Coordinated Care

Welcome to Houston Methodist Coordinated Care (HMCC), an Accountable Care Organization

ACO Name and Location          

Houston Methodist Coordinated Care
7550 Greenbriar Drive
Suite 5-330
Houston, TX 77030

 

ACO Primary Contact

Julia Andrieni, MD
346.356.1553
jdandrieni@houstonmethodist.org

 

Organizational Information

ACO Participants:

ACO Participants

ACO Participant in Joint Venture

Cypress Physicians Association

N

Fort Bend Primary Care, P.A.

N

N. Christine Le MD PA

N

IKP Family Medicine PA

N

Northern Pines Health Partners PA

N

Khan and Mujeeb PLLC

N

Highlands Medical Associates, P.A.

N

TMH Physician Associates, PLLC

N

Katy Internists

N

Priti Jadav

N

Ronald R. Galfione, MD, PA

N

Saba Asad Ansari P.A.

N

TMH Physician Organization

N

Saira Hirani

N

Center for Family & Preventive Medicine, PA

N

Family Health Consultants PA

N

Parul R. Shah DO PA

N

Amir Salim MD PA

N

Mohammad A Haque, M.D., P.A.

N

Progressive Medical Clinic LLP

N

St. Michael Medical Clinic, PA

N

Sweetwater Medical Associates, PLLC

N

Preventive Medicine Institute, PA

N

Rakesh Patel M.D. P. A.

N

Hanh Truong, MD PA

N

Woodlands Family Medicine Professional Limited Liability Company

N

Bhagwat Patel, M.D., P.A.

N

 

ACO Governing Body:

Member

Last Name

Member

First Name

Member

Title/Position

Member's Voting Power (Expressed as a percentage or number)

Membership Type

ACO Participant Legal Business Name and D/B/A, if applicable

Andrieni, MD

Julia

Chair, President & CEO - HMCC

100%

President

 

Robben, MD

Chris

Medical Director – HMCC Employed Physicians

100%

ACO Participant and Management

TMH Physician Associates, PLLC

Jackson, MD

Robert

Medical Director – HMCC Private Physicians

0%

ACO Management

 

Kumar, MD

Varun

Medical Director – HMCC Inpatient Services

0%

ACO Management

 

Agarwal, MD

Kathryn

Medical Director – HMCC Post-Acute

0%

ACO Management

 

Allmon, MD

Brent

ACO Board Member

100%

ACO Participant

Woodlands Family & Community Medicine Professional Limited Liability Company

Lee, MD

Nicoline

ACO Board Member

100%

ACO Participant

TMH Physician Associates, PLLC

Terry, MD

Gregory

ACO Board Member

100%

ACO Participant

TMH Physician Associates, PLLC

Septimus, MD

Joshua

ACO Board Member

100%

ACO Participant

TMH Physician Associates, PLLC

Sims, MD

Kimberly

ACO Board Member

100%

ACO Participant

TMH Physician Associates, PLLC

Patel, MD

Maya

ACO Board Member

100%

ACO Participant

Preventive Medicine Institute

Dryden, MD

Natalie

ACO Board Member

100%

ACO Participant

TMH Physician Associates, PLLC

Roach, MD

Robert

ACO Board Member

100%

ACO Participant

Center for Family & Preventive Medicine, PA

Papageorge, MD

Seva

ACO Board Member

100%

ACO Participant

TMH Physician Associates, PLLC

Miller, MD

Susan

ACO Board Member

100%

ACO Participant

TMH Physician Associates, PLLC

Burns, MD

Tiffany

ACO Board Member

100%

ACO Participant

TMH Physician Associates, PLLC

Irvine, MD

Timothy

ACO Board Member

100%

ACO Participant

IKP Family Medicine PA

Nguyen, MD

Tom-Thuan

ACO Board Member

100%

ACO Participant

St Michael Medical Clinic, PA

Dyer

Connie

ACO Board Member

100%

Medicare Beneficiary

 

Jackson

Ryane

ACO Board Member

100%

Community Stakeholder Representative

 

Meents

Cathy

Director, Corporate Business Practices - Houston Methodist

0%

ACO Management

 

Carr, MBA, MHA

Jeff

Treasurer - HMCC

0%

ACO Management

 

Clark, PhD

Dale

Secretary – HMCC

0%

ACO Management

 

Burns

Kevin

HMH Executive VP and Chief Financial Officer

0%

ACO Management

 

Easterly, JD

Mark

Vice President, Legal Services - Houston Methodist

0%

ACO Management

 

Spielman, MBA, MHA

Stephen

Senior Vice President and COO - HMSPG

0%

ACO Management

 

McLendon, MD

Terry

System Medical Director, Clinical Documentation - Houston Methodist

0%

ACO Management

 

Cantu, JD

Mick

Executive Vice President - Houston Methodist

 

Chief Legal Officer - Houston Methodist Strategic and Business Development Officer - Houston Methodist

0%

ACO Management

 

 

Key ACO Clinical and Administrative Leadership:

 

Julia Andrieni, MD

President & CEO

Jeff Carr, MBA, MHA

Treasurer

Dale Clark, PhD

Secretary

Megan Harkey, MHA

Director – Operations & Finance

Zachary Menn, MD, MHA, MBA

Director – MSSP Clinical Programs

Norman Lancit, MSW, MBA

Director – Transitions in Care

Chris Robben, MD

Medical Director – HMCC Employed Physicians

Robert Jackson, MD

Medical Director – HMCC Private Physicians

Kathryn Agarwal, MD

Medical Director – HMCC Post-Acute

Varun Kumar, MD

Medical Director – HMCC Inpatient Services

Heidi Lopez, MBA, RN, CPC

Director of Business Practices

Catherine Meents, JD

Compliance Officer

Andrea Kelly, JD

Compliance Manager

Mark Easterly, JD

Legal Counsel

Aroub Khleif, PhD

IT Director of Ambulatory Clinical Systems

 

Associated Committees and Committee Leadership:

 

Committee Name

Committee Leader Name and Position

Physician Advisory Committee

Kimberly Sims, MD, Chair

Quality Improvement Committee

Chris Robben, MD, Chair

Finance & Operations Committee

Jeff Carr, MBA, MHA, Chair

 

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

ACO professionals in a group practice arrangement

Hospital employing ACO professionals

Networks of individual practices of ACO professionals


Shared Savings and Losses

Amount of Shared Savings/Losses:

Second Agreement Period

Performance Year 2020, $ 19,439,369

First Agreement Period

Performance Year 2019, $ 4,511,285

Performance Year 2018, $ 1,280,660

Performance Year 2017, $ 1,258,180


Shared Savings Distribution:

Second Agreement Period

Performance Year 2020

Proportion invested in infrastructure: 25%

Proportion invested in redesigned care processes/resources: 18%

Proportion of distribution to ACO participants: 57%

 

First Agreement Period

Performance Year 2019

Proportion invested in infrastructure: 25%

Proportion invested in redesigned care processes/resources: 18%

Proportion of distribution to ACO participants: 57%

 

Performance Year 2018

Proportion invested in infrastructure: 20%

Proportion invested in redesigned care processes/resources: 12%

Proportion of distribution to ACO participants: 68%

 

Performance Year 2017

Proportion invested in infrastructure: 30%

Proportion invested in redesigned care processes/resources: 17%

Proportion of distribution to ACO participants: 53%

 

 

Quality Performance Results

2020 Quality Performance Results:

ACO Quality Measure Number

Measure Name

Rate

ACO Mean

ACO-43

Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91)

1.70

0.95

ACO-13

Falls: Screening for Future Fall Risk

95.84

84.97

ACO-14

Preventive Care and Screening: Influenza Immunization

87.15

76.03

ACO-17

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

84.62

81.67

ACO-18

Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan

85.86

71.46

ACO-19

Colorectal Cancer Screening

74.01

72.59

ACO-20

Breast Cancer Screening

76.40

74.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

90.48

83.37

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

10.00

14.70

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

70.00

72.87

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

 

For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov

 

Note: In the Quality Performance Results file(s) above, search for “Houston Methodist Coordinated Care” to view the quality performance results. This ACO can also be found by using the ACO ID A3473 in the public use files on data.cms.gov.

 

Payment Rule Waivers

Skilled Nursing Facility (SNF) 3-Day Rule Waiver:

Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.

 

Waiver for Payment for Telehealth Services:

Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.

 

 

 


Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public

reporting due to low sample size.

 

Note: In the Quality Performance Results file(s) above, search for “Houston Methodist Coordinated Care” to view

the quality performance results. This ACO can also be found by using the ACO ID A3473 in the public

use files on data.cms.gov.

 

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-day Rule Waiver:
    • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR §425.612.

     

  • Waiver for Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR §425.612(f) and 42 CFR §425.613.