Shared Savings Program ACO Public Reporting

ACO Name and Location

Mount Sinai Care, LLC
One Gustave Levy Place
Box 1126
New York, New York 10029

ACO Primary Contact

Primary Contact Name Denise Prince, CEO Mount Sinai Care
Primary Contact Phone Number 570-412-9609
Primary Contact Email Address Denise.Prince@mountsinai.org

Organizational Information

ACO participants:

ACO Participants

ACO Participant in Joint Venture

Albert Defabritus N
American Medical PC N
Angelo Pilla N
APICHA Community Health Center N
Arthur L Autz Md Pc N
Astoria Cardiology Group, PC N
Benjamin Zaremski M.D. P.C. N
BIMC FACULTY PRACTICE N
Bodhi Medical Care, LLC N
Central Park West Medical Group, PC N
Community Health Project Inc N
Cyrus A Assadi Md Pc N
Downtown Family Medicine PC N
Elisabeth Gomori, MD PC N
Elizabeth Beautyman N
Elliot Belenkov Physician PC N
Emanuel L. Kouroupos, MD PC N
George Castro N
Grand Medical Group, PC N
Howard A Grossman MD PLLC N
HQC Medical PC N
Icahn School Of Medicine At Mount Sinai N
Immediate Medical Healthcare PLLC N
Jeffrey Delson N
Jessica Allan MD PC N
John Wang N
Julie Nissim, DO PC N
Leon Scrimmager, MD N
Luba V. Gringut Medical PC N
Lucy Sourial N
Majorie Lee N
Manhattan Internal Medicine Associates N
Margaret Kearns-Stanley, MD N
Mary Efremov N
Medical Associates of Manhattan, PC N
Medical Associates PC N
Michael R. Zuckman MD P.C. N
Moscow Medical P.C. N
Mount Sinai Hospital N
Mount Sinai School of Medicine N
Mount Sinai School Of Medicine Of New York University N
Mt Sinai School Of Medicine Of New York University N
Namhi Lee, MD N
Nathaniel Brownlow, MD N
Park Avenue Medical Professionals N
Pride Medical PLLC N
Ravindra Goyal N
Ricardo Issa Physician Pc N
Richard Neufeld, MD N
Robert M Romanoff MD PC N
Ryan-Chelsea Clinton Community Health Center N
SLRHC FACULTY PRACTICE N
St. Luke's - Roosevelt Hospital Center N
Stat Medical Care, P.C. N
Susan Klein N
Theodore C. Docu M.D., P.C. N
Thomas Tupper N
Todd B. Linden Md Pc N
Upper East Side Medical PC N
William F Ryan Community Health Center Inc 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
Prince Denise Chairman and Voting Member 5.9% ACO Participant Representative Icahn School of Medicine at Mount Sinai
Bansal Meena  Voting Member 5.9% ACO Participant Representative Icahn School of Medicine at Mount Sinai
Dillon Vivian  Voting Member 5.9% ACO Participant Representative Mount Sinai Health System
Vega Aida  Voting Member 5.9% ACO Participant Representative Mount Sinai Faculty Practice Associates
Icahn School of Medicine at Mount Sinai
Ingber Scott  Voting Member 5.9% ACO Participant Representative North Shore Medical Group of the Mount Sinai School of Medicine
Soriano Theresa  Voting Member 5.9% ACO Participant Representative Icahn School of Medicine at Mount Sinai
Siu Albert  Voting Member 5.9% ACO Participant Representative

Icahn School of Medicine at Mount Sinai

 

Federman

 

 

Alex

 

 

 Voting Member 5.9% ACO Participant Representative

Icahn School of Medicine at Mount Sinai

 

Bernstein Brett  Voting Member 5.9% ACO Participant Representative Icahn School of Medicine at Mount Sinai
Swartz

Jonathan

 

 Voting Member 5.9% ACO Participant Representative William F. Ryan Community Health Network
Burke Gary  Voting Member 5.9% ACO Participant Representative Mount Sinai St. Luke's
Icahn School of Medicine at Mount Sinai
Carnavali Fernando  Voting Member 5.9% ACO Participant Representative Mount Sinai Queens
Icahn School of Medicine at Mount Sinai
Dunn Andrew  Voting Member 5.9% ACO Participant Representative Mount Sinai Health System
West Suzie   Voting Member 5.9% Medicare Beneficiary Representative N/A
Scanlon Donald  Voting Member 5.9% Other Mount Sinai Health System
Fogg Blaine   Voting Member 5.9%

Other

 

Icahn School of Medicine at Mount Sinai
Gandhi Niyum  Voting Member 5.9% Other Mount Sinai Health System

 

Key ACO clinical and administrative leadership:

Denise Prince ACO Executive
Meena Bansal Medical Director
Vivian Dillon Compliance Officer
Meena Bansal Quality Assurance/Improvement Officer

 

Associated committees and committee leadership:

Committee Name

Committee Leader Name and Position

Quality Improvement Committee

 

Chair: Dr. Dan Weisberg

 

Finance and Audit Committee

 

Chair: Brendan Loughlin

IT and Data-Analytics Committee

 

Chair: Michael Berger

 

Compliance Committee Chair: Vivion Dillon
Networking and Contracting Committee Chair: Edward Lucy
Credentialing and Peer Review Committee Chair: Stephen Teitelbaum

 

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

  • Networks of individual practices of ACO professionals
  • Hospital employing ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Second Agreement Period
    • Performance Year 2016, $0
  • First Agreement Period
    • Performance Year 2015, $0
    • Performance Year 2014, $0
    • Performance Year 2013, $0

Shared Savings Distribution

  • Second Agreement Period
    • Performance Year 2016
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
  • First Agreement Period
    • 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
    • Performance Year 2013
      • 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 83.8 79.9
ACO-2 CAHPS: How Well Your Providers Communicate 94.99 92.63
ACO-3 CAHPS: Patients' Rating of Provider 93.81 91.93
ACO-4 CAHPS: Access to Specialists 85.27 83.52
ACO-5 CAHPS: Health Promotion and Education 63.83 60
ACO-6 CAHPS: Shared Decision Making 76.18 75.28
ACO-7 CAHPS: Health Status/Functional Status 71.43 71.82
ACO-34 CAHPS: Stewardship of Patient Resources 22.93 27.52
ACO-8 Risk-Standardized, All Condition Readmission 14.73 14.7
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 16.53 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 49.39 53.2
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 66.48 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 53.6 59.81
ACO-9 Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 8.38 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 ) 12.45 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 92.57 82.72
ACO-39 Documentation of Current Medications in the Medical Record 91.31 87.54
ACO-13 Falls: Screening for Future Fall Risk 58.91 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization 67.99 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults 53.09 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 55.59 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 71.85 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 43.88 53.63
ACO-19 Colorectal Cancer Screening 40.98 61.52
ACO-20 Breast Cancer Screening 36.05 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented 57.79 76.84
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 80.4 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 22.91 18.24
ACO-41 Diabetes: Eye Exam   29.09 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 71.33 70.52
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 82.58 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 85.35 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%) 66.88 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 “Mount Sinai Care, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A52797 in the public use files on data.cms.gov.

Payment Rule Waivers

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

Contact Information

For General Information on ACOs:
Phone: 1-800-MEDICARE (1-800-633-4227)
24 hours a day/ 7 days a week
TTY users, call 1-877-486-2048

Confidential Compliance Hotline:
Phone: 1-800-853-9212
24 hours a day/ 7 days a week

For More Information on Mount Sinai Care:
Phone: 1-877-234-6667

What Providers Need to Know

Find out more about ACOs [PDF]