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Collectively committed to clinical excellence by improving the quality and value of care for the patients we serve.

Seamless Care for Medicare Patients

PPWPA believes in setting the highest care for our Medicare patients, we've become an Accountable Care Organization (ACO) through the Centers for Medicare & Medicaid Services. As a Track 1 ACO, we're committed to providing patients the right time while avoiding errors and unnecessary duplications to services.

In 2017, Physician Partners of Western Pennsylvania (PPWPA) was selected to be an Accountable Care Organization (ACO), a program sponsored by the Centers for Medicare and Medicaid Services (CMS). This information explains PPWPA’s participation in that program.

ACO Name and Location

Physician Partners of Western PA LLC

120 Fifth Avenue Place

FAPHM-133A

Pittsburgh, PA 15222

ACO Primary Contact

Sam Reynolds, MD - Quality Director

Phone: (412) 330-2498

Email:

Organizational Information

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Adiba Ahmed N
Alan Esper N
Allegheny Clinic N
Allegheny Clinic Radiology N
Armstrong County Memorial Hospital N
Associates in Neurology of Pittsburgh N
Brentwood Medical Group, Inc N
Bryant Bojewski N
Cardiovascular Disease Specialists of Pittsburgh PC N
Center for Orthopaedics and Sports Medicine PC N
Cherry Tree Medical Associates Inc N
Corry Medical Services, Inc N
Corry Memorial Hospital Association N
D. Singh MD and Associates N
Decker Family Medicine, LLC N
Digestive Care Consultants PC N
Dr Edward Jew III Internal Medicine N
Dudzinski Enterprises, Inc N
Emmanuel Family Practice Associates, PC N
Family Practice Medical Associate South Inc. N
Flores & Flores Medical Associates, Inc. N
Gary Esper N
Glade Run Medical Associates Inc N
Golla ENT N
Habiba Health Services PC N
Handelsmann Family Practice, LLC N
Healthquest Medical Associates LLC N
Highlands Hospital and Health Center N
Indiana Healthcare Physician Services Inc N
Irwin Family Care Pc N
Jefferson Cardiology Association N
Jefferson Hills Surgical Specialists N
Jefferson Internal Medicine PC N
Johnstown Heart and Vascular Center, Inc N
JRMC Specialty Group Practice N
Lake Erie Medical Group PC N
Lamperski Internal Medicine, LLC N
Levi Walker, M.D., P.C. N
MacIsaac Family Medicine N
Malkit Singh MD N
Martin G Gregorio MD and Associates PC N
Matthew N. Klain MD PC N
Mead Avenue Family Practice, Inc. N
Medical Associates of Erie N
Medigenics Longevity Center Inc N
Montgomery Medical, Inc. N
OB-GYN Associates of Erie, PC N
Osteopathic Internal Medicine Associates, Inc N
Park Cardiothoracic and Vascular Institute N
Partners in Family Care P C N
Paul G. Linder,M.D. & Associates, P.C. N
Physician Landing Zone, P.C. N
Pittsburgh Bone, Joint & Spine, Inc N
Prabhat Seth, MD N
Premier Medical Associates, PC N
Primary Care Group 11 Inc N
Primary Care Group 3 Inc N
Primary Care Group 5, Inc N
Primary Care Group 7, Inc N
Primary Care Group 8, Inc N
Prime Medical Group PCG1 N
Private Physicians Medical Practice LLC N
Rc Medical Associates Pc N
Robert Esper N
Robert Waligura N
S W Leehan MD PC N
Saint Vincent Consultants in Cardiovascular Diseases N
Saint Vincent Medical Education and Research Institute Inc N
Sciamanda Total Health and Wellness N
South Hills Family Medicine, LLC N
South Pittsburgh Urology Associates N
Steel Valley Orthopaedics and Sports Medicine N
Timothy Stanton N
Vincent Fierro N
Warren General Hospital N

ACO GOVERNING BODY

Member

Last Name

First

Title/Position

Member's Voting Power

Member Type

ACO Participant Legal Business Name/DBA, if Applicable

Sauber Timothy Voting Member 1 ACO Participant Representative Allegheny Clinic
Parker Brian Voting Member 1 Other N/A
Crawford-Faucher Amy Voting Member 1 ACO Participant Representative Allegheny Clinic
Johnson Brian Voting Member 1 ACO Participant Representative Allegheny Clinic
Aracri Joseph Voting Member 1 ACO Participant Representative Allegheny Clinic
Morton Margaret Voting Member 1 ACO Participant Representative Emmanuel Family Practice Associates, PC
Preiss Jennifer Voting Member 1 ACO Participant Representative Allegheny Clinic
Crossey Robert Secretary/Voting Member 1 ACO Participant Representative Premier Medical Associates PC
Lund Peter Chair/Voting Member 1 ACO Participant Representative Saint Vincent Medical Education and Research Institute Inc
Tootell Mason Voting Member 1 ACO Participant Representative Crescent Park Family Practice
Hansen Danielle Voting Member 1 ACO Participant Representative Medical Associates of Erie
Shin David Voting Member 1 ACO Participant Representative Allegheny Clinic
Solava James Voting Member 1 ACO Participant Representative Prime Medical Group PCG1
Reynolds Sam Voting Member 1 ACO Participant Representative Allegheny Clinic
Sharbaugh David Voting Member 1 Other N/A
Fantaski Mark Voting Member 1 ACO Participant Representative Healthquest Medical Associates LLC
Farah Tony Voting Member 1 Other N/A
Warden Bradford Voting Member 1 ACO Participant Representative Mon Health System 
Hyjurick John Voting Member 1 Medicare Beneficiary Representative N/A
Johnjulio William Medical Director 0 ACO Participant Representative Allegheny Clinic
DeRosa Julie Voting Member 1 ACO Participant Representative Indiana Regional Medical Center Physician Group

KEY ACO CLINICAL AND ADMINISTRATIVE LEADERSHIP

ACO Acting Executive Director William Johnjulio, MD
Medical Director Sam Reynolds, MD
Compliance Officer Jane Manross
Quality Assurance/Improvement Officer Sam Reynolds, MD

ASSOCIATED COMMITTEES AND COMMITTEE LEADERSHIP

Committee Name

Committee Leader Name and Position

Finance and Contracting Committee David Sharbaugh - Chair
Clinical, Quality Improvement and Credentialing Committee Sam Reynolds, MD - Chair
Nominating Committee Amy Crawford-Faucher, MD - Chair

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

Networks of individual practices of ACO professionals

SHARED SAVINGS AND LOSSES

Amount of Shared Savings/Losses

Amount of Shared Savings/Losses First Agreement Period
  • Performance Year 2020: $6,126,529
  • Performance Year 2019: $11,573,492.92
  • Performance Year 2018: $0
Shared Savings Distribution First Agreement Period
  • Performance Year 2020
    • Proportion invested in infrastructure: 5%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 80%
  • Performance Year 2019
    • Proportion invested in infrastructure: 5%
    • Proportion invested in redesigned care processes/resources: 15%
    • Proportion of distribution to ACO participants: 80%
  • Performance Year 2018
    • 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

2020 QUALITY PERFORMANCE RESULTS

ACO#

Measure Name

Rate

ACO Mean


ACO-8 Risk Stadardized, All Condition Readmission n/a n/a
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions n/a n/a
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91) 1.02 0.95
ACO-13 Falls: Screening for Future Fall Risk 94.62 84.97
ACO-14 Preventive Care and Screening: Influenza Immunization 75.86 76.03
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 87.10 81.67
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 83.52 71.46
ACO-19 Colorectal Cancer Screening 78.47 72.59
ACO-20 Breast Cancer Screening 78.65 74.05
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 85.61 83.37
ACO-40 Depression Remission at Twelve Months n/a n/a
ACO-27 Diabetes: Hemoglobin A1c Poor Control (>9%) 8.06 14.70
ACO-28 Controlling High Blood Pressure 73.33 72.87
* 2020 CAHPS results are not included as CMS did not require the survey due to the COVID Public Health Emergency
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.

PAYMENT RULE WAIVERS

  • Waiver for Payment for Telehealth Services:
    • Yes, our ACO clinicians do provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.