ACO Name and Location

Circle Health Alliance, LLC
295 Varnum Avenue
Lowell, Massachusetts 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)
Nasim Ghaffar, MD Y
Sangita Pillai, MD Y
Gopala Dwarakanath Y
Nicholas Spirito Y
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
Hayward Zwerling, M.D. 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
Carlos Del Rio 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
Alexandra Argasinski, MD Y
Kevin Malone Y
Estella Nonnie Y
Lawrence Johnson Y
David Sidebottom, MD Y
Nonnie Estella Y
DRUM HILL PRIMARY CARE, LLC Y
Sepulveda & Associates, PC Y
LGH Medical Group, Inc. Y
Benjamin Henkle Y
LGH WomanHealth, Inc. Y
Stony Brook Primary Care Y
Pelham Healthcare Associates Pllc Y
G.K. Dwarakanath, MD LLC Y
Dracut Family Healthcare Y
NESC LPHO, LLC Y
Mill City Medical Group, Ltd Y
LGH Merrimack Valley Cardiology Associates, LLC. Y
Benjamin Henkle, MD, LLC Y
Merrimack Radiology - CRA, LLC Y
Riverside Surgical Associates, PC Y
Nicholas Spirito MD PC Y
Westford Vein and Aesthetic Solutions Y
Mass Medical Group LLC Y
Precision Surgical Specialists of Lowell PC Y
Michael Rosenbaum, MD Y
Damian Folch Y
NORTHEAST MEDICAL GROUP, INC. Y
Sangita Pillai Y

ACO governing body:

Member Member's Voting Power Membership Type ACO Participant TIN 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 ACO Participant Drs. Gilchrist, Sevigny & Galvin
Edelstein Robert MD 1 ACO Participant Merrimack Urology Associates, PC
DeAmicis Richard MD 1 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
Folch Damian MD 1 ACO Participant Damian Folch, MD
Lauretano Arthur MD 1 ACO Participant Mass ENT Associates
Prybyla David MD 1 ACO Participant Orthopaedic Surgical Associates
Pickul David MD 1 ACO Participant Mill City Medical Group, Ltd
Reddy Roopa MD 1 ACO Participant Chelmsford Primary Care, LLC
Roman Peter MD 1 ACO Participant Peter D Roman MD PC
Clifford Barbara  FNP 1 Medicare Beneficiary Representative N/A
White Jody President & CEO 1 Other Lowell General Hospital
Green Susan EVP & CFO 1 Other Lowell General Hospital
Hoey Amy EVP & COO 1 Other Lowell General Hospital
Osborn Frank MD 0 Other Merrimack Family Medicine
Tsirigotis Pauline MD & Medical Director 0 Other Circle Health Alliance
Young Emily Executive Director 0 Other Lowell General PHO

Key ACO clinical and administrative leadership:

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

Associated committees and committee leadership:

Committee Name Committee Leader Name and Position
IT Clinical Advisory Committee Frank Osborn, MD, Committee Chair, Family Practice
Compliance Committee Michael McAuliffe, Corporate Compliance Officer, Committee Chair
Finance Committee Michael Jiser, MD, Committee Chair, General Surgeon
Performance and Engagement Committee David Pickul, MD, Committee Chair, Internal Medicine
PCP Performance and Engagement Committee Mark Gilchrist, MD, Committee Chair, Pediatrics
SCP Performance and Engagement Committee Arthur Lauretano, MD, Committee Chair, Otolaryngology
Physician Advisory Committee Richard DeAmicis, MD, Committee Chair, Internal Medicine
Hospital Engagement Committee David Pickul, MD, Committee Chair, Internal Medicine

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 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 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

2016 Quality Performance Results:

ACO Number Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 84.19 80.51
ACO-2 CAHPS: How Well Your Providers Communicate 93.99 93.01
ACO-3 CAHPS: Patients' Rating of Provider 92.55 92.25
ACO-4 CAHPS: Access to Specialists 84.82 83.49
ACO-5 CAHPS: Health Promotion and Education 68.30 60.32
ACO-6 CAHPS: Shared Decision Making 78.95 75.40
ACO-7 CAHPS: Health Status/Functional Status 74.76 72.30
ACO-34 CAHPS: Stewardship of Patient Resources 21.78 26.97
ACO-8 Risk-Standardized, All Condition Readmission 15.65 14.70
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 18.43 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 60.00 53.20
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 89.07 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 68.23 59.81
ACO-9 Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 8.83 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 ) 24.44 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 100.00 82.72
ACO-39 Documentation of Current Medications in the Medical Record 98.27 87.54
ACO-13 Falls: Screening for Future Fall Risk 82.53 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization 70.61 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults 83.78 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 90.51 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 99.22 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 70.16 53.63
ACO-19 Colorectal Cancer Screening 73.85 61.52
ACO-20 Breast Cancer Screening 87.36 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented 91.55 76.79
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 91.48 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 13.84 18.24
ACO-41 Diabetes: Eye Exam 70.24 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 80.43 70.69
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 90.46 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 97.92 88.67
ACO-33 Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) 97.69 79.67

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.

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.