Shared Savings Program Public Reporting
ACO Name and Location
Zenith Independent Physicians ACO
1762 E.Common St.
New Braunfels, TX 78130
ACO Primary Contact
Michelle Robinson
407-765-6878
michelle.robinson@innovacarehealth.com
Organizational Information
ACO Participants:
| ACO Participants | ACO Participant in Joint Venture |
|---|---|
| PAK MEDICAL GROUP PLLC | No |
| ALEMU MEDICAL HOME PLLC | No |
| ANGELICA MARTINEZ FAMILY PRACTICE, PLLC | No |
| BORDER CLINIC PLLC | No |
| C BRIEN WOFFORD DO PA | No |
| DEAN L ZINCONE MD PA | No |
| EDGAR REYNA, MD, PA | No |
| RIVER ACRES MEDICAL GROUP PA | No |
| ROBERT L FRETS, MD, PA | No |
| SAGE MEDICINE PA | No |
| Sankararao Tamtam, MD PA | No |
| SU CLINICA FAMILIAR | No |
ACO Governing Body:
| Member First Name | Member Last Name | Member Title/Position | Member’s Voting Power (Expressed as a percentage) | Membership Type | ACO Participant Legal Business Name, if applicable |
|---|---|---|---|---|---|
| Michelle | Robinson | Voting Member; ACO Executive | ACO Director of Operations | 20 | ACO Participant Representtive | Pake Medical Group LLC |
| Rupesh | Nigam | Chairman; Voting Member; Cheif Medical Officer | 20 | Non-ACO Participant | InnovaCare Health |
| Elena | Marin | Voting Member | 20 | ACO Participant Representative | Su Clinica Familiar |
| Filameno | Gonzalez., MD | Voting Member | 20 | ACO Participant representative | Pak Medical Group PLLC |
| Dennis | Kaderli | Non-Voting Member | 0 | Medicare Beneficiary Representative | N/A |
| James | Bartay, MD | Voting Member | 20 | ACO Participant Representative | River Acres Medical Group PA |
Key ACO Clinical and Administrative Leadership:
ACO Executive: Michelle Robinson
Medical Director: Rupesh Nigam, MD, MBA, FACP
Compliance Office: Tammy Bowen
Quality Assurance/Improvement Officer: Kisha Williams, LVN, MBA
Associated Committees and Committee Leadership:
ACO Name and Location
Zenith Independent Physicians ACO
1762 E.Common St.
New Braunfels, TX 78130
ACO Primary Contact
Michelle Robinson
407-765-6878
michelle.robinson@innovacarehealth.com
Organizational Information
ACO Participants:
A network of individual practices of ACO professionals.
| Committee Name | Committee Leader Name and Position |
|---|---|
| Compliance Committee | Director of Compliance, Misty Kelly |
| Compliance Committee | ACO Executive | Director of ACO Operations, Michelle Robinson |
| Compliance Committee | Representative from Quality Oversight, Nick D’Ambra |
| Compliance Committee | Representative of Care Coordination Oversight, Lilian Alevato |
| Compliance Committee | Representative of Risk Adjustment & Performance, Gary Pilling |
| Operational and Finance Committee | VP of Business Development and Financial Planning, Manuk Ozcan |
| Operational and Finance Committee | Kat Marie Alvarez, Chief Strategy Officer |
| Operational and Finance Committee | Chief Medical Officer, Rupesh Nigam, MD, MBA |
| Operational and Finance Committee | Medical Director for Clinical Services, Lilian Alevato |
| Operational and Finance Committee | Chief Actuary Officer, Tim Dickson |
| Operational and Finance Committee | ACO Executive | Director of ACO Operations, Michelle Robinson |
| Operational and Finance Committee | Chief Financial Officer – NJ • Corporate_INNO, Doug Malton |
| Operational and Finance Committee | VP of Payor Strategy & Partnership, Ozzie Garcia |
| Operational and Finance Committee | VP of Network Operations and Health Plan Relations, Marifran Gonzalez |
| Operational and Finance Committee | VP Risk Adjustment & Performance • Risk Management, Gary Piling |
| Clinical Integrations & Quality Improvement Committee | Chief Medical Officer, Rupesh Nigam, MD, MBA |
| Clinical Integrations & Quality Improvement Committee | Chief Strategy Officer, Kat Marie Alvarez |
| Clinical Integrations & Quality Improvement Committee | Director of Clinical Informatics, Michael Kanthak |
| Clinical Integrations & Quality Improvement Committee | Quality Improvement Manager, Adrian Rios |
| Clinical Integrations & Quality Improvement Committee | ACO Executive | Director of ACO Operations, Michelle Robinson |
| Clinical Integrations & Quality Improvement Committee | VP of Quality, Nick D’Ambra |
| Clinical Integrations & Quality Improvement Committee | Medical Director for Clinical Services, Lilian Alevato |
| Clinical Integrations & Quality Improvement Committee | Director of Quality, Mayna Del Toro Boffilo |
| Clinical Integrations & Quality Improvement Committee | Care Coordination, Ira Burke |
| Clinical Integrations & Quality Improvement Committee | Carlos Rodriguez, Director of Risk Adjustment |
| Clinical Integrations & Quality Improvement Committee | Patricia Burgos, Clinical Services Group Consultant Manager |
| Clinical Integrations & Quality Improvement Committee | Chief Information Officer • IT, Prashanth Kovelamudi |
| Clinical Integrations & Quality Improvement Committee | Director of Quality Improvement, Kisha Williams |
| Clinical Integrations & Quality Improvement Committee | Senior Director of Client Services – Texas, Tammy Bowen |
ACO Participants:
A network of individual practices of ACO professionals.
Shared Savings and Losses
Amount of Shared Savings/Losses:
- First Agreement Period
- Performance Year 2023, $1,409,686.01
- Performance Year 2022, $0
Shared Savings Distribution:
- First Agreement Period
- Performance Year 2023
-
- Proportion invested in infrastructure: 25%
- Proportion invested in redesigned care processes/resources: 25%
- Proportion of distribution to ACO participants: 50%
-
- Performance Year 2022
- 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 2023
Quality Performance Results:
| Measure # | Measure Name | Collection Type | Reported Performance Rate | Current Year Mean Performance Rate (SSP ACOs) |
|---|---|---|---|---|
| Quality ID# 001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1] | CMS Web Interface | 13.36 | 9.84 |
| Quality ID# 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 78.04 | 80.97 |
| Quality ID# 236 | Controlling High Blood Pressure | CMS Web Interface | 81.33 | 77.80 |
| Quality ID# 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 69.23 | 89.42 |
| Quality ID# 110 | Preventative Care and Screening: Influenza Immunization | CMS Web Interface | 55.60 | 70.76 |
| Quality ID# 226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 89.29 | 79.29 |
| Quality ID# 113 | Colorectal Cancer Screening | CMS Web Interface | 67.96 | 77.14 |
| Quality ID# 112 | Breast Cancer Screening | CMS Web Interface | 73.79 | 80.36 |
| Quality ID# 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 84.64 | 87.05 |
| Quality ID# 370 | Depression Remission at Twelve Months | CMS Web Interface | 11.43 | 16.58 |
| Quality ID# 321 | CAHPS for MIPS [3] | CMS Web Interface | 5.71 | 6.25 |
| Measure# 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1] | Administrative Claims | 0.1636 | 0.1553 |
| Measure# 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] | Administrative Claims | 30.83 | 35.39 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | CAHPS for MIPS Survey | 83.86 | 83.68 |
| CAHPS-2 | How Well Providers Communicate | CAHPS for MIPS Survey | 92.06 | 93.69 |
| CAHPS-3 | Patient’s Rating of Provider | CAHPS for MIPS Survey | 91.11 | 92.14 |
| CAHPS-4 | Access to Specialists | CAHPS for MIPS Survey | 80.12 | 75.97 |
| CAHPS-5 | Health Promotion and Education | CAHPS for MIPS Survey | 67.17 | 63.93 |
| CAHPS-6 | Shared Decision Making | CAHPS for MIPS Survey | 65.86 | 61.60 |
| CAHPS-7 | Health Status and Functional Status | CAHPS for MIPS Survey | 77.55 | 74.12 |
| CAHPS-8 | Care Coordination | CAHPS for MIPS Survey | 84.91 | 85.77 |
| CAHPS-9 | Courteous and Helpful Office Staff | CAHPS for MIPS Survey | 89.98 | 92.31 |
| CAHPS-11 | Stewardship of Patient Resources | CAHPS for MIPS Survey | 23.83 | 26.69 |
For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov.