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	858-678-7478
Primary contact email address	gipson.cynthia@scrippshealth.org

Organizational information

ACO participants
ACO governing body
Key ACO clinical and administrative leadership
Associated committees and committee leadership
Shared savings and losses
2017 quality performance results
Payment rule waivers

ACO participants

ACO participants	ACO participant in a joint venture (Y/N)
Torrey Pines Orthopaedic Medical Group, Inc.	N
San Diego Neurosurgeon One, A Professional Corporation	N
Christopher N. Spellman, MD, Inc.	N
John Harrington	N
Paul E. Kim, MD, Inc.	N
Del Mar Med, A Medical Corporation	N
Rocio Flores	N
David Shamblaw	N
San Dieguito Orthopedic Medical Center, A Professional Corporation	N
Francisco S. Pardo, MD, A Professional Corporation	N
Rahele Mazarei, DO, A Professional Corporation	N
Joseph Resnikoff	N
Warren Pleskow	N
Michael Sise	N
Lawrence Cooper	N
Russell P. Edwards, MD, A Professional Corporation	N
Spinezone Medical Fitness, Inc.	N
Edgar Ling	N
Theodore Mazer	N
Paul Phillips	N
Jose R. Pena, MD, A Professional Corporation	N
Dennis Costello	N
Pacific Neurology, A Medical Corporation	N
Frederic Martin	N
Peter Friend	N
Richard Blum	N
Szmidt, A Professional Medical Corporation	N
James J. Longobardi, DPM, Inc.	N
Dermatology and Laser of Del Mar	N
Leticia Uwedjojevwe, MD, A Medical Corporation	N
North County Inpatient Medical Alliance, A Medical Group, Inc.	N
Emergency Medicine Group Of Encinitas, Inc.	N
Christopher Joseph Gualtieri, MD, A Professional Corporation	N
Jack C. Yang, MD, A Medical Corporation	N
Emad Tadros, MD, A Professional Corporation	N
San Diego Rheumatology Medical Group, Inc.	N
Elahe Toulouie, MD, Inc.	N
B.S. Khehar, MD, Inc.	N
Salami Nuclear Cardiology Medical Group, Inc.	N
South Coast Gynecologic Oncology, Inc.	N
Medderm Corporation	N
Leila Rhodes, MD, Inc.	N
Ximed Hospitalists, Inc.	N
George Delgado, MD, Inc.	N
Steven C. Wong MD, A Professional Corporation	N
Kentaro E. Yamada, MD, Inc.	N
Pacific Orthopaedics & Sports Medicine	N
La Jolla Pulmonary and Critical Care, Inc.	N
Clara Lucy Polak, MD, Inc.	N
Brett J. Berman, MD, A Professional Corporation	N
Chula Vista Heart Clinic, Inc.	N
Adema Family Medicine, Inc.	N
Cesar Pena	N
Jay Berenter	N
Calvin K. Wong, MD, A Professional Corporation	N
Douglas M. Keel, DO, Inc.	N
Sumana & Ananthram Reddy, MD, Inc.	N
Revivamed Medical Corporation	N
Dermatology Professionals, Inc.	N
Michael S. Bongiovanni, MD, Inc.	N
Jerry M. Fabrikant, DPM, Inc.	N
Nayana Mohan Trivedi, MD, Inc.	N
Olde Del Mar Surgical Medical Group, Inc.	N
Houman Dahi, MD	N
Synergy Medical Specialists, A Professional Corporation	N
James J. Chao	N
Expert Surgeons Of California, Inc.	N
Tram Le	N
San Diego Women's Health, Inc.	N
Ritvik Mehta, MD, A Professional Corporation	N
Vitali Aizin, MD, Inc.	N
Erick H. Alayo Medical Corporation	N
Maria Lourdes S. Mara, MD, A Medical Corporation	N
Perry W. Sexton, MD, A Professional Corporation	N
Suzanne P. Handler, MD, Inc.	N
San Diego Eye Group, Inc.	N
John A. Grimaldi, DO, Inc.	N
Compass Dermatopathology, Inc.	N
Danielle Weiss	N
Park Row Podiatry, Inc.	N
Akane Institute of Allergy, Asthma And Sleep Medicine	N
Genesis Healthcare Partners, A Professional Corporation	N
Joseph Shurman, MD, Integrative Pain Management, Inc.	N
Robert Afra, MD, A Professional Corporation	N
Frank E. Mayer, MD, A Professional Corporation	N
Del Mar Dermatology, A Medical Corporation	N
Carlos F. Jimenez, MD	N
M. Hertzel Soumekh, MD, A Professional Corporation	N
David G. Smith, MD, A Professional Corporation	N
James Santiago Grisolia, MD, Inc.	N
Julian Lichter, MD, A Professional Corporation	N
North County Neurology Associates	N
Lawrence D. Eisenhauer, MD, Inc., Lawrence D. Eisenhauer, MD, Officer	N
Pierre G. Rivet, MD, A Medical Corporation	N
Bradley W. Greider, MD, Inc.	N
Duc Dinh Vo, MD, Inc.	N
Bijan Razi	N
Southern California Health Providers Medical Group, Inc.	N
Gregory J. Wiener, MD, A Professional Corporation	N
Luis Sanchez	N
Richard M. and Donald R. Green Partners, DBA, San Diego Podiatry Group	N
Andrew Deemer, MD	N
L. Dale Lapp, MD, Inc.	N
La Jolla Gastroenterology Medical Group, Inc.	N
Ear Nose And Throat Associates Of San Diego, A Medical Corporation	N
Luis M. Marquez, MD, Inc.	N
Acute Care Associates, Inc.	N
Piyush (Phil) Kumar, MD, Inc.	N
Cardiac Arrhythmia Associates, A Medical Corporation	N
Perry, Pratt, & Coden, A Medical Corporation	N
Jeffry A. Mullvain, MD, Inc.	N
San Diego Cardiovascular Associates Medical Group, Inc.	N
Scott A. Eisman, MD, Inc.	N
Daniel Michaels, MD, Inc.	N
Rapeport Medical Corporation	N
Medicus MD, Inc., A Delaware Corporation	N
Pacific ENT Medical Group, Inc.	N
Joseph B. Stein, MD, FACC, Inc.	N
Alan C. Westeren, MD, Inc.	N
Alisa L. Williams, MD, FACOG, Inc.	N
Marc M. Sedwitz, MD, Inc.	N
Radiology Medical Group, Inc.	N
Roman B. Cham, MD, Inc.	N
Balboa Park Internal Medicine, Medical Associates, Inc.	N
Jon Kelly	N
Clearview Eye & Laser Medical Center, A Medical Corporation	N
Pain Management Consultants, A Professional Medical Corporation	N
Bradley L. Spitz, MD, Inc.	N
Billie Green, A Medical Corporation	N
Eileen S. Natuzzi, A Medical Corporation	N
Joseph Resnikoff, MD	N
Ronald E. Lieberman, DPM	N
RJ Fernandez, MD, Inc., A Professional Corporation	N
Bone Builders Medical Clinic	N
Hillcrest Internal Medicine, A Medical Corporation	N
Robert Houghton, MD, Inc.	N
Scott Mercer, MD, Inc.	N
Gil Q. Galloway, MD, Inc.	N
San Diego Arrhythmia Associates, A Medical Corporation	N
Dana P. Launer, MD, and M. Jonathan Worsey, MD, A Professional Corporation	N
Carmel Valley Family Practice	N
La Jolla Cardiovascular Medical Associates, Inc.	N
Venustano Guerra	N
Ngocbich Nguyen, MD, Inc.	N
Dori Neill Cage, MD, Inc.	N
Jonathan Licht	N
Vishal Bansal, MD	N
Thomas Diggs	N
Ali Salami	N
Shervin Alborzain, MD, A Professional Corporation	N
Hanh M. Bui, MD, A Professional Medical Corporation	N
Renjit Sundharradas, MD, A Professional Corporation	N
Scripps Health Inpatient Providers Medical Group, Inc.	N
Kelly S. Keefe, MD, Inc.	N
Synergy Specialists Medical Group	N
Chia-Lin Charles Liu, DO, Inc.	N
San Diego SNF Hospitalists	N
Lars R. Newsome, MD, Inc.	N
San Diego Heart Rhythm Center, A Medical Corporation	N
North County Laser Eye Associates, A Professional Corporation	N
NR Medical Associates	N
Timothy A. Peppers, MD, Inc.	N
Jamieson Glenn, MD, Inc.	N
Minimally Invasive Surgeons Of North County, Inc.	N
Sherev Heart and Vascular Clinic, Inc.	N
Frederick J. De La Vega, MD	N
Brian Belnap, DO, A Medical Corporation	N
Comprehensive Surgical Associates, MD, A Professional Corporation	N
Richard Friedman	N
Keeran Kumar, MD, Inc.	N
Wayne Whitwam	N
Kevin T. Toliver, MD, Inc.	N
Asim Guha Roy	N
Coastal Pain & Spinal Diagnostics Medical Group, Inc.	N
Michael T. Couris, MD, Inc.	N
Mark Johnson	N
Garrett J. Tallman, MD, Inc.	N
Craig Sclar	N
James Cordell	N
Peter Seymour	N
Catharine Marshall	N
Patricia Forg, MD	N
Taram Dabo	N
Andrew Deemer	N
Dan I. Giurgiu MD Professional Corporation	N
Walter Jolley, DPM, A Professional Corporation	N
Michael Torrente	N
Bruce Kimura	N
Kiyon Chung, MD	N
Fakhri M. Salem, MD, Inc.	N
Wun-Ling Chang, MD, Inc.	N
California Cancer Associates for Research & Excellence, Inc.	N
Catharine Marshall, MD	N
San Diego Eyelid Specialists, Inc.	N
Peter Morcos, MD, Inc.	N
Nora El-Khatib, MD, Inc.	N
Gordon Schanzlin New Vision Institute, Inc., A Professional Medical Corporation	N
Sudhir Malik, A Professional Medical Corporation	N
Amanda Abramson Lloyd, MD, Inc.	N
Peter James Lloyd, MD, Inc.	N
Nii Aryee Tetteh, MD, Inc.	N
Chula Vista Emergency Room Physicians, A Medical Corporation	N
Scripps Health	N
San Diego Pathologists Medical Group, Inc.	N
San Diego Mental Health Associates Medical Clinic, Inc.	N
California Orthopaedic Institute Medical Associates, Inc.	N
North County Gastroenterology Medical Group, Inc.	N
Centro De Salud De La Comunidad De San Ysidro, Inc.	N
South Bay Skin And Cancer Medical Group, Inc.	N
Tricity Orthopaedic Surgery Medical Group, Inc.	N
San Diego Orthopaedic Associates Medical Group, Inc.	N
North County Oncology Medical Clinic, Inc.	N
San Diego Gastroenterology Medical Associates	N
Girard Orthopedic Surgeons Medical Group, Inc.	N
Jeffrey A. Sandler, MD	N
Howard Miller, MD, A Professional Corporation	N
Paul M. Goodman, MD, A Medical Corporation	N
Stewart L. Frank, MD, Inc.	N
James P. Hatfield, DPM, Inc.	N
Surgical Associates of La Jolla Medical Group, Inc.	N
Jerrold Glassman, MD, A Medical Corporation	N
Nancy Sajben	N
Franklin W. Lusby MD, 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	1	ACO Participant Representative	Scripps Health
Dworsky	Dan	MD	1	ACO Participant Representative	Scripps Health
Eisman	Scott	MD	1	ACO Participant Representative	Acute Care Associates, Inc. and Coastal Pulmonary Associates, Inc.
LaBelle	James	MD	0	ACO Participant Representative	Scripps Health
Polak	Clara	MD	1	ACO Participant Representative	Clara Lucy Polak, MD
Sarnoff	Robert	MD	1	ACO Participant Representative	Scripps Health
Tjosvold	Robert		1	Medicare Beneficiary Representative	N/A
Van Gorder	Chris		1	ACO Participant Representative	N/A
Worsey	Michael	MD	1	ACO Participant Representative	San Diego Colon and Rectal Surgeons

Key ACO clinical and administrative leadership

Barbara Price	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	Barbara Price, ACO Executive
Utilization Management	Anil Keswani, MD, ACO Medical Director
Credentialing	Anil Keswani, MD, ACO Medical Director
Communications	Barbara Price, ACO Executive
Clinical Care Line Council	James LaBelle, ACO Participant Representative
Quality Committee	Anil Keswani, MD, ACO Medical Director

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 2017, $0

Shared savings distribution

First agreement period
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

2017 Quality performance results

ACO#	Measure name	Rate	ACO mean
ACO #1	CAHPS: Getting Timely Care, Appointments, and Information	82.43	80.60
ACO #2	CAHPS: How Well Your Providers Communicate	93.83	93.13
ACO #3	CAHPS: Patients’ Rating of Provider	93.49	92.31
ACO #4	CAHPS: Access to Specialists	79.73	83.32
ACO #5	CAHPS: Health Promotion and Education	53.51	62.30
ACO #6	CAHPS: Shared Decision Making	74.81	75.85
ACO #7	CAHPS: Health Status/Functional Status	74.08	73.05
ACO #34	CAHPS: Stewardship of Patient Resources	20.69	25.68
ACO #8	Risk Standardized, All Condition Readmission	14.37	15.01
ACO #35	Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)	17.97	18.46
ACO #36	All-Cause Unplanned Admissions for Patients with Diabetes	46.34	53.95
ACO #37	All-Cause Unplanned Admissions for Patients with Heart Failure*	67.03	79.16
ACO #38	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions	52.41	61.74
ACO #43	Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91))	1.60	1.93
ACO #11	Use of Certified EHR Technology	97.07	98.48
ACO #12	Medication Reconciliation	50.75	75.32
ACO #13	Falls: Screening for Future Fall Risk	24.26	74.38
ACO #44	Imaging Studies for Low Back Pain	77.55	67.32
ACO #14	Preventive Care and Screening: Influenza Immunization	65.07	72.52
ACO #15	Pneumonia Vaccination Status for Older Adults	71.45	72.92
ACO #16	Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up	30.40	70.69
ACO #17	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	38.25	90.48
ACO #18	Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan	10.22	61.98
ACO #19	Colorectal Cancer Screening	34.16	64.58
ACO #20	Breast Cancer Screening	68.32	70.05
ACO #42	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	79.47	79.89
ACO #27	Diabetes Mellitus: Hemoglobin A1c Poor Control	12.52	16.74
ACO #41	Diabetes: Eye Exam	36.16	50.37
ACO #28	Hypertension (HTN): Controlling High Blood Pressure	78.39	71.47
ACO #30	Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic	74.46	86.86

The ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.

See the 2017 quality performance results.

Note: In the Quality Performance Results file(s) above, search for “Scripps Accountable Care Organization, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A46655 in the public use files on data.cms.gov.

Payment rule waivers

Yes, our ACO does use the SNF 3-Day Rule Waiver
Disclosure #1
Disclosure #2
Disclosure #3