ACO Name and Location
Circle Health Alliance, LLCPrevious 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 | Â 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
- 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.
- For 2017 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2017-Shared-Savings-Program-SSP-Accountable-Care-O/gk7c-vejx/data
- For 2016 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2016-Shared-Savings-Program-SSP-Accountable-Care-O/3jk5-q6dr/data
- For 2015 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/x8va-z7cu/data
- For 2014 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/ucce-hhpu/data
- For 2013 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/yuq5-65xt/data
Payment Rule Waivers
- No, our ACO does not use the SNF 3-Day Rule Waiver.