
| Aretha | Persaud | Director | 14.29% | ACO Physician | Primary PartnerCare Physicians, PLLC |
| Donato | Balsamo | Director | 14.29% | ACO Physician | Primary PartnerCarePhysicians, PLLC |
| Marion | Davis | Chief Executive Officer & Director | 14.29% | Other | |
| TBD | TBD | Medicare Beneficiary | 14.29% | Other |
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 2022, $6,060,262
- 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 | Proportion invested in infrastructure | Proportion invested in redesigned care processes/ resources | Proportion of distribution to ACO participants | |
|---|---|---|---|---|
| Third Agreement Period | 2022 | 35% | 15% | 50% |
| 2021 | 35% | 15% | 50% | |
| 2020 | 35% | 15% | 50% | |
| Second Agreement Period | 2019 | 32% | 18% | 50% |
| 2018 | 36% | 14% | 50% | |
| 2017 | 28% | 22% | 50% | |
| First Agreement Period | 2016 | N/A | N/A | N/A |
| 2015 | N/A | N/A | N/A | |
| 2014 | N/A | N/A | N/A |
Quality Performance Results
2022 Quality Performance Results: Quality performance results are based on CMS Web Interface
| Measure # | Measure Name | Rate | ACO Mean |
|---|---|---|---|
| 001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control | 6.12 | 10.71 |
| 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | 96.34 | 76.97 |
| 236 | Controlling High Blood Pressure | 93.87 | 76.16 |
| 318 | Falls: Screening for Future Fall Risk | 97.58 | 87.83 |
| 110 | Preventative Care and Screening: Influenza Immunization | 96.86 | 77.34 |
| 226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | 96.55 | 79.27 |
| 113 | Colorectal Cancer Screening | 93.98 | 75.32 |
| 112 | Breast Cancer Screening | 90.11 | 78.07 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 93.59 | 86.37 |
| 370 | Depression Remission at Twelve Months | 0.00 | 16.03 |
| 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups | 0.1395 | 0.1510 |
| 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions | 25.71 | 30.97 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | 90.79 | 84.67 |
| CAHPS-2 | How Well Providers Communicate | 95.67 | 93.56 |
| CAHPS-3 | Patient’s Rating of Provider | 94.49 | 92.06 |
| CAHPS-4 | Access to Specialists | 81.60 | 77.00 |
| CAHPS-5 | Health Promotion and Education | 71.12 | 62.68 |
| CAHPS-6 | Shared Decision Making | 67.14 | 60.97 |
| CAHPS-7 | Health Status and Functional Status | 72.30 | 73.06 |
| CAHPS-8 | Care Coordination | 87.60 | 85.46 |
| CAHPS-9 | Courteous and Helpful Office Staff | 94.01 | 91.97 |
| CAHPS-11 | Stewardship of Patient Resources | 25.99 | 25.62 |
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 1-877-486-2048.