ACO: Patient Information

Download 2019 ACO Patient Information (PDF)

Download CMS “Accountable Care Organizations and You” Patient Information Guide (PDF)

ACO Name and Location

Westchester Medical Group, P.C.
Previous Names: Westmed Medical Group, P.C.
800 Westchester Avenue (Suite N-715)
Rye Brook, NY 10573

ACO Primary Contact

 

Calie Santana, MD
aco@westmedgroup.com
(914) 848-8599

Organizational Information

ACO participants
Westchester Medical Group, P.C.
(WESTMED Medical Group)

ACO participants in joint ventures between ACO professional and hospitals
No participants are involved in a joint venture between ACO professionals and hospitals

ACO governing body

  1. Michael Suzman, MD, Chairman/Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group
  2. David Cziner, MD, Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group
  3. Herbert Gretz, MD, Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group
  4. Jonathan Finegold, MD, Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group
  5. Cordelia Schwarz, MD, Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group
  6. Randy Stein, MD, Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group
  7. Ronald Dennett, MD, Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group
  8. Monica Rieckhoff, MD, Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group
  9. Joshua Waldman, MD, Voting Member, ACO Participant, Westchester Medical Group, P.C./WESTMED Medical Group

Key ACO clinical and administrative leadership

  1. Steven Meixler, MD (ACO Executive & Medical Director)
  2. Toni Mileo Drohan, Esq. (Compliance Officer)
  3. Calie Santana, MD (Quality Assurance/Improvement Officer)

Associated committees and committee leadership

  1. ACO Advisory Committee: Four (4)Westmed patients who are Medicare FFS Beneficiaries

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

  1. ACO professionals in a group practice arrangement

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period (for contract starting 2019 with shared savings/losses Enhanced)
    • Performance Year 2019, $ 2,631,915.20
  • Second Agreement Period
    • Performance Year 2018, $6,203,325
    • Performance Year 2017, $5,384,460
    • Performance Year 2016, $0
  • First Agreement Period
    • Performance Year 2015, $0
    • Performance Year 2014, $3,266,226
    • Performance Year 2013, $0

Shared Savings Distribution

  • First Agreement Period (Enhanced Track)
    • Performance Year 2019
      • Proportion invested in infrastructure: 30%
      • Proportion invested in redesigned care processes/resources: 50%
      • Proportion of distribution to ACO participants: 20%
    • Second Agreement Period
      • Performance Year 2018
        • Proportion invested in infrastructure: 30%
        • Proportion invested in redesigned care processes/resources: 50%
        • Proportion of distribution to ACO participants: 20%
      • Performance Year 2017
        • Proportion invested in infrastructure: 30%
        • Proportion invested in redesigned care processes/resources: 50%
        • Proportion of distribution to ACO participants: 20%
      • Performance Year 2016
        • 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 2015
        • 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 2014
        • Proportion invested in infrastructure: 30%
        • Proportion invested in redesigned care processes/resources: 50%
        • Proportion of distribution to ACO participants: 20%
      • Performance Year 2013
        • Proportion invested in infrastructure: N/A
        • Proportion invested in redesigned care processes/resources: N/A
        • Proportion of distribution to ACO participants: N/A

    Quality Performance Results

    2019 Quality Performance Results Table
    ACO Number Measure Name
    Rate ACO Mean
    ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 85.49 85.86
    ACO-2 CAHPS: How Well Your Providers Communicate 93.03 94.11
    ACO-3 CAHPS: Patients’ Rating of Provider 93.01 92.69
    ACO-4 CAHPS: Access to Specialists 77.43 81.54
    ACO-5 CAHPS: Health Promotion and Education 55.92 60.44
    ACO-6 CAHPS: Shared Decision Making 55.62 62.78
    ACO-7 CAHPS: Health Status/Functional Status 74.60 73.79
    ACO-34 CAHPS: Stewardship of Patient Resources* 18.56 26.17
    ACO-45 CAHPS: Courteous and Helpful Office Staff 93.20 92.84
    ACO-46 CAHPS: Care Coordination 86.20 86.89
    ACO-8 Risk Standardized, All Condition Readmission 14.45 14.86
    ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 62.21 58.15
    ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.77 1.87
    ACO-13 Falls: Screening for Future Fall Risk 69.77 84.04
    ACO-14 Preventive Care and Screening: Influenza Immunization 82.33 74.77
    ACO-17 Preventive Care and Screening: Tobacco Use:Screening and Cessation Intervention 68.42 78.04
    ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 66.29 70.40
    ACO-19 Colorectal Cancer Screening 80.59 70.76
    ACO-20 Breast Cancer Screening 85.62 73.84
    ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 88.68 82.17
    ACO-40 Depression Remission at Twelve Months 16.22 13.58
    ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 9.15 13.88
    ACO-28 Hypertension (HTN): Controlling High Blood Pressure 76.42 75.04
    For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.

    Payment Rule Waivers

      • Skilled Nursing Facility (SNF) 3-day Rule Waiver: Applying for 1/1/2021
        • Our ACO is applying to use 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.

    Beneficiary Incentive Program
    Our ACO does not use the Beneficiary Incentive Program (BIP) established under 42 CFR §425.304(c)