Welcome to NorthShore Physician Associates Value Based Care, LLC.,
an Accountable Care Organization
NorthShore Physician Associates Value Based Care (NPA VBC) is an Accountable Care Organization (ACO) that was formed as a wholly owned subsidiary of NorthShore Physician Associates (NPA). The NPA is the population health oversight and operational vehicle for the broader NorthShore University HealthSystem (NorthShore).
NorthShore Physician Associates Value Based Care's Mission is to drive the highest level of value for the patients of our community through clinically integrated care. More specifically, the mission is to develop and deliver care delivery models for the patients we serve that result in:
- Equitable quality of care and health outcomes
- Efficient and cost-effective care
- High levels of engagement between NorthShore University HealthSystem and its physician partners
What is an ACO?
An Accountable Care Organization (ACO) is a group of doctors and other healthcare providers who agree to work together with Medicare to give you the best possible care. ACOs may take different approaches to giving you coordinated care. Some ACOs may have special nurses that help you set up appointments or make sure your medications are in order when you enter or leave a hospital. Other ACOs may help your doctors get you equipment for monitoring your medical conditions better at home, if you need it. Most ACOs use advanced systems that let them more carefully coordinate your care, and make sure your doctor has the most up-to-date information about your health.
The goal of the ACO is to support your doctor in caring for you by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions over and over. Working together, your doctors can do more to follow your health, make sure you get the best possible care, and may hire additional staff to help meet your unique care needs, depending on what works best for you.
Doctors and other healthcare providers choose to participate in an ACO because they're committed to providing you with a better care experience. They may also be financially rewarded for offering you better, more coordinated care. If your doctor chooses to participate in an ACO, you'll see a poster with information displayed in the office or hospital.
An ACO isn't a Medicare Advantage Plan or Health Maintenance Organization (HMO). You're still in Original Medicare, and your Medicare benefits, services, rights and protections won't change. And you still have the right to use any doctor or hospital that accepts Medicare at any time, the same way you do now.
ACO Name and Location
NorthShore Physician Associates Value Based Care, LLC
1301 Central Street
Suite 301
Evanston, Illinois 60201
ACO Primary Contact
Primary Contact Name
|
Diane Montanez
|
Primary Contact Phone Number
|
847-982-4103
|
Primary Contact Email Address
|
DMontanez@northshore.org
|
For general questions or additional information about Accountable Care Organizations,
please visit
www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227).
Organizational Information
ACO Participants
ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
ABK Medical Center Ltd
|
N
|
Advanced Internal Medicine Associates, Inc
|
N
|
Advanced Primary Care SC
|
N
|
Anshu Gupta MD PC
|
N
|
Anuj Lal, MD, Ltd
|
N
|
Argiro Zofakis, Ltd
|
N
|
Brikha Medical Center
|
N
|
C.J. Ireland, DO, SC
|
N
|
Covenant Medical Group, LLC
|
N
|
Deerfield Medical Associates, SC
|
N
|
Denenberg Medical, SC
|
N
|
Dangremond & Jaharis, LLC (DBA Winnetka Family Medicine)
|
N
|
Kathy Fisher, MD
|
N
|
East West Internal Medicine Associates, P.C.
|
N
|
Family Doctors of Round Lake, PC
|
N
|
Family Medical, Ltd (DBA Dr. Elena Edwards)
|
N
|
First Clinic, SC
|
N
|
Gabriel I. Berlin, M.D. LLC
|
N
|
Glen Medical Associates, SC
|
N
|
Gregory Kaczmarek, MD, LLC
|
N
|
Joseph P. Wyse, MD, Ltd
|
N
|
L. Scott Kanter, MD
|
N
|
Medical Health Clinic Ltd
|
N
|
Mohammad Siddiqui, MD, Ltd
|
N
|
NorthShore University HealthSystem
|
N
|
NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)
|
N
|
North Sheridan Family Medicine (DBA Julia Gorelik, MD)
|
N
|
North Shore Associates in Gynecology and Obstetrics, SC
|
N
|
Robin Wind, MD, SC (DBA Wind Medical Group)
|
N
|
Sheilendr Khipple, MD
|
N
|
Smriti Goel, MD, SC
|
N
|
Stephen J. Clark, MD, PC
|
N
|
Stephen Kashian, MD
|
N
|
Vadim Edelstein MD Ltd
|
N
|
Vandana Jain, MD, SC
|
N
|
Winnetka Avenue Physicians SC
|
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 |
Gutmann
|
Norman
|
NPA VBC Medical Director
|
1
|
ACO Participant Representative
|
NorthShore Medical Group
|
Murtos
|
Kristen
|
ACO Executive; Chief Administrative and Strategy Officer
|
1
|
ACO Participant Representative
|
NorthShore University HealthSystem
|
Fisk
|
Benjamin
|
NPA VBC Executive Director
|
1
|
Other
|
|
Halasyamani
|
Mahalakshmi
|
Chief Quality and Care Transformation Officer
|
1
|
ACO Participant Representative
|
NorthShore Medical Group
|
Boyle
|
Christopher
|
Utilization Management Physician Lead
|
1
|
ACO Participant Representative
|
NorthShore Medical Group
|
Chon
|
Chris
|
Affiliate Physician
|
1
|
ACO Participant Representative
|
First Clinic, SC
|
Denham
|
Ervin
|
Employed Physician
|
1
|
ACO Participant Representative
|
NorthShore Medical Group
|
Kaul
|
Karen
|
Clinical Chairman
|
1
|
ACO Participant Representative
|
NorthShore Medical Group
|
Revis
|
John
|
Employed Physician
|
1
|
ACO Participant Representative
|
NorthShore Medical Group
|
Wallman
|
Gregory
|
Affiliate Physician
|
1
|
ACO Participant Representative
|
Covenant Medical Group, LLC
|
MacGregor
|
Scott
|
Employed Physician
|
1
|
ACO Participant Representative
|
NorthShore Medical Group
|
Kirkorsky
|
Deborah
|
VP, Medical Group
|
1
|
ACO Participant Representative
|
NorthShore Medical Group
|
Grabowy
|
James
|
|
1
|
Medicare Beneficiary Representative
|
|
Hensing
|
Thomas
|
Associate Chief Quality Officer for Ambulatory Care
|
0
|
ACO Participant Representative
|
NorthShore Medical Group
|
Oshman
|
Lauren
|
Employed Physician
|
0
|
ACO Participant Representative
|
NorthShore Medical Group
|
Bauer
|
Tyler
|
VP, Medical Group
|
0
|
ACO Participant Representative
|
NorthShore Medical Group
|
Rahija
|
David
|
President, Skokie Hospital
|
0
|
ACO Participant Representative
|
NorthShore University HealthSystem
|
Braund
|
Victoria
|
Employed Physician
|
0
|
ACO Participant Representative
|
NorthShore Medical Group
|
Smith
|
Steven
|
NPA VBC Information Technology Executive
|
0
|
Other
|
|
Jones
|
Harry
|
NPA VBC Compliance Officer
|
0
|
Other
|
|
Eminger
|
Tricia
|
NBA VBC Operations Executive
|
0
|
Other
|
|
Key ACO Clinical and Administrative Leadership
Kristen Murtos
|
ACO Executive
|
Norman Gutmann, MD
|
Medical Director
|
Harry Jones
|
Compliance Officer
|
Mahalakshmi Halasyamani, MD
|
Quality Assurance/Improvement Officer
|
Associated Committees and Committee Leadership
Committee Name | Committee Leader Name and Position |
Quality Committee
|
Mahalakshmi K. Halasyamani, MD, Chief Quality and Transformation Officer
|
Ambulatory Care Quality Council
|
Thomas A. Hensing, MD, Associate Chief Quality Officer for Ambulatory Care Norman Gutmann, MD, NPA VBC Medical Director
|
Hospitals Quality Council
|
Gregory A. Wallman, DO, NPA VBC Participant & Board Member Mahalakshmi K. Halasyamani, MD, Chief Quality and Transformation Officer Mary Keegan, Chief Nursing Officer
|
Operations Committee
|
Benjamin Fisk, NPA VBC Executive Director
|
Finance Committee
|
Ervin Woody Denham, MD, ACO Participant
|
Compliance Committee
|
Harry Jones, NPA VBC Compliance Officer
|
Types of ACO Participants or Combinations of Participants that Formed the ACO
- Partnerships or joint venture arrangements between hospitals and ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses
- First Agreement Period
- Performance Year 2018, $0
Shared Savings Distribution
- First Agreement Period
- 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
2018 Quality Performance Results:
ACO# | Measure Name | Rate | ACO Mean |
ACO-1
|
CAHPS: Getting Timely Care, Appointments, and Information
|
84.95
|
86.14
|
ACO-2
|
CAHPS: How Well Your Providers Communicate
|
95.29
|
93.93
|
ACO-3
|
CAHPS: Patients’ Rating of Provider
|
93.58
|
92.45
|
ACO-4
|
CAHPS: Access to Specialists
|
78.00
|
81.50
|
ACO-5
|
CAHPS: Health Promotion and Education
|
60.41
|
59.26
|
ACO-6
|
CAHPS: Shared Decision Making
|
59.89
|
61.94
|
ACO-7
|
CAHPS: Health Status/Functional Status
|
75.39
|
73.35
|
ACO-34
|
CAHPS: Stewardship of Patient Resources
|
29.65
|
26.26
|
ACO-8
|
Risk Standardized, All Condition Readmission
|
15.01
|
14.98
|
ACO-35
|
Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)
|
19.38
|
18.59
|
ACO-36
|
All-Cause Unplanned Admissions for Patients with Diabetes
|
39.43
|
37.01
|
ACO-37
|
All-Cause Unplanned Admissions for Patients with Heart Failure
|
86.63
|
76.75
|
ACO-38
|
All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions
|
64.73
|
59.00
|
ACO-43
|
Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91)
|
1.93
|
1.98
|
ACO-11
|
Use of Certified EHR Technology
|
99.95
|
98.20
|
ACO-12
|
Medication Reconciliation Post-Discharge
|
99.36
|
85.91
|
ACO-13
|
Falls: Screening for Future Fall Risk
|
88.97
|
79.73
|
ACO-44
|
Use of Imaging Studies for Low Back Pain
|
66.67
|
64.36
|
ACO-14
|
Preventive Care and Screening: Influenza Immunization
|
62.47
|
72.71
|
ACO-15
|
Pneumonia Vaccination Status for Older Adults
|
86.23
|
75.97
|
ACO-16
|
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up
|
91.28
|
76.83
|
ACO-17
|
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
|
33.33
|
72.81
|
ACO-18
|
Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan
|
59.41
|
66.74
|
ACO-19
|
Colorectal Cancer Screening
|
79.67
|
68.27
|
ACO-20
|
Breast Cancer Screening
|
75.55
|
71.96
|
ACO-42
|
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
|
73.88
|
81.47
|
ACO-27
|
Diabetes Mellitus: Hemoglobin A1c Poor Control
|
8.63
|
15.51
|
ACO-41
|
Diabetes: Eye Exam
|
60.39
|
52.42
|
ACO-28
|
Hypertension (HTN): Controlling High Blood Pressure
|
75.95
|
73.10
|
ACO-30
|
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
|
88.96
|
88.92
|
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
Note: In the Quality Performance Results file(s) above, search for “NorthShore Physician Associates Value Based Care, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A3702 in the public use files on data.cms.gov.
Payment Rule Waivers
- No, our ACO does not use the SNF 3-Day Rule Waiver
ACO Participation Waiver Protection Arrangements
NorthShore University HealthSystem (NS), an ACO participant, has entered into agreements with certain primary care physician practices participating in the NorthShore Physician Associates Value Based Care ACO (NPA VBC) commencing on or after August 1, 2018, pursuant to which NS furnishes certain electronic medical record (EMR) and practice management software and support to primary care physicians in an effort to achieve a more consolidated EMR platform amongst the ACO participants. NPA VBC’s governing body made a bona fide determination that the furnishing of such EMR and practice management software and support will allow all ACO participating primary care physicians and the ACO to utilize an interconnected EMR, which are reasonably related to, and will continue to further, the purposes of the Medicare Shared Savings Program by:
- Promoting accountability for the quality, cost, and overall care for Medicare beneficiaries;
- Allowing for the managing and coordinating of care for Medicare fee-for service beneficiaries through the ACO; and
- Encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare beneficiaries.