ACO CMS Medicare Shared Savings Program

ACO Name and Location

UCI Health Accountable Care Organization
101 The City Drive South, Building 54, Suite 5700
Orange, California 92868

ACO Primary Contact

Primary Contact Name	Natalie Maton
Primary Contact Phone Number	714-456-6897
Primary Contact Email Address	MedicareACO@hs.uci.edu

Organizational Information

ACO participants:

ACO Participants	Doing Business As	ACO Participant in Joint Venture (Enter Y or N)
Regents of the University of California	UC Irvine Pathology Services	Y
Regents of the University of California	Ob-Gyn University Associates	Y
Regents of the University of California	UCI Department of Pathology	Y
Regents of the University of California	UCI Department of Ophthalmology	Y
Regents of the University of California	Plastic Surgery Division UCI	Y
Regents of the University of California	UCI Ophthalmology Group	Y
Regents of the University of California	Orthopaedic Faculty of Irvine	Y
Regents of the University of California	Neurosurgical Associates of Irvine	Y
University of California Irvine	UCI Medical Center/UCI, Family Health Center- Santa Ana	Y
UCI Department of Dermatology	UCI Department of Dermatology	Y
UC Regents	UCI Radiology Associates	Y
UCI Department of Urology	UCI Department of Urology	Y
UCI Physical Medicine & Rehabilitation	UCI Physical Medicine & Rehabilitation (PM&R)	Y
The Department of Psychiatry	The Department of Psychiatry	Y
The Regents of the University of California-Irvine	UC Irvine Hospitalist Program	Y
Regents of the University of	UC Irvine Department of Family Medicine	Y
Regents of the University of	University Anesthesia Associates	Y
Regents of the University of	Emergency Medicine Faculty Group	Y
University Head & Neck Surgeons	University Head & Neck Surgeons	Y
UC Regents UCI Dept of Medicine	UCI Department of Medicine	Y
Regents of the University of California Univ Neurosciences	University Neurosciences	Y
UC Regents Department of Radiation Oncology	UC Regents Department of Radiation Oncology	Y
University Surgeons of Orange A Medical Group	University Surgeons of Orange A Medical Group	Y
Regents of the University of California	UCI Primary Care Medical Group	Y

ACO governing body:

Last Name	First Name	Title/Position	Member's Voting Power	Membership Type	ACO Participant TIN Legal Business Name/DBA, if Applicable
Lefteris	Chad	Chief Executive Officer	5.9%	ACO Participant Rep.	University of California, Irvine
Amin, MD	Alpesh	Chair, Dept of Medicine	5.9%	ACO Participant Rep.	Regents of the University of California
Reikes, MD	Andrew	Chief, Primary Care	5.9%	ACO Participant Rep.	Regents of the University of California
Carmichael, MD	Joseph	Chief Medical Officer	5.9%	ACO Participant Rep.	University of California, Irvine
Chow, MD	Emilie	Asst. Chief, Primary Care	5.9%	ACO Participant Rep.	Regents of the University of California
Gibbs, MD	Lisa	Chief, Geriatrics	5.9%	ACO Participant Rep.	Regents of the University of California
Siwabessy	Randolph	Chief Financial Officer	5.9%	ACO Participant Rep.	University of California, Irvine
Maton	Natalie	Executive Director of Operations	5.9%	ACO Participant Rep.	University of California, Irvine
Choriatis	George	Health Science Counsel	5.9%	ACO Participant Rep.	University of California, Irvine
Michaels Jed	Meredith	Medicare Beneficiary	5.9%	Medicare Beneficiary
Haq, MD	Cynthia	Chief, Dept of Fam Medicine	5.9%	ACO Participant Rep.	Regents of the University of California
Altamira	Erwin	Sr. Dir, Ambulatory Administration	5.9%	ACO Participant Rep.	University of California, Irvine
Mayorga, MD	Jose	Executive Medical Director, Family Health Centers	5.9%	ACO Participant Rep.	Regents of the University of California
Boone, MD	Matthew	Associate Dean Clinical Affairs	5.9%	ACO Participant Rep.	University of California, Irvine
Ezzat, MSN, RN	Mary	Senior Practice Manager	5.9%	ACO Participant Rep.	University of California, Irvine
Niedzwiecki	Doug	Executive Director, Ambulatory	5.9%	ACO Participant Rep.	University of California, Irvine
Dixon	Valerie	Compliance Officer	5.9%	ACO Participant Rep.	University of California, Irvine

Key ACO clinical and administrative leadership:

Randolph Siwabessy	ACO Executive
Lisa Gibbs, MD	Medical Director
Valerie Dixon	Compliance Officer
Lisa Gibbs, MD	Quality Assurance/Improvement Officer

Associated committees and committee leadership:

Committee Name	Committee Leader Name and Position
Clinical Workflow and Quality Improvement Committee	Lisa Gibbs, MD, ACO Medical Director
Finance Review Committee	Erwin Altamira, Sr. Dir Ambulatory Administration

Types of ACO participants, or combinations of participants, that formed the ACO:

Hospital employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

First Agreement Period
- Performance Year 2018, $0
- Performance Year 2019, $0
- Performance Year 2020, $2,529,885
- Performance Year 2021, $0
Second Agreement Period
- Performance Year 2022, $0

Shared Savings Distribution

First Agreement Period
- 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 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 2020
  - Proportion invested in infrastructure: 30%
  - Proportion invested in redesigned care processes/resources: 30%
  - Proportion of distribution to ACO participants: 40%
- 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
Second Agreement Period
- Performance Year 2022
  - Proportion invested in infrastructure: N/A
  - Proportion invested in redesigned care processes/resources: N/A
  - Proportion of distribution to ACO participants: N/A

Quality Performance Results

2022 Quality Performance Results:
Quality performance results are based on CMS Web Interface.

ACO Quality Measure Number	Measure Name	Rate	ACO Mean
001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1]	15.86	10.71
134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	72.50	76.97
236	Controlling High Blood Pressure	66.67	76.16
318	Falls: Screening for Future Fall Risk	95.38	87.83
110	Preventative Care and Screening: Influenza Immunization	68.39	77.34
226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	82.35	79.27
113	Colorectal Cancer Screening	76.29	75.32
112	Breast Cancer Screening	84.05	78.07
321	CAHPS for MIPS [2]	N/A	N/A
479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1]	0.1496	0.1510
484	Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1]	24.40	30.97
370	Depression Remission at Twelve Months	10.00	16.03

[1] A lower performance rate corresponds to higher quality.

[2] CAHPS for MIPS is a composite measure, so numerator, denominator, and performance rate values are not applicable (N/A)

Measure ID	Measure Name	Rate	ACO Mean
CAHPS-1	Getting Timely Care, Appointments, and Information	82.23	83.96
CAHPS-2	How Well Providers Communicate	93.40	93.47
CAHPS-3	Patient’s Rating of Provider	93.56	92.06
CAHPS-4	Access to Specialists	77.71	77.00
CAHPS-5	Health Promotion and Education	58.60	62.68
CAHPS-6	Shared Decision Making	54.20	60.97
CAHPS-8	Care Coordination	84.76	85.46
CAHPS-9	Courteous and Helpful Office Staff	92.70	91.97
CAHPS-11	Stewardship of Patient Resources	23.70	25.62

Payment Rule Waivers

No, our ACO does not use the SNF 3-Day Rule Waiver.

Contact

For general questions or additional information about Accountable Care Organizations, visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

ACO Participant TIN Legal Business Name/DBA, if Applicable

ACO CMS Medicare Shared Savings Program

ACO Name and Location

ACO Primary Contact

Organizational Information

Shared Savings and Losses

Quality Performance Results

Payment Rule Waivers

Contact

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