ACO Name and Location:

Commonwealth Primary Care ACO

Previous Legal Business Entity Name: Commonwealth Primary Care ACO, d/b/a/GPIPA

5030 S Mill Ave

Suite D-8

Tempe, Arizona 85282

ACO Primary Contact:

Primary Contact Name Dr. Curtis Page, CEO
Primary Contact Phone Number 480-296-1276
Primary Contact Email Address  cpage@commonwealthaco.com

Organizational Information:

  • ACO Participants:

ACO ParticipantsACO Participant in Joint Venture (Enter Y or N)
DOC MARTINS Inc. A.C.C.N
James Nichols Md, Ltd.N
Central Phoenix Family Medicine, PLCN
Arizona Sun Family MedicineN
Dr. Kevin Chan, PCN
Cholla Medical Group, Inc.N
A Daniel Greco MD PLLCN
Thomas C. Fiel DO PCN
Page Family PracticeN
Ryan Internal Medicine, P.C.N
White Mountain Foot And Ankle Care Center PllcN
Timothy C. Bryan, Md, PlcN
Ian Brimhall PCN
Arizona Independent Medical AssociatesN
Generations Family Practice, PLLCN
Ravi Gupta MD, PLLCN
Walk In Medical, PLLCN
Primary Care Associates, PLLCN
Lahodas PllcN
Desert Bloom Family PracticeN
Ana Aragon MedPeds MD, PLLCN
Medi Clinic IncN
Northeastern Anesthesia PLLCN
East Valley Diabetes & Endocrinology PlcN
Allen Family Medicine, PLLCN
Companion Hospice and Palliative Care of Maricopa, LLCN
Jeffrey M Reagan MD PLLCN
Shawn G. Platt DO, PLLCN
Innovative Primary Care, LLCN
Robert J Bloomberg MD PCN
East Flagstaff Family Medicine, LTDN
Mesa Family Physicians, PLCN
Deseret Family Medicine, PCN
Alta Mesa Family Medical Center, LtdN
Southwest Medical Associates LtdN
Mark D. Goldberg, MD PCN
Dr. Dilip Dhavadi MDN
West Park Medical CorpN
Healthy Outlook Family Medicine, PCN
Aztech Radiology And Open MriN
HealthFirst Primary CareN
Arizona Institute of Medicine and Pediatrics, PLCN
JR Medical Group, PLCN
Petar N Novakovic MD PCN
Steven D Washburn PCN
Gilbert Center for Family MedicineN
Rajiv Parikh MDN
Leon A Driss PCN
Christopher Labban, DON
Quality of Life Medical Center, LLCN
Scottsdale Family and Urgent Care, LLCN
Homewood Family MedicineN
McKellips Family Medical Clinic PLLCN
Kent Walter Cox Md PsN

 

 

 

  • ACO Governing Body:

Member     
Last NameFirst NameTitle/PositionMember's Voting PowerMembership TypeACO Participant TIN Legal Business Name/DBA, if Applicable
PageCurtisCEO1 VoteVoting MemberPage Fmaily Practice
BloombergRobertACO Participant Representative1 VoteVoting MemberRobert J Bloomberg MD PC
GoldbergMarkACO Participant Representative1 VoteVoting MemberMark D. Goldberg, MD PC
LabbanChristopherACO Participant Representative1 VoteVoting MemberChristopher Labban, DO PC
MartinAndrewACO Participant Representative1 VoteVoting MemberDOC MARTINS Inc. A.C.C
NovakovicPetarACO Participant Representative1 VoteVoting MemberPetar Novakovic MD PC
JarvinaJonathanACO Participant Representative1 VoteVoting MemberDeseret Family Medicine, PC
VothRJMedicare Beneficiary Representative1 VoteVoting Member
DonkerbrookLanceCIO1 VoteVoting Member
  • Key ACO clinical and administrative leadership:

    • Curtis Page, MD, ACO Executive
    • Curtis Page, MD, Medical Director
    • Gerard Chamberlin, MD Compliance Officer
    • Robert Bloomberg, MD, Quality Assurance/Improvement Offices

    Associated committees and committee leadership:

    Patient Engagement and Clinical Coordination Committee

    • Chair: Jonathan Jarvina, MD
    • Committee Member #1: Petar Novakovic, MD

    Physician Engagement and Operations Subcommittee

    • Chair: Curtis P. Page, MD
    • Committee Member #1: Mark Goldberg, MD
    • Committee Member #2: Christopher Labban, DO
    • Committee Member #3: Sunny Maheshwari, MD

    Clinical and Quality Improvement Committee:

    • Chair: Robert Bloomberg, MD

    Compliance and Ethics Committee:

    • Chair: Gerard Chamberlin, MD
  • Types of ACO participants or combinations of participants that formed the ACO:

    • ACO professionals in a group practice arrangement
    • Network of individual practices of ACO professionals

Shared Savings and Losses:

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2016: $0
  • First Agreement Period
    • Performance Year 2015: $7,404,173
    • Performance Year 2014: $0
    • Performance Year 2013: $0

Shared Savings Distribution

  • Second Agreement Period
    • 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: 33%
      • Proportion invested in redesigned care processes/resources: 7%
      • Proportion of distribution to ACO participants: 40%
      • Proportion of distribution to Contractual and Other Obligations: 20%
    • Performance Year 2014:
      • 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 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

2016 Performance Summary Statistics

Measure NumberMeasure Name2016 Reporting Period
ACO Performance RateMean Performance Rate (SSP-ACOs)
ACO-1CAHPS: Getting Timely Care, Appointments, and Information76.9179.9
ACO-2CAHPS: How Well Your Providers Communicate90.4492.63
ACO-3CAHPS: Patients’ Rating of Provider89.9191.93
ACO-4CAHPS: Access to Specialists81.0483.52
ACO-5CAHPS: Health Promotion and Education58.7060
ACO-6CAHPS: Shared Decision Making78.1275.28
ACO-7CAHPS: Health Status/Functional Status72.6471.82
ACO-34CAHPS: Stewardship of Patient Resources*26.2927.52
ACO-8Risk Standardized, All Condition Readmission13.9114.70
ACO-35Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)*
Readmission
15.5518.17
ACO-36All-Cause Unplanned Admissions for Patients with Diabetes*49.1653.20
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure*54.0775.23
ACO-38All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions43.9359.81
ACO-9Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5)4.559.27
ACO-10Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8)10.2714.53
ACO-11Percent of Primary Care Physicians who Successfully Meet Meaningful Use
Requirements
55%82.72%
ACO-39Documentation of Current Medications in the Medical Record*96.17%87.54%
ACO-13Falls: Screening for Future Fall Risk69.04%64.04%
ACO-14Preventive Care and Screening: Influenza Immunization78.71%68.32%
ACO-15Pneumonia Vaccination Status for Older Adults71.58%69.21%
ACO-16Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up91.75%74.45%
ACO-17Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention96.82%90.98%
ACO-18Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan62.06%53.63%
ACO-19Colorectal Cancer Screening70.93%61.52%
ACO-20Breast Cancer Screening79.20%67.61%
ACO-21Preventive Care and Screening: Screening for High Blood Pressure and
Follow-Up Documented
92.12%76.84%
ACO-42Statin Therapy for the Prevention and Treatment of Cardiovascular Disease75.71%77.72
ACO-27Diabetes Mellitus: Hemoglobin A1c Poor Control10.57%18.24%
ACO-41Diabetes: Eye Exam*61.51%44.94%
ACO-28Hypertension: Controlling High Blood Pressure75.82%70.52%
ACO-30Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic 83.77%85.05%
ACO-31Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 93.71%88.67%
ACO-33Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)82.73%79.67%
CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.
*= Measure required beginning Reporting Year 2015.
N/A= Reporting on the depression remission measure is not required for 2015, as indicated by N/A

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 “Commonwealth Primary Care ACO” or “Commonwealth Primary Care ACO” to view the quality performance results. This ACO can also be found by using the ACO ID A02541 in the public use files on data.cms.gov.

2015 Performance Summary Statistics

Measure NumberMeasure Name2015 Reporting Period
ACO Performance RateMean Performance Rate (SSP-ACOs)
ACO-1CAHPS: Getting Timely Care, Appointments, and Information75.8880.61
ACO-2CAHPS: How Well Your Providers Communicate91.8992.65
ACO-3CAHPS: Patients’ Rating of Provider89.7091.94
ACO-4CAHPS: Access to Specialists80.2183.61
ACO-5CAHPS: Health Promotion and Education55.7659.06
ACO-6CAHPS: Shared Decision Making75.3775.17
ACO-7CAHPS: Health Status/Functional Status71.5172.30
ACO-34CAHPS: Stewardship of Patient Resources*26.7426.87
ACO-8Risk Standardized, All Condition Readmission13.9914.86
ACO-35Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)*
Readmission
17.4318.07
ACO-36All-Cause Unplanned Admissions for Patients with Diabetes*42.7154.60
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure*55.1676.96
ACO-38All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions45.7062.92
ACO-9Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5).541.11
ACO-10Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8).811.04
ACO-11Percent of Primary Care Physicians who Successfully Meet Meaningful Use
Requirements
85.26%80.14%
ACO-39Documentation of Current Medications in the Medical Record*98.51%84.07%
ACO-13Falls: Screening for Future Fall Risk42.52%56.46%
ACO-14Preventive Care and Screening: Influenza Immunization63.24%62.03%
ACO-15Pneumonia Vaccination Status for Older Adults70.76%63.73%
ACO-16Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up87.71%71.15%
ACO-17Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention94.75%90.16%
ACO-18Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan42.41%42.25%
ACO-19Colorectal Cancer Screening62.18%60.06%
ACO-20Breast Cancer Screening70.33%65.67%
ACO-21Preventive Care and Screening: Screening for High Blood Pressure and
Follow-Up Documented
93.93%70.04
ACO-40Depression Remission at Twelve Months*N/AN/A
ACO-27Diabetes Mellitus: Hemoglobin A1c Poor Control12.71%20.38%
ACO-41Diabetes: Eye Exam*50.28%41.05%
ACO-28Hypertension: Controlling High Blood Pressure68.13%69.62%
ACO-30Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic 80.80%83.82%
ACO-31Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 95.58%87.22%
ACO-33Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%)79.15%77.73%
CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.
*= Measure required beginning Reporting Year 2015.
N/A= Reporting on the depression remission measure is not required for 2015, as indicated by N/A

2012 - 2014 Quality Performance Results Table

Measure NumberPerformance Measure2012 reporting period2013 reporting period2014 reporting period
ACO performance rateMean performance rate for all ACOsACO performance rateMean performance rate for all ACOsACO performance rateMean performance rate for all ACOs
ACO-1Getting Timely Care, Appointments, and InformationNot in operationsNot in operationsN/AN/A75.0380.13
ACO-2How Well Your Doctors CommunicateNot in operationsNot in operationsN/AN/A89.6892.39
ACO-3Patients’ Rating of DoctorNot in operationsNot in operationsN/AN/A88.2491.58
ACO-4Access to SpecialistsNot in operationsNot in operationsN/AN/A83.7183.97
ACO-5Health Promotion and EducationNot in operationsNot in operationsN/AN/A58.458.29
ACO-6Shared Decision MakingNot in operationsNot in operationsN/AN/A73.2574.60
ACO-7Health Status/Functional StatusNot in operationsNot in operationsN/AN/A71.5571.10
ACO-8Risk Standardized, All Condition ReadmissionsNot in operationsNot in operations14.4914.9014.5715.15
ACO-9ASC Admissions: COPD or Asthma in Older AdultsNot in operationsNot in operations.811.17.541.08
ACO-10ASC Admission: Heart FailureNot in operationsNot in operations.931.20.861.19
ACO-11Percent of PCPs who Qualified for EHR Incentive PaymentNot in operationsNot in operations51.43%66.21%68.57%76.71%
ACO-12Medication ReconciliationNot in operationsNot in operationsN/AN/A94.93%82.61%
ACO-13Falls: Screening for Fall RiskNot in operationsNot in operationsN/AN/A32.71%45.60%
ACO-14Influenza ImmunizationNot in operationsNot in operationsN/AN/A54.19%57.51%
ACO-15Pneumococcal VaccinationNot in operationsNot in operationsN/AN/A23.31%55.03%
ACO-16Adult Weight Screening and Follow-upNot in operationsNot in operationsN/AN/A85.90%66.75%
ACO-17Tobacco Use Assessment and Cessation InterventionNot in operationsNot in operationsN/AN/A90.88%86.79%
ACO-18Depression ScreeningNot in operationsNot in operationsN/AN/A56.7%39.27%
ACO-19Colorectal Cancer ScreeningNot in operationsNot in operationsN/AN/A40.78%56.14%
ACO-20Mammography ScreeningNot in operationsNot in operationsN/AN/A58.91%61.41%
ACO-21Proportion of Adults who had blood pressure screened in past 2 yearsNot in operationsNot in operationsN/AN/A96.37%60.24%
ACO-22Hemoglobin A1c Control (HbA1c) (<8 percent)Not in operationsNot in operationsN/AN/A18.84%N/A
ACO-23Low Density Lipoprotein (LDL) (<100 mg/dL)Not in operationsNot in operationsN/AN/AN/AN/A
ACO-24Blood Pressure (BP) <140/90Not in operationsNot in operationsN/AN/A71.13%N/A
ACO-25Tobacco Non UseNot in operationsNot in operationsN/AN/A69.89%N/A
ACO-26Aspirin UseNot in operationsNot in operationsN/AN/A84%N/A
ACO-27Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent)Not in operationsNot in operationsN/AN/A21.77%20.35%
ACO-28Percent of beneficiaries with hypertension whose BP <140/90Not in operationsNot in operationsN/AN/A68.24%68.02%
ACO-29Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dlNot in operationsNot in operationsN/AN/AN/AN/A
ACO-30Percent of beneficiaries with IVD who use Aspirin or other antithromboticNot in operationsNot in operationsN/AN/A80.99%80.79%
ACO-31Beta-Blocker Therapy for LVSDNot in operationsNot in operationsN/AN/A89.87%82.71
ACO-32Drug Therapy for Lowering LDL CholesterolNot in operationsNot in operationsN/AN/AN/AN/A
ACO-33ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSDNot in operationsNot in operationsN/AN/A77.43%N/A
Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease,, EHR = electronic health record, IVD = ischemic vascular disease, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

Payment Rule Waivers

  • No, our ACO does not use the SNF 3-Day Rule Waiver

ACO Participation Waivers

The Commonwealth Primary Care ACO, LLC Board of Managers has formally approved the following arrangements as reasonably related to the purposes of the Medicare Shared Savings Program, as required for the MSSP ACO Participation Waiver.

Companion Hospice
Participation Agreement with Companion Hospice. Commonwealth has entered into an ACO Participant Agreement dated on or about December 27, 2013 (“Participant Agreement”) with Companion Hospice, to further the purposes of the Medicare Shared Savings Program by assisting Commonwealth to improve reporting, communications, process and protocols related to hospice. The arrangement between Commonwealth and Companion Hospice is reasonably related to the purposes of the MSSP, because these arrangements: (i) promote the accountability for the quality, cost and overall care for the Medicare population that is managed by the Company by encouraging the development of a transitional care program and a network of home care and hospice providers; (ii) encourage the management and coordination of care for patients of the Company through the provision of nurse managers and post acute care services, and (iii) encourages Companion Hospice to invest in the infrastructure and transitional care processes for the Company to deliver high quality and efficient services to the population it serves.

Gentiva Home Health
Participant Agreement with Gentiva Home Health. Commonwealth has entered into an ACO Participant Agreement dated on or about March 1, 2014 (“Participant Agreement”) with Gentiva, to further the purposes of the Medicare Shared Savings Program by assisting Commonwealth to improve process, protocol and communications related to home health. The arrangement between Commonwealth and Gentiva is reasonably related to the purposes of the MSSP, because these arrangements: (i) promote the accountability for the quality, cost and overall care for the Medicare population that is managed by the Company by encouraging the development of a transitional care program and a network of home care providers; (ii) encourage the management and coordination of care for patients of the Company through the provision of nurse managers and post acute care services, and (iii) encourages Gentiva to invest in the infrastructure and transitional care processes for the Company to deliver high quality and efficient services to the population it serves.

Simon Med Imaging, Inc
Participant Agreement with Simon Med Imaging, Inc (SimonMed). Commonwealth has entered into an ACO Participant Agreement dated on or about May 1, 2016 (“Participant Agreement”) with SimonMed, to further the purposes of the Medicare Shared Savings Program by assisting Commonwealth to improve process, protocol and communications related to radiology services. The arrangement between Commonwealth and SDI are reasonably related to the purposes of the MSSP, because these arrangements: (i) promote the accountability for the quality, cost and overall care for the Medicare population that is managed by the Company by fostering communication and education between the primary care physicians and to create a network of radiology providers; (ii) manage and coordinate care for Medicare beneficiaries through the Company by coordination of care, preventative screening, quality metric screening and potential of programs for new service offerings and; (iii) encourage SDI to invest in the infrastructure and processes for the Company to deliver high quality and efficient services to the population it serves.

Premier Medical Group, LLC
Commonwealth has entered into an agreement, on or about May 17, 2016, to help support the creation of a single tax id primary care group, Premier Medical Group LLC. Commonwealth and Premier will further the purposes of the Medicare Shared Savings Program to promote accountability for the quality, cost and overall care for populations served by the ACO by forming a large primary care practice that better aligns physicians and improves the management and coordination of care and better promotes the development of redesigned care processes to promote high quality and efficient service delivery for ACO’s patients.

EMR Support for Participating Primary Care Practices
Commonwealth has entered into an agreement, dated on or about December 1, 2016, with its participating primary care practices to help support the migration to a more consolidated electronic medical record (EMR) platform. This program supported by Commonwealth will further the purposes of the Medicare Shared Savings Program to promote greater access and accountability for the quality, cost and overall care for populations served by the ACO by forming a more consolidated EMR platform that supports Medicare initiatives, especially promoting the advancement of required activities under MACRA and MIPS requirements for 2017 and beyond. This effort to consolidate EMRs better aligns physicians with ACO initiatives and improves the management and coordination of care and better promotes the development of consistent use of quality and care processes to promote high quality and efficient service delivery for ACO’s patients.

Third Party Vendor Support for Participating Primary Care Practices
Commonwealth has entered into an agreement to help support the migration to an eventual single electronic medical record (EMR) platform.  The agreement  is with a third party vendor to assist ACO practices in EMR migrations, integrations, templating and workflow.  This Agreement promotes accountability for the quality, cost and overall care for the Medicare population that is managed by the Company and supports the infrastructure for the ACO by enabling the ACO to migrate to fewer electronic medical records (EMR) which will better position the ACO,  over the course of time, to promote a standard primary care workflow which translates to more uniform practice patterns which will be based on template-driven evidence based medicine.  Having a single EMR in place at the ACO will improve the coordination of care and patient management and will assist in more consistent adherence to care processes established by the ACO.

Sonora Quest Laboratories LLC
Participant Agreement with Sonora Quest Laboratories LLC (Sonora Quest). Commonwealth has entered into an ACO Participant Agreement dated on or about May 1, 2017 (“Participant Agreement”). the arrangements between the Company and Sonora Quest described herein and stated in the Agreement are reasonably related to the purposes of the MSSP, because these arrangements: (i) promote the accountability for the quality, cost and overall care for the Medicare population that is managed by the Company through the use of Sonora Quests proprietary Actionable Insights Management tool, by education and instruction to the primary care physicians and to create a sustainable network; (ii) manage and coordinate care for Medicare beneficiaries through the Company by improving communication and information related to care coordination; (iii) invest in the infrastructure and processes for the Company to improve patient care and outcomes to the population it serves.