Public Reporting

ACO Name and Location

UPSA ACO LLC
8207 Callaghan Road, Ste. 320
San Antonio, TX 78230

ACO Primary Contact

Primary Contact Name David Reyes
Primary Contact Phone Number (210) 330-0817
Primary Contact Email Address admin@upsaaco.com

 

Organizational Information

ACO participants:

1
ACO Participant ACO Participant in Joint Venture
Lindsay White Y
Graciela Moreno, MD, PA Y
Buena Vista Family Practice, PA Y
General Physicians Group Y
Alexander Mora Y
Briggs Family Medicine Pllc Y
Vicki Sparks Y
Louis Holst Y
Lloyd Van Winkle Y
David W. Talafuse, MD, PA Y
Gilberto Melendez, MD,PA Y
Metropolitan Family Practice, PA Y
J. H. Luna, MD, PA Y
Tamre B. McClelland, MD, PA Y
Carlos Porter PA Y
Federico Roman Ng, MDPA Y
Jeremias M Abueme PA Y
Jesus Lopez Y
Shavano Family Practice, PA Y
Quiroz Adult Medicine Clinic, PA Y
Khanh Gia Do, MD, PA Y
C Kelly Family Clinic PA Y

 

ACO Governing Body:

Member Last Name Member First Name Member Title/Position Member's Voting Power Membership Type ACO Participant TIN Legal Business Name
Van Winkle Lloyd Chairman 20% ACO Participant Representative Lloyd Van winkle, MD,PA
Porter Carlos Treasurer 20% ACO Participant Representative Carlos Porter, MD, PA
Clemens Richard 20% ACO Participant Representative San Antonio Preventive & Diagnostic Medicine, PA
McClelland Tamre Secretary 20% ACO Participant Representative Tamre B. McClelland, MD, PA
Banks Daniel Medicare Beneficiary Advisor 10% Medicare Beneficiary Representative NA
Reyes David ACO Administrator 10% Other- ACO Administrator NA

 

Key ACO clinical and administrative leadership:

  • Eric Weaver - ACO Executive
  • Lloyd Van Winkle - Medical Director
  • Eric Weaver - Compliance Officer
  • Carlos Porter - Quality Assurance/Improvement Officer

Associated committees and committee leadership:

Committee Name Committee Leader Name and Position
Medical Management Committee Lloyd Van Winkle, MD / President

 

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

  • First Agreement Period
    • Performance Year 2016, $895,632
    • Performance Year 2015, $0
    • Performance Year 2014, $0

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2016
      • Proportion invested in infrastructure: 10%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 30%
    • 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

Quality Performance Results

2016 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 74.34 79.9
ACO-2 CAHPS: How Well Your Providers Communicate 92.6892.63
ACO-3 CAHPS: Patients' Rating of Provider 92.73 91.93
ACO-4 CAHPS: Access to Specialists 82.85 83.52
ACO-5 CAHPS: Health Promotion and Education 62.16 60
ACO-6 CAHPS: Shared Decision Making 77.87 75.28
ACO-7 CAHPS: Health Status/Functional Status 73.65 71.82
ACO-34 CAHPS: Stewardship of Patient Resources 29.35 27.52
ACO-8 Risk-Standardized, All Condition Readmission 14.17 14.7
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 18.37 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 42.43 53.2
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 56.8375.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 42.07 59.81
ACO-9 Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 7.37 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 ) 10.66 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 59.26 82.72
ACO-39 Documentation of Current Medications in the Medical Record 94.75 87.54
ACO-13 Falls: Screening for Future Fall Risk 63.14 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization 57.9 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults 75.3 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 81.67 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 91 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 47.31 53.63
ACO-19 Colorectal Cancer Screening 61.54 61.52
ACO-20 Breast Cancer Screening 71.25 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented 84.88 76.84
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 82.43 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 17.87 18.24
ACO-41 Diabetes: Eye Exam 40.8 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 75.1 70.52
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 70 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 91.43 88.67
ACO-33 Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy – for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) 75.48 79.67

 

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples.

Note: In the Quality Performance Results file(s) above, search for “UPSA ACO LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A74254 in the public use files on data.cms.gov.

Payment Rule Waivers

  • No, our ACO does not use the SNF 3-Day Rule Waiver