Accountable Care Organization
ACO Name and Location
ProHealth Physicians ACO, LLC
3 Farm Glen Blvd
Farmington, Connecticut 06032-1981
ACO Primary Contact
Primary Contact Name | Ms. Cheryl Lescarbeau |
Primary Contact Phone Number | (860) 284-5204 |
Primary Contact Email Address | clescarbeau@prohealthmd.com |
Organizational Information
ACO participants:
ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
ProHealth Physicians, PC | 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 | |||
Brown | Seth | ACO Provider | 19.6% | ACO Participant Representative | ProHealth Physicians, PC |
Buckley | Timothy | ACO Provider | 19.6% | ACO Participant Representative | ProHealth Physicians, PC |
Donahue | Jennifer | ACO Provider | 19.6% | ACO Participant Representative | ProHealth Physicians, PC |
Herlands | Stuart | ACO Provider | 19.6% | ACO Participant Representative | ProHealth Physicians, PC |
Pazer | David | ACO Provider | 19.6% | ACO Participant Representative | ProHealth Physicians, PC |
Cox-Chapman | James | ACO Medicare Beneficiary | 2% | Medicare Beneficiary Representative | NA |
Key ACO clinical and administrative leadership:
Cheryl Lescarbeau | ACO Executive |
Richard Guerriere | Medical Director |
Maura Geirin | Compliance Officer |
Richard Guerriere | Quality Assurance/Improvement Officer |
Associated committees and committee leadership:
Committee Name | Committee Leader Name and Position |
Clinical Council | Dr. Richard Guerriere, SVP, Chief Medical Officer and Medical Director (Chair) |
Privacy and Security Committee | Richard Lugli, SVP, General Counsel and Privacy Officer (Co-chair)Elizabeth Thornquist, VP Information Services and Security Officer (Co-chair)Maura Geirin, Compliance Officer (Co-chair) Richard Guerriere, SVP, Chief Medical Officer and Medical Director (Co-chair, Clinical Lead) |
Patient Advisory Council | Tracy Weber Tierney, Director of Patient Experience (Chair) |
Types of ACO participants, or combinations of participants, that formed the ACO:
- ACO professionals in a group practice arrangement
Shared Savings and Losses
Amount of Shared Savings/Losses
- Second Agreement Period
- Performance Year 2017, $8,618,964
-
- Performance Year 2016, $5,996,474
- First Agreement Period
-
- Performance Year 2015, $0
- Performance Year 2014, $0
- Performance Year 2013, $0
Shared Savings Distribution
- Second Agreement Period
- Performance Year 2017
- Proportion invested in infrastructure: 30%
- Proportion invested in redesigned care processes/resources: 40%
- Proportion of distribution to ACO participants: 30%
- Performance Year 2017
-
- Performance Year 2016
-
-
- Proportion invested in infrastructure: 25%
- Proportion invested in redesigned care processes/resources: 25%
- Proportion of distribution to ACO participants: 50%
-
- 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: 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
2017 Quality Performance Results:
ACO# | Measure Name | Rate | ACO Mean |
ACO-1 | CAHPS: Getting Timely Care, Appointments, and Information | 79.51 | 80.60 |
ACO-2 | CAHPS: How Well Your Providers Communicate | 93.15 | 93.13 |
ACO-3 | CAHPS: Patients’ Rating of Provider | 92.96 | 92.31 |
ACO-4 | CAHPS: Access to Specialists | 83.24 | 83.32 |
ACO-5 | CAHPS: Health Promotion and Education | 66.18 | 62.30 |
ACO-6 | CAHPS: Shared Decision Making | 75.03 | 75.85 |
ACO-7 | CAHPS: Health Status/Functional Status | 77.18 | 73.05 |
ACO-34 | CAHPS: Stewardship of Patient Resources | 18.65 | 25.68 |
ACO-8 | Risk-Standardized, All Condition Readmission | 14.90 | 15.01 |
ACO-35 | Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) | 16.46 | 18.46 |
ACO-37 | All-Cause Unplanned Admissions for Patients with Heart Failure | 74.01 | 79.16 |
ACO-38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 55.46 | 61.74 |
ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) | 1.70 | 1.93 |
ACO-11 | Use of Certified EHR Technology | 100 | 98.48 |
ACO-12 | Medication Reconciliation | 99 | 75.32 |
ACO-13 | Falls: Screening for Future Fall Risk | 90 | 74.38 |
ACO-44 | Imaging Studies for Low Back Pain | 72.41 | 67.32 |
ACO-14 | Preventive Care and Screening: Influenza Immunization | 86.61 | 72.52 |
ACO-15 | Pneumonia Vaccination Status for Older Adults | 90.21 | 72.92 |
ACO-16 | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up | 75.86 | 70.69 |
ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 99.67 | 90.48 |
ACO-18 | Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan | 95.12 | 61.98 |
ACO-19 | Colorectal Cancer Screening | 81.82 | 64.58 |
ACO-20 | Breast Cancer Screening | 82.30 | 70.05 |
ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 79.30 | 79.89 |
ACO-27 | Diabetes Mellitus: Hemoglobin A1c Poor Control | 8.95 | 16.74 |
ACO-41 | Diabetes: Eye Exam | 72.29 | 50.37 |
ACO-28 | Hypertension (HTN): Controlling High Blood Pressure | 79.22 | 71.47 |
ACO-30 | Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic | 94.29 | 86.86 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples, and the ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes quality measure is not included in public reporting due to a non-material technical error.
- For 2017 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2017-Shared-Savings-Program-SSP-Accountable-Care-O/gk7c-vejx/data
- For 2016 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2016-Shared-Savings-Program-SSP-Accountable-Care-O/3jk5-q6dr/data
- For 2015 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/x8va-z7cu
- For 2014 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/ucce-hhpu
- For 2013 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/yuq5-65xt
Note: In the Quality Performance Results file(s) above, search for “ProHealth Physicians ACO, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A65320 in the public use files on data.cms.gov.
Payment Rule Waivers
- No, our ACO does not use the SNF 3-Day Rule Waiver.