Scripps Accountable Care Organization (ACO)

A Scripps physician talks with a mature male patient in a clinic hallway.

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

Akane Institute Of Allergy, Asthma And Sleep Medicine

N

Alan C. Westeren M.D. Inc.

N

Ali Salami

N

Alisa L Williams, Md, Facog, Inc.

N

Amanda Abramson Lloyd, Md, Inc

N

Andrew Deemer MD

N

ARNOLD S KREMER DO A PROFESSIONAL CORPORATION

N

ARTHRITIS CARE AND RESEARCH CENTER

N

ASIM GUHA ROY

N

Balboa Park Internal Medicine, Medical Associates Inc

N

Bijan Razi

N

Billie Green, Medical Corporation

N

Bone Builders Medical Clinic

N

Bradley L. Spitz, M.D. Inc

N

Bradley W. Greider, MD, Inc

N

BRETT J. BERMAN, M.D., PROFESSIONAL CORPORATION

N

Brian Belnap, DO, A Medical Corporation 

N

BRIAN H WEEKS MD INC

N

Bruce Kimura

N

CALIFORNIA CANCER ASSOCIATES FOR RESEARCH AND EXCELLENCE, INC..

N

CALIFORNIA ORTHOPAEDIC INSTITUTE MEDICAL ASSOCIATES INC

N

Calvin K. Wong, Md P C

N

Cardiac Arrhythmia Associates A Medical Corporation

N

Catharine Marshall MD

N

Cesar Pena

N

Chia-Lin Charles Liu,D.O.,Inc

N

Christopher N. Spellman, MD, Inc. 

N

Chula Vista Emergency Room Physicians A Medical Corporation

N

Chula Vista Heart Clinic, Inc.

N

Clara Lucy Polak, M.D. Inc.

N

COAST SURGICAL GROUP A MEDICAL CORPORATION

N

Coastal Pain & Spinal Diagnostics Medical Group, Inc.

N

Compass Dermatopathology,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

Del Mar Dermatology Medical Corp

N

Del Mar Med A Medical Corporation

N

Dennis Costello

N

Dermatology And Laser Of Del Mar

N

Dermatology Professionals Incorporated

N

DORI NEILL CAGE M D INC

N

Douglas M Keel Do Inc

N

Edgar Ling

N

Eileen S Natuzzi A Medical Corporation

N

Elahe Toulouie, Md, Inc

N

Emad Tadros Md A Prof Corp

N

Emergency Medicine Group Of Encinitas, Inc

N

ENLIGHTENED HEALTHCARE ALLIANCE MEDICAL CORPORATION

N

Erick H. Alayo Medical Corporation

N

Expert Surgeons Of California Inc

N

Fakhri M Salem Md Inc

N

FAKHRI SALEM

N

Francisco S. Pardo MD PC

N

Frank E. Mayer, M.D., A Professional Corporation

N

Frederic Martin

N

Frederick J De La Vega Md

N

Garrett J Tallman Md Inc

N

Gil Q. Galloway,MD Inc

N

Girard Orthopedic Surgeons Medical Group Inc

N

Gordon Schanzlin New Vision Institute, Inc. A Professional Medical Cor

N

GREGORY J WIENER MD PROFESSIONAL CORPORATION

N

Gregory P Ranches MD ACP

N

GREGORY RANCHES

N

Hanh M Bui Md Apmc

N

Hillcrest Internal Medicine A Medical Corporation

N

HOUMAN DAHI M.D., APC

N

Howard Miller MD APC

N

HUSSNA WAKILY

N

IAN PURCELL, MD, APC

N

INTERNAL MEDICINE ASSOCIATES MEDICAL GROUP OF SAN DIEGO, INC.

N

JACK C YANG MD A MEDICAL CORPORATION

N

James J Longobardi Dpm Inc

N

James P. Hatfield, DPM, 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

Jerry M Fabrikant Dpm Inc

N

John A.Grimaldi,DO,INC

N

John Harrington

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

Keeran Kumar MD, Inc.

N

Kelly S. Keefe MD, Inc

N

Kentaro E. Yamada, M.D., Inc.

N

KESHAV R NAYAK MD AMC

N

Kevin T. Toliver, M.D., Inc.

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 Cooper

N

Lawrence D Eisenhauer Md Inc Lawrence D Eisenhauer M D Officer

N

Leila Rhodes MD Inc

N

Leticia Uwedjojevwe Md Medical Corporation

N

LINDSEY URBAND MD CORP

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 J. OLEARY, MD, INC

N

Michael S Bongiovanni Md Inc

N

Michael Sise

N

Michael T Couris, M.D., Inc.

N

Michael Torrente

N

NAIRA KOCHARIAN MD A PC

N

Ngocbich Nguyen, M.D., Inc.

N

Nii Aryee Tetteh Md Inc

N

Nora El-Khatib Md, Inc.

N

North County Gastroenterology Medical Group Inc

N

North County Inpatient Medical Alliance, A Medical Group, Inc

N

North County Laser Eye Associates, APC 

N

North County Neurology Associates

N

North County Oncology Medical Clinic, Inc

N

Olde Del Mar Surgical Medical Group Inc

N

PACIFIC ENT MEDICAL GROUP, INC.

N

Pain Management Consultants A Professional Medical Corporation

N

Park Row Podiatry Inc.

N

PATRICIA FORG

N

Paul E. Kim, MD Inc

N

Paul Phillips

N

PERRY MANSFIELD

N

Perry W. Sexton, Md Professional Corporation

N

Perry, Pratt, & Coden , A Medical Corporation

N

Peter Friend

N

Peter James Lloyd MD INC

N

Peter Morcos Md Inc

N

Peter Seymour

N

Radiology Medical Group Inc

N

Rahele Mazarei, D.O., A.P.C.

N

Rapeport Medical Corporation

N

Revivamed Medical Corporation

N

Richard Blum

N

Richard Friedman

N

RICK T CHAC MD INC

N

Ritvik Mehta Md, Pc

N

Rj Fernandez Md Inc Apc.

N

RM FLORES MD INC

N

Robert Afra Md A Professional Corporation

N

Robert Houghton Md Inc

N

Ronald E Lieberman, DPM

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 Eye Group, Inc.

N

San Diego Eyelid Specialists, Inc.

N

SAN DIEGO FOOT & ANKLE, 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

San Diego Pathologists Medical Group, Inc.

N

San Diego Snf Hospitalists

N

San Diego Women's Health, Inc

N

San Dieguito Orthopedic Medical Center, P.C.

N

Scott A Eisman Md Inc

N

SCOTT LEARY, M.D., INC.

N

Scott Mercer, Md, Inc

N

Scripps Health

N

Scripps Health Inpatient Providers Medical Group Inc

N

SENTA CLINIC, INC.

N

Sherev Heart and Vascular Clinic, Inc

N

Shervin Alborzain Md Pc

N

South Bay Skin And Cancer Medical Group, Inc.

N

SOUTH BAY SURGICAL ASSOCIATES MEDICAL GROUP INC

N

South Coast Gynecologic Oncology, Inc

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

TOOSIEMD INC

N

Tram Le

N

Tricity Orthopaedic Surgery Medical Group, Inc.

N

VISHAL BANSAL

N

Vitali Aizin Md Inc

N

Wayne Whitwam

N

Wun-Ling Chang, M.D., Inc.

N

Ximed Hospitalists, 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.