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 & Rehabilitiation (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 Claifornia Univ Neursciences 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


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  1  ACO Participant Rep. University of California, Irvine
Amin, MD Alpesh Chair, Dept of Medicine  1  ACO Participant Rep. Regents of the University of California
Reikes, MD Andrew Chief, Primary Care
 1  ACO Participant Rep. Regents of the University of California
Carmichael, MD Joseph Chief Medical Officer  1  ACO Participant Rep. University of California, Irvine
Chow, MD Emilie Asst. Chief, Primary Care
 1  ACO Participant Rep. Regents of the University of California
Gibbs, MD Lisa Chief, Geriatrics
 1  ACO Participant Rep. Regents of the University of California
Siwabessy Randolph Chief Financial Officer  1  ACO Participant Rep. University of California, Irvine
Maton Natalie Executive Director of Operations
 1  ACO Participant Rep. University of California, Irvine
Choriatis George Health Science Counsel
 1  ACO Participant Rep. University of California, Irvine
Michaels Jed Meredith Medicare Beneficiary
 1  Medicare Beneficiary
Haq, MD Cynthia Chief, Dept of Fam Medicine  1  ACO Participant Rep. Regents of the University of California
Altamira Erwin Sr. Dir, Ambulatory Administration
 1  ACO Participant Rep. University of California, Irvine
Mayorga, MD Jose Executive Medical Director, Family Health Centers
 1 ACO Participant Rep. Regents of the University of California
Boone, MD Matthew Associate Dean Clinical Affairs  1 ACO Participant Rep. University of California, Irvine
Ezzat, MSN, RN Mary Senior Practice Manager  1 ACO Participant Rep. University of California, Irvine
Niedzwiecki Doug Executive Director, Ambulatory  1 ACO Participant Rep. University of California, Irvine
Dixon Valerie Compliance Officer  1 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

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

Quality Performance Results

2021 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 Control2

17.73

12.46

134

Preventative Care and Screening: Screening for Depression and Follow-up Plan1

69.76

74.38

236

Controlling High Blood Pressure

64.95

74.87

318

Falls: Screening for Future Fall Risk

91.54

87.03

110

Preventative Care and Screening: Influenza Immunization

75.38

80.52

226

Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention

62.50

80.97

113

Colorectal Cancer Screening

79.25

73.63

112

Breast Cancer Screening

76.23

75.11

438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease1

85.22

84.24

321

CAHPS for MIPS3

N/A

N/A
479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2 0.1631 0.1540
MCC1 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2 30.28 33.99

[1] For PY 2021, measures #134, #438, and #370 do not have CMS Web Interface benchmarks and are not scored as a result.
Please note, the Quality ID #: 370 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

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

[3] 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

80.24

84.67

CAHPS-2

How Well Providers Communicate

93.48

93.56

CAHPS-3

Patient’s Rating of Provider

91.74

92.19

CAHPS-4

Access to Specialists

82.87

78.80

CAHPS-5

Health Promotion and Education

64.61

61.61

CAHPS-6

Shared Decision Making

56.97

60.89

CAHPS-7

Health Status and Functional Status

71.15

71.78

CAHPS-8

Care Coordination

86.58

85.66

CAHPS-9

Courteous and Helpful Office Staff

94.14

91.88

CAHPS-11

Stewardship of Patient Resources

15.65

24.71

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 Participant TIN Legal Business Name/DBA, if Applicable 
ACO Participant TIN Legal Business Name/DBA, if Applicable 

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