Medicare Accountable Care Organization (ACO)

Overview

Have questions and want to learn more about Cleveland Clinic Florida Integrated Health, a designated Medicare Accountable Care Organization (ACO)? Watch this short video for the answers to many of your questions.

What's an ACO?

An ACO is a group of health care providers, including doctors, hospitals, and other medical professionals, who partner to provide coordinated, high-quality care to the Medicare patients they serve. Through coordinated care networks like ACOs, we focus on ensuring Medicare patients, especially the chronically ill, receive the right care at the right time by working together to avoid unnecessary duplication of services and prevent medical errors.

How ACOs work

Integrated Care: ACOs consist of a network of local health care providers that agree to work together to provide Medicare patients with high quality, coordinated care.
Focus On You: Your health care providers will be better able to keep focus on your care, listen and honor your choices, and keep you informed.
Improved Communication: Doctors and other providers within the ACO network will have access to your Medicare medical information. Ensuring the medical professionals providing your care are all looking at the same information will improve communication between health care providers while partnering with you in making health care decisions.
Less Paperwork: ACO network providers have access to a centralized electronic health record for patient information, which means you may spend less time filling out medical forms.
Fewer Tests: Because your doctors and hospitals will share information and coordinate your care, you’ll likely have fewer duplicate medical tests.
Flexible Care Network: One of the differences between an ACO and HMOs, managed care, or some insurance plans, is that an ACO can't tell you which health care providers to see and they can't change your Medicare benefits.

How ACOs share information

Cleveland Clinic Florida Integrated Health doctors will have access to your Medicare medical information and use it to help improve how they provide care. By accessing centralized patient data, health care providers will be reviewing the same information which may include your medical conditions, prescriptions, and visits to the doctor. Health care professionals will be working together to coordinate your care and provide the right care at the right time in the right setting. Doctors, hospitals, and other health care providers collaborate to authorize care, avoid duplicate medical services, reduce delays, and prevent errors. The privacy and security of your medical information is protected by federal law. You'll continue to get the same rights enjoyed by all people with Medicare.

Declining to share your health information

We value your privacy and understand how important it is to safeguard your information. While we believe that having access to your Medicare information is the way to provide the best care possible, you control how your personal information is used. To prevent Medicare from sharing your personal information with Cleveland Clinic Florida Integrated Health:

Call 1.800.MEDICARE (633.4227).
TTY users should call 1.877.486.2048.

Consent to change your personal health information preference

Call 1.800.MEDICARE (633.4227).
TTY users should call 1.877.486.2048.

Cleveland Clinic Florida Integrated Health contact information

Call Cleveland Clinic Florida Integrated Health at 772.781.2754.
Business hours are Monday – Friday 10 a.m. - 3 p.m.

Where can I find more information about ACOs?

Visit innovation.cms.gov/innovation-models/aco.
Call 1.800.MEDICARE (1.800.633.4227) 24 hours a day/7 days a week.
TTY users should call 1.877.486.2048.
Information on the Medicare Shared Savings Program.
Frequently Asked Questions: Accountable Care Organizations & You.

Other resources

*Cleveland Clinic Florida Integrated Health is only for fee-for-service (FFS) Medicare patients and not Medicare Advantage based beneficiaries.

ACO Public Reporting Information

ACO Name and Location

Treasure Coast Integrated Healthcare, LLC (d/b/a Cleveland Clinic Florida Integrated Health)
PO Box 9010
200 Hospital Avenue
Stuart, FL 34995

ACO Primary Contact

Zachary Meverden
772.781.2754
CCFIH@ccf.org

Organizational Information

ACO Participants:

ACO Participants	ACO Participant in Joint Venture
MARTIN MEMORIAL PHYSICIANS CORPORATION	N
CLEVELAND CLINIC FLORIDA	N
INDIAN RIVER HEALTH SERVICES INC	N

ACO Governing Body:

Member First Name	Member Last Name	Member Title/Position	Member’s Voting Power (Expressed as a percentage)	Membership Type	ACO Participant Legal Business Name, if applicable
Surendra	Khera	President	5.88%	ACO Participant Representative	Martin Memorial Physicians Corporation Inc
David	Cato	Member	5.88%	ACO Participant Representative	Cleveland Clinic Florida
Charmaine	Rochester	Treasurer	5.88%	ACO Participant Representative	Cleveland Clinic Florida
Sarah	Vogler	Member	5.88%	ACO Participant Representative	Martin Memorial Physicians Corporation Inc
Richard	Rothman	Member	5.88%	ACO Participant Representative	Indian River Health Services Inc
Rishi	Singh	Member	5.88%	ACO Participant Representative	Martin Memorial Physicians Corporation Inc
Scott	Ross	Member	5.88%	ACO Participant Representative	Cleveland Clinic Florida
David	Peter	Member	5.88%	ACO Participant Representative	Indian River Health Services Inc
Manjaree	Daw	Chief Medical Officer	5.88%	ACO Participant Representative	Martin Memorial Physicians Corporation Inc
Isabel	Casariego	Secretary	5.88%	ACO Participant Representative	Martin Memorial Physicians Corporation Inc
Gabriel	Gavrilescu	Member	5.88%	ACO Participant Representative	Cleveland Clinic Florida
Herman	Stubbe	Member	5.88%	ACO Participant Representative	Cleveland Clinic Florida
Ryan	Fisher	Member	5.88%	ACO Participant Representative	Cleveland Clinic Florida
Dalia	McCoy	Member	5.88%	ACO Participant Representative	Cleveland Clinic Florida
Genon	Wicina	Member	5.88%	ACO Participant Representative	Martin Memorial Physicians Corporation Inc
Samantha	Somwaru	Member	5.88%	ACO Participant Representative	Indian River Health Services Inc
Ellen	Pietz	Member	5.88%	Medicare Beneficiary Representative

Key ACO Clinical and Administrative Leadership

ACO Executive: Marria Janjua
Medical Director: Manjaree Daw, MD
Compliance Officer: Cessalie Harris
Quality Assurance/Improvement Officer: Manjaree Daw, MD

Associated Committees and Committee Leadership:

Committee Name	Committee Leader Name and Position
Clinical and Quality Committee	Sarah Vogler, MD, Chairperson
Finance	Michael Moehring, Chairperson
Technology	Jean Vickers, MD, Chairperson
Governance and Compliance	Sarah Vogler, MD, Chairperson

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:

Second Agreement Period
- Performance Year 2022, $0

First Agreement Period
- Performance Year 2021, $0
- Performance Year 2020, $0
- Performance Year 2019, $0
- Performance Year 2018, $0

Shared Savings Distribution:

Second Agreement Period
- Performance Year 2022
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A

First Agreement Period
- 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

Performance Year 2020
- 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 2018
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A

2022 Quality Performance Results:

Quality performance results are based on CMS Web Interface Measure Set

Measure #	Measure Name	Collection Type	Reported Performance Rate	Current Year Mean Performance Rate (SSP ACOs)
Quality ID# 001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control	Web Interface	7.25	10.71
Quality ID# 134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	Web Interface	70.71	76.97
Quality ID# 236	Controlling High Blood Pressure	Web Interface	75.99	76.16
Quality ID# 318	Falls: Screening for Future Fall Risk	Web Interface	97.55	87.83
Quality ID# 110	Preventative Care and Screening: Influenza Immunization	Web Interface	84.86	77.34
Quality ID# 226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	Web Interface	92.31	79.27
Quality ID# 113	Colorectal Cancer Screening	Web Interface	84.18	75.32
Quality ID# 112	Breast Cancer Screening	Web Interface	83.73	78.07
Quality ID# 438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	Web Interface	85.71	86.37
Quality ID# 370	Depression Remission at Twelve Months	Web Interface	10.00	16.03
Quality ID# 321	CAHPS for MIPS	Web Interface	N/A	N/A
Measure# 479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups	Administrative Claims	0.1600	0.1510
Measure# 484	Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions	Administrative Claims	36.46	30.97
CAHPS-1	Getting Timely Care, Appointments, and Information	CAHPS for MIPS Survey	74.68	83.96
CAHPS-2	How Well Providers Communicate	CAHPS for MIPS Survey	91.91	93.47
CAHPS-3	Patient’s Rating of Provider	CAHPS for MIPS Survey	90.14	92.06
CAHPS-4	Access to Specialists	CAHPS for MIPS Survey	70.56	77.00
CAHPS-5	Health Promotion and Education	CAHPS for MIPS Survey	61.14	62.68
CAHPS-6	Shared Decision Making	CAHPS for MIPS Survey	56.54	60.97
CAHPS-7	Health Status and Functional Status	CAHPS for MIPS Survey	74.86	73.06
CAHPS-8	Care Coordination	CAHPS for MIPS Survey	82.77	85.46
CAHPS-9	Courteous and Helpful Office Staff	CAHPS for MIPS Survey	87.19	91.97
CAHPS-11	Stewardship of Patient Resources	CAHPS for MIPS Survey	21.75	25.62

For previous years’ Financial and Quality Performance Results, please visit: data.cms.gov

Public Disclosure of Arrangements for MSSP Waivers

The Board of Managers (“Board”) of Treasure Coast Integrated Healthcare, LLC (the “ACO”) has duly approved the following arrangements and has determined that such arrangements are reasonably related to the purposes of the Medicare Shared Savings Program (“MSSP”). These arrangements are described in more detail below in order to seek protection under the waivers of federal fraud and abuse laws for MSSP participants set forth by the Centers for Medicare and Medicaid Services (“CMS”) and the Office of Inspector General of the Department of Health and Human Services.

Arrangement	Dates	Description*
ACO Start-Up Costs	January 14, 2017 through December 30, 2017	Martin Memorial Medical Center, Inc., the majority Member of the ACO entity and an ACO participant, and its parent company, Martin Memorial Health Systems, Inc. d/b/a Martin Health System (collectively, “Martin”), have paid various start-up costs necessary for the development of the financial, technological and governance structure of the ACO, the recruitment of ACO participants, and the submission of the ACO’s initial MSSP application. The start-up costs include expenses of several strategic planning meetings attended by Martin personnel, potential ACO participants, consultants, and outside legal counsel; expenses of recruitment meetings for potential ACO participants; salary and benefits of the Executive Director of the ACO; compensation of consultants and outside legal counsel; and costs of other administrative services and supplies for the ACO, including website development, marketing, accounting services, and technology.
Administrative Support	January 1, 2018 through present	Martin provides administrative support to the ACO by paying the salary and benefits of the ACO’s Executive Director, who is employed by Martin but loaned full-time to the ACO and is responsible for the day-to-day operations of the ACO. Martin also provides use of space which is owned or leased by Martin to the ACO for its activities.
Care Management Support	January 1, 2018 through present April 12, 2018 through present	Martin pays the salary and benefits of schedulers and healthcare navigators who are employees of Martin but are loaned to the ACO on a full-time or part-time basis. The ACO uses the schedulers and healthcare navigators to provide scheduling and care management support to patients of ACO participants. All ACO participants are eligible for this support. Martin pays for the costs associated with expanding care management support to develop care utilization management including a chronic disease management program for ACO at-risk lives.
Credentialing Support	July 11, 2017 through present	Minimal credentialing support is provided by Martin to the ACO at this time; Martin’s credentialing process is available to the ACO when necessary to review the qualifications of prospective ACO Members.
Electronic Medical Records Support	November 30, 2017 through present	While no electronic medical records support is provided at this time, Martin is interested in pursuing options in this area and supports and pays for the ACO’s referral management technology platform (and pays the salaries of relevant personnel and covers the operational costs) in the interest of streamlining, tracking, and improving the referral management process in order to better ensure access to care providers and to provide a mechanism for identifying opportunities for quality improvement.
Hospital Quality and Efficiency Program	October 1, 2018 – September 30, 2019	Martin has partnered with TCIH to align efforts in improving quality and reducing costs in the care pathway for all patients undergoing interventional cardiology procedures in the MHS Catheterization Lab. The HQEP’s focus is to ensure that patients are receiving evidence-based care while minimizing cost and unnecessary time in an inpatient setting, when clinically appropriate.
Transitional Care Program	November 30, 2017 through present	Martin is supporting and paying the salaries of relevant personnel and covering the operational costs associated with the ACO’s Transitional Care Program pilot, which has expanded the ACO’s organizational infrastructure and care coordination and quality improvement mechanisms, working to help reduce readmissions, improve access to Transitional Care Visits, and decrease costs for patients.
Management Services Agreement	October 1, 2017 through present	Martin provides management services including but not limited to: employing or engaging an executive director and additional non-clinical administrators or managers; assisting in the supervision of and human resource management for TCIH personnel; providing payroll, accounting, legal and marketing services and support to TCIH; and furnishing office space for Personnel, including necessary furniture, equipment, utilities, supplies and maintenance services.

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