ACO Name and Location

Circle Health Alliance, LLC
Previous Names: N/A
295 Varnum Avenue
Lowell, MA 01854

ACO Primary Contact

Primary Contact Name Emily Young
Primary Contact Phone Number (978) 788-7271
Primary Contact Email Address Emily.Young@lowellgeneral.org

Organizational Information

ACO participants:

ACO Participants ACO Participant in Joint Venture (Enter Y or N)
K Tomany Y
LOWELL GENERAL HOSPITAL, THE Y
Merrimack Urology Assoc, Pc Y
Massachusetts Eye Associates Pc Y
Nasim Ghaffar Y
Lowell Community Health Center, Inc. Y
David C Morley JR MD PC Y
Orthopaedic Surgical Associates of Lowell, PC Y
Zeuscorp Y
MASSACHUSETTS E.N.T. ASSOCIATES, INC. Y
Pathology Associates of Lowell, P.C. Y
Damian Folch Y
Peter D Roman MD PC Y
JOSHI MEDICAL SERVICES, P.C. Y
MEDICAL HEALTHCARE SPECIALISTS, P.C. Y
Alexandra Argasinski, MD Y
Jack Chang, MD, PC Y
Riverside Medical Group, PC Y
Lawrence P Johnson Md Pc Y
VASCULAR ASSOCIATES OF THE MERRIMACK VALLEY, P.C. Y
Kevin Tomany Md Pc Y
LOWELL SURGICAL ASSOCIATES, P.C. Y
CHELMSFORD FAMILY PRACTICE, P.C. Y
DINELI, A PROFESSIONAL CORPORATION Y
Northeast Plastic Surgery Y
Chelmsford Primary Care, LLC Y
New England Foot & Ankle, P.C. Y
KEVIN MALONE DO PC Y
David Morley Y
Peter Roman Y
Kevin Malone Y
Lawrence Johnson Y
David Sidebottom, MD Y
Nonnie Estella Y
Sepulveda & Associates, PC Y
Benjamin Henkle Y
LGH WomanHealth, Inc. Y
Stony Brook Primary Care Y
Pelham Healthcare Associates Pllc Y
NESC LPHO, LLC Y
Mill City Medical Group, Ltd Y
LGH Merrimack Valley Cardiology Associates, LLC. Y
Carlos Del Rio Y
Benjamin Henkle, MD, LLC Y
Merrimack Radiology - CRA, LLC Y
Riverside Surgical Associates, PC Y
Westford Vein and Aesthetic Solutions Y
Mass Medical Group LLC Y
Precision Surgical Specialists of Lowell PC Y
NORTHEAST MEDICAL GROUP, INC. Y
Sangita Pillai Y

ACO governing body:

Member Member's Voting Power - Expressed as a percentage or number Membership Type ACO Participant Legal Business Name/DBA, if Applicable
Last Name First Name Title/Position
Jiser Michael MD & Chair 1 ACO Participant Lowell Surgical Associates, PC
Gilchrist Mark MD & Vice Chair 1 Other
Edelstein Robert MD 1 ACO Participant Merrimack Urology Associates, PC
DeAmicis Richard MD 0 ACO Participant Medical Healthcare Spec., PC
Estella Nonnie-Marie MD 1 ACO Participant N.M. Estella, MD, PC
Ewald Eric MD 1 ACO Participant LGH Merrimack Valley Cardiology Associates
Lauretano Arthur MD 1 ACO Participant Mass ENT Associates
Mazraany Wassim MD 1 ACO Participant Riverside Surgical Associates, PC
Patel Sachin MD 1 ACO Participant Northeast Medical Group, Inc.
Patel Tushar MD & Medical Director 1 ACO Participant Riverside Medical Group PC
Pickul David MD 1 ACO Participant Mill City Medical Group, Ltd
Prybyla David MD 1 ACO Participant Orthopaedic Surgical Associates
Reddy Roopa MD 1 ACO Participant Chelmsford Primary Care, LLC
Clifford Barbara  FNP 1 Medicare N/A
White Jody President & CEO 1 ACO Participant Lowell General Hospital
Green Susan CFO 0 Other
Hoey Amy EVP & COO 1 ACO Participant Lowell General Hospital
Wyman William VP of Finance 1 ACO Participant Lowell General Hospital
Osborn Frank MD 0 ACO Participant Merrimack Family Medicine
Tsirigotis Pauline MD & Medical Director 0 ACO Participant Mill City Medical Group, Ltd
Young Emily Executive Director 0 Other

Key ACO clinical and administrative leadership:

Emily Young ACO Executive
Tushar Patel Medical Director
Michael McAuliffe Compliance Officer
Katherine LaChance Quality Assurance/Improvement Officer

Associated committees and committee leadership:

Committee Name Committee Leader Name and Position
Finance & Budget Committee Michael Jiser, MD - Chair
Clinical Performance Committee TBD
Executive Risk Allocation Committee Harsh Sanchorawala, MD - Chair
Joint Performance & Incentives Committee TBD
Contract Review Committee David Pickul, MD - Chair
Physician Advisory Credentialing and Compliance Committee Richard DeAmicis, MD - Chair
Nominating Committee Michael Jiser, MD - Chair

Types of ACO participants, or combinations of participants, that formed the ACO:
  • Circle Health Alliance, LLC is a joint venture between Circle Health Alliance, LLC and the Lowell General Physician Hospital Organization.

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2017, $1,569,838
    • Performance Year 2016, $4,063,944
  • First Agreement Period
    • Performance Year 2015, $2,755,899
    • Performance Year 2014, $3,240,503
    • Performance Year 2013, $6,087,568
Shared Savings Distribution

  • Second Agreement Period
    • Performance Year 2017
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 75%
      • Proportion of distribution to ACO participants: 0%
    • Performance Year 2016
      • Proportion invested in infrastructure: 10%
      • Proportion invested in redesigned care processes/resources: 38%
      • Proportion of distribution to ACO participants: 52%
  • First Agreement Period
    • Performance Year 2015
      • Proportion invested in infrastructure: 18%
      • Proportion invested in redesigned care processes/resources: 41%
      • Proportion of distribution to ACO participants: 41%
    • Performance Year 2014
      • Proportion invested in infrastructure: 29%
      • Proportion invested in redesigned care processes/resources: 18%
      • Proportion of distribution to ACO participants: 53%
    • Performance Year 2013
      • Proportion invested in infrastructure: 19%
      • Proportion invested in redesigned care processes/resources: 28%
      • Proportion of distribution to ACO participants: 53%

Quality Performance Results

2017 Quality Performance Results:

ACO Number Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 83.44 80.60
ACO-2 CAHPS: How Well Your Providers Communicate 94.11 93.13
ACO-3 CAHPS: Patients' Rating of Provider 93.13 92.31
ACO-4 CAHPS: Access to Specialists 81.24 83.32
ACO-5 CAHPS: Health Promotion and Education 68.16 62.30
ACO-6 CAHPS: Shared Decision Making 74.40 75.85
ACO-7 CAHPS: Health Status/Functional Status 73.85 73.05
ACO-34 CAHPS: Stewardship of Patient Resources 23.32 25.68
ACO-8 Risk-Standardized, All Condition Readmission 15.61 15.01
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 20.00 18.46
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 98.06 79.16
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 72.69 61.74
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 2.74 1.93
ACO-11 Use of Certified EHR Technology 100.00 98.48
ACO-12 Medication Reconciliation 94.71 75.32
ACO-13 Falls: Screening for Future Fall Risk 91.08 74.38
ACO-44 Imaging Studies for Low Back Pain 58.97 67.32
ACO-14 Preventive Care and Screening: Influenza Immunization 80.47 72.52
ACO-15 Pneumonia Vaccination Status for Older Adults 82.63 72.92
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 92.05 70.69
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 99.61 90.48
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 61.83 61.98
ACO-19 Colorectal Cancer Screening 77.17 64.58
ACO-20 Breast Cancer Screening 88.05 70.05
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 90.30 79.89
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 10.14 16.74
ACO-41 Diabetes: Eye Exam 70.28 50.37
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 85.36 71.47
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 95.20 86.86

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples and the ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes quality measure is not included in public reporting due to a non-material technical error.

Note: In the Quality Performance Results file(s) above, search for "Circle Health Alliance, LLC" to view the quality performance results. This ACO can also be found by using the ACO ID A46043 in the public use files on data.cms.gov.

Payment Rule Waivers

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