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Public Reporting

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Leadership and governance

ACO Name and Location

ProHEALTH Accountable Care Medical Group, PLLC
1 Dakota Drive, Suite 320
Lake Success, N.Y. 11042

Composition of ACO

Our ACO is composed solely of medical providers in a group practice arrangement, all of whom are either partners or employees of ProHEALTH Care Associates, LLP.

ACO Primary Contact

Carole Romano
cromano@prohealthcare.com
516-608-6849

ACO Participants

ProHEALTH Care Associates, LLP: All providers in all ProHEALTH locations throughout Long Island and the New York boroughs. Individual providers can be located by visiting our website at http://lookup.prohealthcare.com/find-doctors.

No Participants are involved in a joint venture between ACO professionals and hospitals.

ACO Governing Body: Board of Managers

David Cooper, MD, CEO, Chair, Voting Member
Gary Weissman, MD, Medical Director and Voting Member
Anthony Ardito, MD, Associate Medical Director, Chief Primary Care, Voting Member
Mark W. Dobriner, MD, Voting Member
Mark Weinstein, MD, Voting Member
Dana Lustbader, MD, Voting Member

Key Clinical and Administrative Leadership

ACO Executive: David Cooper, MD

Medical Director: Gary Weissman, MD

Compliance Official: Walter LeStrange, CCO

Quality Assurance/Improvement Officer: Gary Weissman, MD

ACO Committees, Workgroups and Committee Leaderships

Executive Board: David Cooper, MD, CEO, Chair

Quality Assurance & Improvement Committee: Gary Weissman, MD, Medical Director, Chair

Finance Committee: David Cooper, MD, CEO, Chair

Advisory Panel: Anthony Ardito, MD, Chair

ACO Core Workgroup: Gary Weissman, MD, Clinical Lead

Care Coordination Workgroup: Ronald Richman, MD & Dana Lustbader, MD, Clinical Lead

Types of ACO Participants Forming the ACO

ACO professionals in a group medical practice arrangement

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Shared savings

Aggregate Amount of Shared Savings/Losses – Agreement Period Beginning 2012:

Performance Year 1: July 2012 to December 2013:  $10,737,854

Performance Year 2: January 2014 to December 2014: $8,183,196

Performance Year 3: January 2015 to December 2015: $6,289,913

How Shared Savings are Distributed:

PY 3

Investment in Infrastructure: 65%

Investment in Care Processes & Resources:  5%

Distribution to ACO Participants (Providers):  30%

 

PROVIDER BONUS DISTRIBUTION

Designation Percentage
Primary Care 94.67%
Specialists 5.33%
Grand Total 100%

Payment rule Waivers:

Our ACO does not utilize the SNF 3-Day Rule Waiver

 

PY 2

Repayment of capital and infrastructure investments, including

operational and administrative costs: 34.5%

Reinvested in Infrastructure and Care Processes: 34.5%

Distribution to ACO Participants (Providers): 31.0%

 

PROVIDER BONUS DISTRIBUTION

Designation Percentage
Primary Care 77.22%
Medical Subspecialty 11.46%
Surgical Subspecialty 5.58%
Pediatrics 3.40%
Radiology 1.11%
Urgent 0.68%
Pathology 0.30%
Surgical Pediatrics 0.24%
Grand Total 100%

 

PY 1

Repayment of capital and infrastructure investments, including

operational and administrative costs: 33%

Reinvested in Infrastructure and Care Processes: 33%

Distribution to ACO Participants (Providers): 33%

 

PROVIDER BONUS DISTRIBUTION

Designation Percentage
Internal Medicine Providers 75.80%
Specialists, Medical 13.80%
Specialists, Pediatrics 3.00%
Surgical Sub-Specialist 7.40%
Grand Total 100%

 

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2015 Quality performance results

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Quality performance years 2014 to 2012