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, MD Inc |
N |
BRETT J. BERMAN, MD, PROFESSIONAL CORPORATION |
N |
Bruce Kimura |
N |
Cardiac Arrhythmia Associates A Medical Corporation |
N |
Catharine Marshall MD |
N |
Cesar Pena |
N |
Chia-Lin Charles Liu,DO,Inc |
N |
Chula Vista Heart Clinic, Inc. |
N |
Clara Lucy Polak, MD Inc. |
N |
Coastal Cardiovascular Care Inc |
N |
Coastal Pain & Spinal Diagnostics Medical Group, Inc. |
N |
CRAIG SCLAR |
N |
Dan I Giurgiu M D Professional Corporation |
N |
Dana P. Launer, MD and M.Jonathan Worsey, MD, A Professional Corp. |
N |
Daniel Michaels, MD, INC |
N |
Danielle Weiss |
N |
Dennis Costello |
N |
Edward Kocharian MD APC |
N |
Elahe Toulouie, Md, Inc |
N |
Enlightened Healthcare Alliance Medical Corporation |
N |
Francisco S. Pardo MD PC |
N |
Frank E. Mayer, MD, A Professional Corporation |
N |
Frederick J De La Vega Md |
N |
Gregory P Ranches MD ACP |
N |
Gregory Ranches |
N |
Hanh M Bui Md Apmc |
N |
HOUMAN DAHI MD, APC |
N |
INTERNAL MEDICINE ASSOCIATES MEDICAL GROUP OF SAN DIEGO, INC. |
N |
James Santiago Grisolia, MD Inc |
N |
Jay Berenter |
N |
Jeffry A Mullvain Md Inc |
N |
Jerrold Glassman, MD, 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 Pulmonary And Critical Care Inc |
N |
Lars R Newsome Md Inc. |
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 |
Medicus M D Inc A Deleware Corporation |
N |
Michael Sise |
N |
Michael T Couris, MD, Inc. |
N |
Michael Torrente |
N |
Naira Kocharian MD APC |
N |
Ngocbich Nguyen, MD, 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 |
Pamela Resnikoff |
N |
Paul Phillips |
N |
Perry W. Sexton, Md Professional Corporation |
N |
Peter Friend |
N |
Peter Morcos Md Inc |
N |
Richard Friedman |
N |
Ritvik Mehta Md, Pc |
N |
Robert Houghton Md Inc |
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 MD, Apc |
N |
Stewart L Frank, MD, Inc. |
N |
Sudhir Malik, A Professional Medical Corporation |
N |
SUNIL RAYAN, MD, INC. |
N |
Surgical Associates Of La Jolla Medical Group, Inc. |
N |
Suzanne P Handler Md Inc |
N |
Szmidt A Professional Medical Corp |
N |
Thomas Diggs |
N |
Tram Le |
N |
Vg Cardiac Associates, A Medical Corporation |
N |
Vitali Aizin Md Inc |
N |
Wayne Whitwam |
N |
Wun-Ling Chang, MD, Inc. |
N |
ACO governing body
First name |
Last name |
TItle/Position |
Voting power |
Membership type |
ACO participant TIN legal business name |
Kevin |
Hirsch |
MD, Chair |
12.5% |
ACO Participant Representative |
Scripps Health |
Dan |
Dworsky |
MD |
12.5% |
ACO Participant Representative |
Scripps Health |
Scott |
Eisman |
MD |
12.5% |
ACO Participant Representative |
Acute Care Associates, Inc. and Scott A Eisman MD Inc. |
Andrew |
King |
MD |
12.5% |
ACO Participant Representative |
Scripps Health |
Clara |
Polak |
MD |
12.5% |
ACO Participant Representative |
Clara Lucy Polak, MD |
Robert |
Tjosvold |
|
12.5% |
Medicare Beneficiary Representative |
N/A |
Chris |
Van Gorder |
|
12.5% |
ACO Participant Representative |
Scripps Health |
Michael |
Worsey |
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 |
Dan Dworsky, MD, Committee Chair |
Communications |
Cindy Gipson, Growth and Accountable Care Assistant Vice President |
Clinical Care Line Council |
Anil Keswani, MD, ACO Medical Director |
Quality Committee |
Dan Dworsky, 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
Second agreement period
- Performance year 2021, $0
- Performance year 2020, $7,758,213.65
First agreement period
- Performance year 2019, -$8,726,114.79
- Performance year 2018, $0
- Performance year 2017, $0
Shared savings distribution
Second agreement period
Performance Year 2021
- 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 2020
- Proportion invested in infrastructure: 44%
- Proportion invested in redesigned care processes/resources: 29%
- Proportion of distribution to ACO participants: 27%
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
2021 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 |
9.26 |
12.46 |
134 |
Preventative Care and Screening: Screening for Depression and Follow-up Plan |
59.44 |
74.38 |
236 |
Controlling High Blood Pressure |
72.00 |
74.87 |
318 |
Falls: Screening for Future Fall Risk |
63.27 |
87.03 |
110 |
Preventative Care and Screening: Influenza Immunization |
82.23 |
80.52 |
226 |
Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention |
40.00 |
80.97 |
113 |
Colorectal Cancer Screening |
74.04 |
73.63 |
112 |
Breast Cancer Screening |
82.86 |
75.11 |
438 |
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease |
82.45 |
84.24 |
479 |
Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups |
0.1444 |
0.1540 |
MCC1 |
All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC) |
31.88 |
33.94 |
CAHPS-1 |
Getting Timely Care, Appointments, and Information |
82.84 |
84.67 |
CAHPS-2 |
How Well Providers Communicate |
94.27 |
93.56 |
CAHPS-3 |
Patient’s Rating of Provider |
93.82 |
92.19 |
CAHPS-4 |
Access to Specialists |
79.14 |
78.80 |
CAHPS-5 |
Health Promotion and Education |
54.45 |
61.61 |
CAHPS-6 |
Shared Decision Making |
56.80 |
60.89 |
CAHPS-7 |
Health Status and Functional Status |
73.01 |
71.78 |
CAHPS-8 |
Care Coordination |
87.56 |
85.66 |
CAHPS-9 |
Courteous and Helpful Office Staff |
93.62 |
91.88 |
CAHPS-11 |
Stewardship of Patient Resources |
23.34 |
24.71 |
Please note, the Quality ID #: 370 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
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.
Fraud and Abuse Waivers
ACO Pre-Participation Waiver:
The following information describes each arrangement for which our ACO seeks protection under the ACO Pre-Participation Waiver, including any material amendment or modification to a disclosed arrangement.
- Parties to the arrangement: Scripps ACO and ACO Participants
- Date of arrangement: December 8, 2017
- Items, services, goods, or facility provided: Scripps Health EpicCare EHR
- Date and nature of any amendments to the arrangement, if applicable: N/A
- Parties to the arrangement: Scripps ACO and ACO Participants
- Date of arrangement: May 30, 2018
- Items, services, goods, or facility provided: Chronic Disease Care Management services
- Date and nature of any amendments to the arrangement, if applicable: N/A
- Parties to the arrangement: Scripps ACO and ACO Participants
- Date of arrangement: September 26, 2018
- Items, services, goods, or facility provided: Clinical and hospital facilities for coordinated oncology services
- Date and nature of any amendments to the arrangement, if applicable: N/A
- Parties to the arrangement: Scripps ACO and ACO Participants
- Date of arrangement: January 23, 2020
- Items, services, goods, or facility provided: Home-based care management services
- Date and nature of any amendments to the arrangement, if applicable: N/A
- Parties to the arrangement: Scripps ACO and ACO Participants
- Date of arrangement: January 23, 2020
- Items, services, goods, or facility provided: Advance care planning services
- Date and nature of any amendments to the arrangement, if applicable: N/A
- Parties to the arrangement: Scripps ACO and ACO Participants
- Date of arrangement: February 24, 2021
- Items, services, goods, or facility provided: Remote monitoring devices to assist in management and care of chronic and/or acute conditions
- Date and nature of any amendments to the arrangement, if applicable: N/A