Scripps Accountable Care Organization (ACO)
A Medicare Shared Savings Program participant
ACO name and location
Scripps Accountable Care Organization, LLC
Previous names: N/A
10140 Campus Point Drive
San Diego, California 92121
ACO primary contact
|
Primary contact name |
Cindy Gipson |
|
Primary contact phone number |
|
|
Primary contact email address |
ACO Participants
|
ACO participants |
ACO participant in joint venture (Y/N) |
|
Acute Care Associates, INC. |
N |
|
Adema Family Medicine Inc |
N |
|
Ali Salami |
N |
|
Alisa L Williams, Md, Facog, Inc. |
N |
|
ASIM GUHA ROY |
N |
|
Balboa Park Internal Medicine, Medical Associates Inc |
N |
|
Bijan Razi |
N |
|
Billie Green, Medical Corporation |
N |
|
Bradley L. Spitz, M.D. Inc |
N |
|
BRETT J. BERMAN, M.D., PROFESSIONAL CORPORATION |
N |
|
Bruce Kimura |
N |
|
Cardiac Arrhythmia Associates A Medical Corporation |
N |
|
Catharine Marshall MD |
N |
|
Cesar Pena |
N |
|
Chia-Lin Charles Liu,D.O.,Inc |
N |
|
Chula Vista Heart Clinic, Inc. |
N |
|
Clara Lucy Polak, M.D. Inc. |
N |
|
Coastal Pain & Spinal Diagnostics Medical Group, Inc. |
N |
|
CRAIG SCLAR |
N |
|
Dan I Giurgiu M D Professional Corporation |
N |
|
Dana P. Launer, M.D. And M.Jonathan Worsey, M.D, A Professional Corp. |
N |
|
Daniel Michaels, MD, INC |
N |
|
Danielle Weiss |
N |
|
Dennis Costello |
N |
|
Elahe Toulouie, Md, Inc |
N |
|
Enlightened Healthcare Alliance Medical Corporation |
N |
|
Francisco S. Pardo MD PC |
N |
|
Frank E. Mayer, M.D., A Professional Corporation |
N |
|
Frederick J De La Vega Md |
N |
|
Frederic Martin |
N |
|
Gregory P Ranches MD ACP |
N |
|
Hanh M Bui Md Apmc |
N |
|
Hillcrest Internal Medicine A Medical Corporation |
N |
|
HOUMAN DAHI M.D., APC |
N |
|
INTERNAL MEDICINE ASSOCIATES MEDICAL GROUP OF SAN DIEGO, INC. |
N |
|
James Santiago Grisolia, M.D. Inc |
N |
|
Jay Berenter |
N |
|
Jeffry A Mullvain Md Inc |
N |
|
Jerrold Glassman,.M.D., A Medical Corporation |
N |
|
JOSE R PENA MD PC |
N |
|
JOSEPH CAPERNA MD A PROFESSIONAL CORPORATION |
N |
|
Joseph Resnikoff MD |
N |
|
Julian Lichter Md A Professional Corporation |
N |
|
Kelly S. Keefe MD, Inc |
N |
|
KESHAV R NAYAK MD AMC |
N |
|
Kiyon Chung, MD |
N |
|
L Dale Lapp M D Inc |
N |
|
La Jolla Cardiovascular Medical Assoc Inc |
N |
|
La Jolla Gastroenterology Medical Group, Inc |
N |
|
La Jolla Pulmonary And Critical Care Inc |
N |
|
Lars R Newsome Md Inc. |
N |
|
Lawrence D Eisenhauer Md Inc Lawrence D Eisenhauer M D Officer |
N |
|
Leila Rhodes MD Inc |
N |
|
Leticia Uwedjojevwe Md Medical Corporation |
N |
|
Luis M Marquez,MD Inc |
N |
|
Luis Sanchez |
N |
|
Maria Lourdes S Mara Md - A Medical Corp |
N |
|
Medderm Corporation |
N |
|
Medicus M D Inc A Deleware Corporation |
N |
|
Michael Sise |
N |
|
Michael T Couris, M.D., Inc. |
N |
|
Michael Torrente |
N |
|
Ngocbich Nguyen, M.D., Inc. |
N |
|
North County Gastroenterology Medical Group Inc |
N |
|
North County Oncology Medical Clinic, Inc |
N |
|
Olde Del Mar Surgical Medical Group Inc |
N |
|
Pain Management Consultants A Professional Medical Corporation |
N |
|
Paul Phillips |
N |
|
Perry W. Sexton, Md Professional Corporation |
N |
|
Peter Friend |
N |
|
Peter Morcos Md Inc |
N |
|
Peter Seymour |
N |
|
Richard Friedman |
N |
|
Ritvik Mehta Md, Pc |
N |
|
Rj Fernandez Md Inc Apc. |
N |
|
Robert Houghton Md Inc |
N |
|
Russell P Edwards, Md Apc |
N |
|
Salami Nuclear Cardiology Medical Group Inc |
N |
|
San Diego Arrhythmia Associates, A Medical Corporation |
N |
|
San Diego Cardiovascular Associates Medical Group Inc |
N |
|
San Diego Gastroenterology Medical Associates |
N |
|
SAN DIEGO HEART ARRHYTHMIA CENTER, AMC |
N |
|
San Diego Heart Rhythm Center, A Medical Corporation |
N |
|
San Diego Orthopaedic Associates Medical Group, Inc. |
N |
|
Scott A Eisman Md Inc |
N |
|
Scott Mercer, Md, Inc |
N |
|
Scripps Health |
N |
|
Southern California Health Providers Medical Grp Inc |
N |
|
Spinezone Medical Fitness INC |
N |
|
Steven C. Wong M.D., Apc |
N |
|
Stewart L Frank, M.D., Inc. |
N |
|
Sudhir Malik, A Professional Medical Corporation |
N |
|
SUNIL RAYAN, M.D., INC. |
N |
|
Surgical Associates Of La Jolla Medical Group, Inc. |
N |
|
Suzanne P Handler Md Inc |
N |
|
Szmidt A Professional Medical Corp |
N |
|
Theodore Mazer |
N |
|
Thomas Diggs |
N |
|
Tram Le |
N |
|
Vitali Aizin Md Inc |
N |
|
Wayne Whitwam |
N |
|
Wun-Ling Chang, M.D., Inc. |
N |
ACO governing body
|
Last name |
First name |
TItle/Position |
Voting power |
Membership type |
ACO participant TIN legal business name |
|
Hirsch |
Kevin |
MD, Chair |
12.5% |
ACO Participant Representative |
Scripps Health |
|
Dworsky |
Dan |
MD |
12.5% |
ACO Participant Representative |
Scripps Health |
|
Eisman |
Scott |
MD |
12.5% |
ACO Participant Representative |
Acute Care Associates, Inc. and Scott A Eisman MD Inc. |
|
Polak |
Clara |
MD |
12.5% |
ACO Participant Representative |
Clara Lucy Polak, MD |
|
Tjosvold |
Robert |
|
12.5% |
Medicare Beneficiary Representative |
N/A |
|
Van Gorder |
Chris |
|
12.5% |
ACO Participant Representative |
N/A |
|
Walker |
Richard |
MD |
12.5% |
ACO Participant Representative |
Scripps Health |
|
Worsey |
Michael |
MD |
12.5% |
ACO Participant Representative |
Dana P. Launer, MD, and M. Jonathan Worsey, MD, A Professional Corp. |
Key ACO clinical and administrative leadership
|
Tracy Chu |
ACO Executive
|
|
Anil Keswani, MD |
Medical Director |
|
Taunya Juliano |
Compliance Officer |
|
Karen Patel |
Quality Assurance/Improvement Officer
|
Associated committees and committee leadership
|
Committee name |
Committee leader name and position |
|
Network Alignment |
Michael Worsey, MD, Network Alignment Committee Chair |
|
Utilization Management |
Anil Keswani, MD, ACO Medical Director |
|
Credentialing |
Thomas Carter, MD, Committee Chair |
|
Communications |
Cindy Gipson, ACO Senior Director |
|
Clinical Care Line Council |
Anil Keswani, MD, ACO Medical Director |
|
Quality Committee |
Thomas Carter, MD, Committee Chair |
Types of ACO participants, or combinations of participants, that formed the ACO:
- Hospital employing ACO professionals
- 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
First agreement period
- Performance year 2019, -$8,726,114.79
- Performance year 2018, $0
- Performance year 2017, $0
Shared savings distribution
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: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
2019 Quality Performance Results
|
ACO# |
Measure name |
Rate |
ACO Mean |
|
ACO-1 |
CAHPS: Getting Timely Care, Appointments, and Information |
83.19 |
85.86 |
|
ACO-2 |
CAHPS: How Well Your Providers Communicate |
92.71 |
94.11 |
|
ACO-3 |
CAHPS: Patients’ Rating of Provider |
91.17 |
92.69 |
|
ACO-4 |
CAHPS: Access to Specialists |
81.89 |
81.54 |
|
ACO-5 |
CAHPS: Health Promotion and Education |
56.23 |
60.44 |
|
ACO-6 |
CAHPS: Shared Decision Making |
56.18 |
62.78 |
|
ACO-7 |
CAHPS: Health Status/Functional Status |
74.91 |
73.79 |
|
ACO-34 |
CAHPS: Stewardship of Patient Resources |
22.81 |
26.17 |
|
ACO-45 |
CAHPS: Courteous and Helpful Office Staff |
92.24 |
92.84 |
|
ACO-46 |
CAHPS: Care Coordination |
86.02 |
86.89 |
|
ACO-8 |
Risk Standardized, All Condition Readmission |
14.57 |
14.86 |
|
ACO-38 |
All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions |
55.88 |
58.15 |
|
ACO-43 |
Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) |
1.55 |
1.87 |
|
ACO-13 |
Falls: Screening for Future Fall Risk |
72.49 |
84.04 |
|
ACO-14 |
Preventive Care and Screening: Influenza Immunization |
47.71 |
74.77 |
|
ACO-17 |
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention |
55.56 |
78.04 |
|
ACO-18 |
Preventive Care and Screening: Screening for Clinical Depression and Follow Up Plan |
58.51 |
70.40 |
|
ACO-19 |
Colorectal Cancer Screening |
55.45 |
70.76 |
|
ACO-20 |
Breast Cancer Screening |
72.43 |
73.84 |
|
ACO-42 |
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease |
73.28 |
82.17 |
|
ACO-27 |
Diabetes: Hemoglobin A1c Poor Control (>9) |
9.67 |
13.88 |
|
ACO-28 |
Controlling High Blood Pressure |
79.57 |
75.04 |
For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.
Payment rule waivers
- Skilled Nursing Facility (SNF) 3-day Rule Waiver:
- Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR §425.612.
- 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.