Medicare Accountable Care Organization (ACO)

Medicare Accountable Care Organization (ACO)

Have questions and want to learn more about Cleveland Clinic Medicare ACO? Watch this short video for the answers to many of your questions.

What's an ACO?

An ACO is a group of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to the Medicare patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors. 

How ACOs Work

  • Local health care providers and hospitals volunteer to work together to provide you with coordinated care.
  • The doctors and other providers who are helping care for
    you will communicate with each other, and partner with you in making health care decisions. 
  • You may spend less time filling out medical history paper work because your doctors may already have this information in an electronic health record. 
  • You’ll likely have fewer repeated medical tests because your doctors and hospitals will share information and coordinate your care. 
  • You’ll be in the center of care, and your doctors will be better able to keep you informed, and to keep listening and honoring your choices. 
  • Unlike HMOs, managed care, or some insurance plans, an ACO can't tell you which health care providers to see and can't change your Medicare benefits. 

How ACOs Share Information

Cleveland Clinic Medicare ACO doctors will use data from Medicare to help improve how they provide care. For example, your doctors will get your medical information from Medicare to help them to know your medical history, including your medical conditions, prescriptions, and visits to the doctor, and give you the right care at the right time in the right setting. Doctors, hospitals, and other health care providers working together in an ACO are able to read your medical records, along with other office staff authorized to help coordinate your care.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

Your privacy is very important to us, and you control how your personal information is used. 
To help you get the best possible care, Medicare shares information with Cleveland Clinic Medicare ACO about the care their patients get. To prevent Medicare from sharing your personal information with Cleveland Clinic Medicare ACO:

  • 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 Medicare ACO Contact Information

  • Call Cleveland Clinic Medicare ACO at 216.445.3666
  • Business hours are Monday – Friday 10 a.m. - 3 p.m.

Where Can I Find More Information About ACOs?

Other Resources

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

ACO Public Reporting Information

ACO Public Reporting Information

ACO Name and Location

Cleveland Clinic Medicare ACO, LLC
6000 West Creek Rd., #10
Independence, Ohio 44131

ACO Primary Contact

Ms. Monica Deadwiler
deadwim@ccf.org
216.445.0300

Organizational Information

ACO Participants ACO Participant in Joint Venture
(Enter Y or N)
Med Care Group Inc N
Henry Bloom N
Gary E Bollin M.D., LLC N
Heart Rhythm Associates N
N Presswala N
Asaf Dar N
DR KHALAFI MD LLC N
Joel D. Weisblat, M.D., Inc. N
Montrose Sleep Center Llc N
Nitin Govani MD PC N
FAMILY MEDICAL CARE PLUS INC N
Comprehensive Podiatry LLC N
Retina Specialists of Ohio N
N Presswala N
BRCH Oncology LLC N
Advanced Neurology & EMG LLC N
Chv Home Medical Equipment Company N
Boca Thoracic & Cardiovascular Surgery Llc N
Richard R. Watkins, M.D.., Llc N
Mahlies Internal Medicine Specialist Inc N
Jeffrey A Chaitoff MD LLC N
Dayem Health Services LLC N
Northern Ohio Internal Medicine Associates, Inc. N
SUSHIL K JAIN MD INC N
Clinic Regional Physicians Llc N
HASSAN ALZOUBI, MD N
BocaCare, Inc N
Union Physician Services Llc N
Cleveland Clinic Nevada N
Edwin Shaw Rehab Llc N
Cleveland Eye Care & Surgery, Inc. N
Health First Primary Care LLC N
CCF Tennessee Medical Services, P.C. N
TED PETERSON DPM N
Neuro Health and Wellness LLC N
Hassan Alzoubi N
Randal March N
Michael Kalus N
Vyacheslav Isakov N
John Aron N
Emmanuel Tuffuor N
Thomas Mandat N
Franklin Price N
Gary Greenspan N
Richard Koletsky N
Cynthia Weinstein N
Rami N Hachwi MD Inc N
Hackett Medical Ltd N
Marcus Tower N
Primary Care Services Of Jupiter Medical Specialists Llc N
Marymount Hospital Inc N
Akron General Medical Center N
Cleveland Clinic Children's Hospital For Rehabilitation N
The Cleveland Clinic Foundation N
Cleveland Clinic Health System - East Region N
Fairview Hospital N
Lutheran Hospital N
Visiting Nurse Service Inc N
Lodi Community Hospital N
Ashtabula County Medical Center N
Medina Hospital N
Associates in Orthopaedics, Inc. N
GASTROENTEROLOGY ASSOCIATION OF CLEVELAND, INC N
Cardiovascular Consultants of Cleveland Inc N
Praful V Maroo MD Inc N
NEIGHBORHOOD HEALTH CARE INCORPORATED N
Community Internists Inc N
Harold Mars MD Inc N
VIJAY G MISTRY MD INC N
Hillcrest Mayfield Eye Associates Inc N
Creighton G Heyl DO Inc N
Mohan J Durve, MD Inc N
North Shore Gastroenterology, Inc. N
Tim Nice MD Inc N
Lakeshore Heart, Inc. N
Retina Associates of Cleveland, Inc. N
Cleveland Clinic Foundation Cleveland Clinic Home Care N
Marcus Tower MD N
Henry Bloom N
ID Consultants, Inc N
Dinkar V Rao, M.D. Inc N
Andrew Liu N
Center of Orthopedic Surgery Inc N
Gary Greenspan N
System Optics Inc N
Michael Kalus MD N
Northcoast Foot And Ankle Associates, Inc. N
Brunswick Internal Medicine, Inc. N
Ronald A Freireich DPM N
Kishor Patel, MD N
Med Consults, Inc. N
Digestive Health Inc N
A & S KHANDELWAL MD INC N
Mila Davidovic N
Ara E. Kallibjian N
M Bashar Mamlouk Md Inc N
Western Reserve Ophthalmology Inc N
Oscar Nicholson Jr MD Inc N
Cleveland Clinic Home Care Services N
Psychological & Behavioral Consultants, Inc. N
Advanced Dermatology Inc N
MEDINA EYE ASSOCIATES INC. N
Family Medicine & Occupational Health Center, Inc. N
Cynthia Weinstein N
FOOT AND ANKLE PHYSICIANS OF GEAUGA, INC. N
Northcoast Dermatology Associates, Inc. N
New Family Physicians Associates, Inc. N
Partners Physician Group N
FAIRLAWN FAMILY PRACTICE INC N
Wooster Clinic, LLC N
Jeffrey A. Halpert Dpm, Llc N
Summit Infectious Diseases, Inc. N
HUDSON FAMILY PRACTICE INC N
Clinic Physician Services Co. Llc N
Clinic Medical Services Company N
Tessy Meridores MD Inc N
Broadview Heights Family Medicine, Inc N
Abrams Eye Center, Inc. N
Walter J Chlysta MD Inc N
Ori Kushnir MD OBGYN LLC N
Stephen Musser DPM, Inc. N
Yatish Goyal MD Inc N
Katrina Rakowsky N
Cardiovascular Medicine of Cleveland LLC N
GERMAN L NERI MD FACP LLC N
Cleveland Ear Nose Throat Inc N
Prestige Foot & Ankle Center Llc N
Cleveland Clinic Support Services N
Vyacheslav Isakov N
MARK A. LANG, M.D., LLC N
Great Lakes Hypertension & Kidney Care Inc N
Timothy Levar N
Great River Cardiology Inc N
Key Clinics, LLC N
Cleveland Clinic Rehabilitation Hospitals, Llc N
OBGYN of Westlake, LLC N
Andrew Liu N
Franklin Price N
Cosmopolitan Dermatology Inc N
Allied Dermatology and Skin Surgery LLC N
Signature Psychiatry Associates, Inc. N
Cleveland Clinic Avon Hospital N
Great Lakes Care Inc N
CardioPlus LLC N
Advanced Recovery Concepts LLC N
Katrina Rakowsky N
Yael Dinar Kushnir, MD N
Boca Raton Regional Hospital, Inc N
Jupiter Medical Center N
Cleveland Clinic Florida N
Bsaspb Pa N
Cleveland Clinic Florida Health System Nonprofit Corporation N
Alley & Alley Internal Medicine, PA N
Richard M King MD Inc N
Ridgepark Family Practice N
Benhaven Counseling 2 Llc N
Diane Eden Md &Associates,Inc N

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

Harrington

Michael

Finance Committee Chair

0

ACO Participant Representative

The Cleveland Clinic Foundation

Gorodeski

Eiran

Physician

1

Voting Member

The Cleveland Clinic Foundation

Henkel

Oliver

Medicare Beneficiary Representative and Community Stakeholder Representative

1

Voting Member

N/A

Keating

Catherine

Physician

1

Voting Member

The Cleveland Clinic Foundation

Modic

Michael

Physician

1

Voting Member

The Cleveland Clinic Foundation

Rabovsky

Michael

Physician

1

Voting Member

The Cleveland Clinic Foundation

Rosencrance

Gregory

Physician

1

Voting Member

The Cleveland Clinic Foundation

Rosenthal

Edward

Physician

1

Voting Member

Edward S. Rosenthal

Sears

Kevin

Executive Director, Market & Network Services

1

Voting Member

The Cleveland Clinic Foundation

Stark

Rebecca

Physician

1

Voting Member

The Cleveland Clinic Foundation

Vakharia

Nirav

Chair of Quality Committee

1

Voting Member

The Cleveland Clinic Foundation

Ware

Rebecca

Physician

1

Voting Member

NorthShore Healthcare

Gutierez

James

Medical Director of ACO

1

Voting Member

The Cleveland Clinic Foundation

Donley

Brian

Chair, Board of Managers

1

Voting Member

The Cleveland Clinic Foundation

Key ACO Clinical and Administrative Leadership

  • ACO Executive: Brian G. Donley, MD
  • Medical Director: James Gutierrez, MD
  • Compliance Official: Don Sinko, CPA
  • Quality Assurance/Improvement Officer: Nirav Vakharia, MD

Associated Committees and Committee Leadership

  • Quality Assurance and Improvement Committee: Nirav Vakharia, MD, Chair
  • Finance Committee: Michael Harrington, Chair
  • Compliance Committee: Don Sinko, CPA, Compliance Official

Types of ACO participants, or combinations of participants, that formed the ACO:

  • ACO professionals in a group practice arrangement
  • Networks of individual practices of ACO professionals
  • Federally Qualified Health Center (FQHC)

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2016: $19,914,592
    • Performance Year 2015: $16,614,051

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2016
      • Proportion invested in infrastructure: 5%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 90%
    • Performance Year 2015
      • Proportion invested in infrastructure: 5%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 90%

2016 Quality Performance Results

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 80.11 80.51
ACO-2 CAHPS: How Well Your Providers Communicate 93.13 93.01
ACO-3 CAHPS: Patients’ Rating of Provider 93.21 92.25
ACO-4 CAHPS: Access to Specialists 79.30 83.49
ACO-5 CAHPS: Health Promotion and Education 64.59 60.32
ACO-6 CAHPS: Shared Decision Making 71.84 75.40
ACO-7 CAHPS: Health Status/Functional Status 73.40 72.30
ACO-34 CAHPS: Stewardship of Patient Resources 25.47 26.97
ACO-8 Risk Standardized, All Condition Readmission 14.81 14.70
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 17.85 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 47.03 53.20
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 77.38 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 60.01 59.81
ACO-9 Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 10.39 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) 13.65 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 98.78 82.72
ACO-39 Documentation of Current Medications in the Medical Record 94.09 87.54
ACO-13 Falls: Screening for Future Fall Risk 96.08 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization 76.85 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults 87.64 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 90.08 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 95.76 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 59.14 53.63
ACO-19 Colorectal Cancer Screening 79.46 61.52
ACO-20 Breast Cancer Screening 80.73 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented 73.20 76.79
ACO-42 Statin therapy for the Prevention and Treatment of Cardiovascular Disease 76.99 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 15.16 18.24
ACO-41 Diabetes: Eye Exam 60.35 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 74.78 70.69
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 91.98 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 100.00 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%) 82.97 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 “Cleveland Clinic Medicare ACO, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A25097 in the public use files on data.cms.gov.

Payment Rule Waivers

  • Yes, our ACO uses the SNF 3-Day Rule Waiver. 

Website Disclosure Statement

Public Disclosure of Arrangement Conducted Under the MSSP ACO Participation Waiver

The Centers for Medicare and Medicaid Services (“CMS”) and the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) have made available a waiver of certain federal fraud and abuse laws in connection with the operation of accountable care organizations (“ACOs”) that have entered into a participation agreement under the Medicare Shared Savings Program (“MSSP”).

In order to receive the benefit of such waiver, the governing body of the Cleveland Clinic Medicare ACO, LLC (“CCF ACO”) has made a bona fide, detailed determination that the following arrangement is reasonably related to the purposes of the MSSP.

The CCF ACO proposes to provide, at no cost, an annual license to the Epic Systems electronic health records platform (the “Epic Platform”) to enable use of the Epic Platform (the “Proposed Epic License Program”), to certain physicians (“Eligible Physicians”), some of whom already have a license to use the Epic Platform and some of whom do not.  For those Eligible Physicians who do not already have a license to use the Epic Platform, CCF ACO will also pay a one-time activation fee. Eligible Physicians will include primary care physicians participating in CCF ACO, and other physicians who:  (i) serve a population that includes Medicare beneficiaries; (ii) demonstrate alignment with “the triple aim” by serving on a sub-committee of the CCF ACO or working toward the achievement of identified metrics that are complimentary to those of CCF ACO; (iii) have privileges at any CCF hospital; and (iv) satisfy any other eligibility requirements to be established by the CCF ACO.

The governing body of CCF ACO approved the Proposed Epic License Program following a determination that the Proposed Epic License Program would support the purposes of the MSSP by managing and coordinating care for beneficiaries through the CCF ACO, encouraging investment in infrastructure for high quality and efficient service delivery for patients, providing enabling technology to monitor patients and access patient medical records, evaluating health needs of CCF ACO’s assigned population, and allowing for the potential for more efficient decision-making.

The Centers for Medicare and Medicaid Services (“CMS”) and the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) have made available waivers of certain federal fraud and abuse laws in connection with the operation of accountable care organizations (“ACOs”) that have entered into a participation agreement under the Medicare Shared Savings Program (“MSSP”).

In order to receive the benefit of such waivers, the governing body of Cleveland Clinic Medicare ACO, LLC, an Ohio nonprofit limited liability company (the “Company”) has made a bona fide, detailed determination that the following arrangement is reasonably related to the purposes of the MSSP.

The Company has authorized a waiver of certain federal fraud and abuse laws for an arrangement whereby The Cleveland Clinic Foundation bears the full costs associated with the implementation of the Clinovations health information technology product for independent primary care providers, most of whom are participants in the Company but all of whom treat Medicare beneficiaries attributed to the Company (the “Arrangement”). 

The governing body of the Company authorized the application of the waiver to the Arrangement on December 14, 2017, following a determination that the Arrangement supports the goals of the Company and is reasonably related to the purposes of the MSSP, in each case because the Arrangement: (i) provides enabling technology to gain greater and more comprehensive access to patient information, which allows for the delivery of higher quality healthcare services to Medicare beneficiaries attributed to the Company; (ii) is targeted toward use for the Medicare-eligible patient population; (iii) encourages investment in infrastructure for high quality and efficient service delivery for Medicare beneficiaries attributed to the Company and maximizes the efficiency of the EpicCare Ambulatory platform; (iv) assists in managing and coordinating care for Medicare beneficiaries attributed to the Company; and (v) assists in evaluating the health needs of the Company’s assigned population.