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 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