Prime Healthcare ACO

3300 E. Guasti Road, 3rd Floor
Ontario, CA 91761
(775) 770-6229

Primary Contact:

Alan Smith
West Sixth Street
Reno, Nevada 89503
(775) 770-7227
asmith@primehealthcare.com

ACO Participants

  • High Desert Heart Institute Medical Corporation
  • Wadie Alkhouri
  • Archana Shende Md Inc
  • Theodore Mazer
  • Thomas Young
  • Sambin Wang
  • Anthony Borgia
  • Michael H. Michalski, Md, A Medical Corporation
  • North Vista Hospital Inc
  • Pacific Health Systems
  • Ian Purcell, Md Apc
  • Northern Heart & Vascular Institute Inc Medical Associates
  • Elahe Toulouie, Md, Inc
  • Prime Healthcare Services-Sherman Oaks, Llc
  • Mohamed H. Khan, M.D., Inc
  • Tim Gurtch Md, Inc.
  • Prime Healthcare Services Iii, Llc
  • Ashkan Soleymani, Dpm, Inc
  • Nancy Conley Md Family Medicine
  • Michael L. Farley, D.O., A Medical Corporation
  • Prime Healthcare Anaheim Llc
  • Prime Healthcare Huntington Beach
  • Prime Healthcare La Palma Llc
  • Alvarado Hospital Llc
  • Prime Healthcare Paradise Valley
  • South Meadows Endoscopy Center, Llp
  • Paradise Valley Medical Group, Inc.
  • Abhinav Sinha, M.D., Pc
  • Ramin Hazany
  • William I. Han, M.D. Inc
  • Frank Yoo
  • Duane Bridges
  • Sumana & Ananthram Reddy Md Inc
  • Prime Healthcare Centinela Llc
  • Passion Medical Associates Llc
  • Ramin Ashtiani, Md A Professional Corporation
  • Prime Healthcare Services Encino Llc
  • Prime Healthcare Services - San Dimas Llc
  • Prime Healthcare Services Garden Grove Llc
  • Prime Healthcare Services Shasta Llc
  • Shasta Regional Medical Group Inc
  • Dr. Sunny Bhatia M.D. Inc.
  • Elijah Mobley, M.D. Inc
  • Kaushik V. Patel, Md, Inc
  • Stephen Casey Md Inc
  • Afshin Saadat Md Inc
  • Advanced Endoscopy Consultants
  • Metcalf, Tiller & Chen, Inc
  • Southern California Cardiology Medical Group Inc
  • Larry I Emdur Do Phd
  • Reddiwandla Seenu Reddy, M.D., Inc.
  • John Wilkinson
  • Alvarado Orthopedic Medical Group, Inc.
  • Kumara Prathipati, M.D.,Inc
  • Theodore Mazer, Md
  • Desert Valley Hospital Inc
  • Fariborz Shams, D.O., Inc.
  • Gerard C. Arcilla Md, Inc
  • Roderick A Comunale Ii Md Inc
  • Desert Valley Medical Group Inc
  • Manorama M Reddy M.D Inc
  • Akther Kotha
  • Joel Q. Velasquez, M.D. Incorporated
  • University Square Medical Clinic Inc
  • Roman B. Cham, Md Inc
  • Healthcare Medical Group Of La Mesa
  • Om Sood Md A Professional Med Corp
  • Michael J. Oleary, Md, Inc
  • Veritas Health Services Inc
  • Inland Physicians Service Inc
  • Reliant Radiology Medical Group A Professional Corporation
  • Enrique Espinosa-Melendez Md Inc
  • Pueblo Medical Center Inc
  • Wadie Alkhouri Md
  • Jonardi Handoko
  • Krishna J Mohan Md Inc
  • John Wilkinson
  • High Desert Nephrology Medical Association
  • Said Jacob
  • Richard Mooney, Md. Inc.
  • Kibrom G Asrat Dpm Apc
  • North Vista Physicians Pc
  • Prime Healthcare Services Reno Llc
  • Saint Marys Medical Group Inc
  • Steven D Macina Do A Professional Medical Corporation
  • High Desert Pathology Medical Group
  • Owais Zaidi Medical Corporation
  • Valley Cardiology And Vascular Associates Inc
  • Alvarado Physicians Medical Group
  • Paul Nguyen, M.D., Ltd.
  • Pulmonary Consultants And Wellness Center Inc. Pc
  • Rana Ashwani Bahl, M.D., Inc.
  • Kent Brusett
  • James Liu
  • Oscar Guzman, M.D.
  • Howard Staniloff
  • Ron Dunchok, M.D.
  • James Gonzalez
  • Stephen Edney
  • Paul Beck, M.D.
  • Cyrus Nasserian, M.D.
  • Varick Bernstein Md Ltd
  • Ronald Smith
  • Hamid Rabiee, Md
  • Ramin Hazany
  • Karl Sun
  • Nilesh Patel
  • Sabah Kadhium
  • Siskiyou Medical Group Pc
  • Shasta Orthopaedics & Sports Medicine
  • James Gonzalez
  • Rnc Medical Group, Inc.
  • Critical Care Cardiology Medical Corp
  • Saint Marys Urgent Care Llc
  • Reno Endoscopy Center,Llp
  • Carson Endoscopy Center,Llp
  • Gastroenterology Consultants, Ltd.
  • Ronald Smith
  • Stephen Edney
  • Vegas Valley Primary Care
  • Bernard K. Addo-Quaye, Md, Pc
  • Clinica Medica Del Pueblo
  • Habib A. Ismail, M.D., Inc.
  • Kevin Bernstein, M.D., Llc
  • Epic Medical Group Inc.
  • Redding Urologic Assocs
  • B V Chandramouli Md Inc
  • Alvarado La Mesa Urology Medical Group, Inc.
  • John P Anderson Md Russell M Perry Md And Mark A Sharzer Md A Med Crp
  • Fernando A Zamudio Md Inc
  • Michael P. Koumjian, Md, A Professional Corporation
  • Mohsen Ali
  • Franklin G Cabebe M D Inc
  • Zuhair O Yahya Md Inc
  • Leon Bachoura, M.D., Inc.
  • John H. Choie,Md A Professional Corporation
  • Centinela Radiology Medical Group
  • Coast Gastroeneterology Medical Group
  • California Kidney Specialists
  • Neelakantan Ramineni Md Inc
  • Naji Bouz Md Inc & N Kassar Md Inc Ptrs
  • Thomas Johnson Md
  • Said Jacob, M.D.
  • Shorr, Smith & Hurst Mds
  • Medical Associates Of Westchester
  • Century Eye Care Medical Center, Inc.
  • Sabah Kadhium
  • May Medical Management Corporation
  • Habib Moussa Bashoura Md Inc
  • Hourany Medical Corporation
  • Nilesh Patel
  • Mahipal M. Shah, M.D.,P.C.
  • Rohinder Kaur Sandhu M.D., Inc.
  • East Valley Glendora Hospital L P

No participants are involved in a joint venture between ACO Professionals and hospitals.

Prime ACO Governing Body:

  • Prem Reddy, MD; Voting Member and Chairman Prime Healthcare Services Inc
  • Paryus Patel, MD; CMO Voting Member, Pulmonary Consultants & Wellness Center Inc
  • Mike Sarian; President/Executive Director Non-Voting Member
  • Christopher Doan, Chief Compliance Officer Non-Voting Member
  • Alan Smith; Secretary Executive Director Non-Voting Member
  • James Lally, DO Voting Member, Inland Physicians Service, Inc.
  • Richard Bryan, MD Voting Member, Saint Mary's Medical Group, Inc.
  • Hassan Alkhouli, MD Non-Voting Member, Community Stakeholder
  • Dr. Sunny Bhatia, MD Voting Member, Epic Cardiology
  • Richard Fletcher Voting Member, Shasta Regional Medical Center
  • Victor Sabo, MD Voting Member, Desert Valley Medical Group
  • Linda Bradley Voting Member, Centinela Hospital and Medical Center
  • Helen Lidholm Voting Member, Saint Mary’s Regional Medical Center
  • Ted Dutton* - Voting Member, Medicare Beneficiary
  • Fariborz Shams MD Voting Member, Fariborz Shams, D.O., Inc.

Key Clinical and Administrative Leadership

  • ACO Executive: Alan Smith
  • Medical Director: Paryus Patel, M.D.
  • Compliance Officer: Christopher Doan

ACO Committees and Committee Leaderships

  • Quality Improvement and Assurance Committee Executive: Dr. Sunny Bhatia, M.D., Chair
  • Compliance Committee: Christopher Doan, Chair

Types of ACO Participants or Combinations of Participants Who formed the ACO:

  • ACO professionals in a group practice arrangement
  • Networks of individual practices of ACO professionals
  • Hospital employing ACO professionals

Shared Savings/Losses:

Amount of Shared Savings/Losses

  • Performance Year 1: Not in operations
  • Performance Year 2014: Not in operations

The goal of our shared savings program is to promote the overall CMS Three-part aim of improvements in quality, reduction in cost and increased patient satisfaction. With this purpose in mind, Prime ACO is committed to sharing a portion of the shared savings achieved through the MSSP with ACO Participants, as well as to invest in our provider network, technology and infrastructure. We will be monitoring the provider network's quality and cost, and helping to identify ways to improve both. We will bring in new partners, if needed, and support our network with the infrastructure and technical advancements they need to be better performers and have healthier patients

A. How savings will be shared and invested

The Governing Board will determine the distribution of any shared savings. All shared savings will be distributed through multiple methods that secure Prime ACO’s ability to accomplish its strategic goals. Our Quality Improvement and Assurance committee will be looking continuously at ways that our network can improve quality initiatives. Prime ACO will build a data analytic and care coordination infrastructure to help ACO Participants operationalize Population Health Management objectives. When needed, the committees can bring in guests and experts to help evaluate the data. We will be supporting our infrastructure development, and evaluating if our initial determinations on staffing and needs are being met to full capacity. As well, we will continue to build on the IT infrastructure to be sure that our physicians are getting data that is meaningful to their practices, and helpful in helping them make practice management redesigns as necessary. We are piloting a centralized system to work gaps in care for our primary care patients, and hopefully increase preventive care and evidence based care for our chronically ill patients. If this model works, we foresee utilizing a portion of the savings to invest in our infrastructure improvement.

B. Percentage of savings intended for distribution to each category

The current plan is to allocate 25% of any shared savings to infrastructure development and operating expenses, 25% to the hospital partners and 50% to the physician partners. Of the 50% to the physician partners, the savings will be shared with both primary care and specialty care physicians. To be eligible for shared savings distributions, a physician partner must meet established “gate” metrics prior to receiving payments. These metrics include specific quality measures and/or total cost of care goals that align participation in Prime ACO with MSSP goals. The Prime ACO Governing Board may adjust the allocation of shared savings to promote the goals of the ACO and will be responsible for approving final allocation methods.

C. How our plan will achieve the goals of the ACO

We envision using the shared savings as a mechanism to further move the ACO towards meeting the Three-part aim. The investment in infrastructure and resources will work to harness the ability of the ACO to address population health. To this end, some of the quality metrics we are considering flow with what we are already measuring to improve our community’s health, including working to monitor and address conditions such as high blood pressure, high cholesterol, diabetes, and coronary artery disease. As well, we will look at preventive care measures such as flu shots, smoking cessation and well visits.

Prime Healthcare ACO Quality Performance Results

Measure Number Performance Measure 2012 reporting period 2013 reporting period 2014 reporting period
ACO Performance Rate Mean Performance Rate for All ACOs ACO Performance Rate Mean Performance Rate for All ACOs ACO Performance Rate Mean Performance Rate for All ACOs
ACO#1 Getting Timely Care, Appointments, and Information Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#2 How Well Your Doctors Communicate Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#3 Patients’ Rating of Doctor Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#4 Access to Specialists Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#5 Health Promotion and Education Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#6 Shared Decision Making Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#7 Health Status/Functional Status Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#8 Risk Standardized, All Condition Readmissions Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#9 ASC Admissions: COPD or Asthma in Older Adults Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#10 ASC Admission: Heart Failure Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#11 Percent of PCPs who Qualified for EHR Incentive Payment Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#12 Medication Reconciliation Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#13 Falls: Screening for Fall Risk Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#14 Influenza Immunization Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#15 Pneumococcal Vaccination Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#16 Adult Weight Screening and Follow-up Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#17 Tobacco Use Assessment and Cessation Intervention Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#18 Depression Screening Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#19 Colorectal Cancer Screening Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#20 Mammography Screening Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#21 Proportion of Adults who had blood pressure screened in past 2 years Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#22 Hemoglobin A1c Control (HbA1c) (<8 percent) Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#23 Low Density Lipoprotein (LDL) (<100 mg/dL) Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#24 Blood Pressure (BP) <140/90 Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#25 Tobacco Non Use Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#26 Aspirin Use Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#27 Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent) Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#28 Percent of beneficiaries with hypertension whose BP <140/90 Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#29 Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dl Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#30 Percent of beneficiaries with IVD who use Aspirin or other Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#31 Beta-Blocker Therapy for LVSD Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#32 Drug Therapy for Lowering LDL Cholesterol Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation
ACO#33 ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD Not in operation Not in operation Not in operation Not in operation Not in operation Not in operation

Contact Prime Healthcare ACO

Phone Number:

(844) 505-4228

Address:

3300 E. Guasti Road, 3rd Floor
Ontario, CA 91761