UMass Memorial Medicare Accountable Care Organization (ACO)

 

UMass Memorial ACO Focuses on Quality Care

A close-cropped shot of a dark-haired woman sitting between her aging parents.

Participating in the Medicare ACO is our commitment to providing the Worcester and Central Massachusetts region with quality, personalized and innovative care. Our Medicare ACO leverages our resources to focus on providing Medicare patients (also called Medicare Fee-for-Service beneficiaries) with the best possible experience of timely, appropriate and high-quality health care services.

  • Providing personalized care coordination services across the health continuum
  • Facilitating more effective physician visits and communication among your doctors and providers
  • Providing you with targeted health information and wellness programs that focus on disease prevention
  • Helping you coordinate timely appointments, manage medications and determine appropriate follow-up care
  • Improving the efficiency of your health care

Learn more below, or call our toll-free number at 844-549-0213.

For additional resources: Please visit www.medicare.gov or call 800-MEDICARE (800-633-4227) or (TTY users should call 877-486-2048) for general questions or additional information about Accountable Care Organizations. 

 

The Health Policy Commission (HPC) Accountable Care Organization (ACO) Certification Program

2025 ACO Seal

 

We are honored to receive ACO Certification from the Massachusetts Health Policy Commission.  This program is designed to accelerate care delivery transformation in Massachusetts and promote a high quality, efficient health system. The purpose of the HPC Accountable Care Organization ACO certification program is to complement existing local and national care transformation and payment reform efforts, encourage value-based care delivery, and promote investments by all payers in high-quality and cost-effective care across the continuum. 

 

ACO Name and Location      

UMass Memorial Accountable Care Organization, Inc.
One Biotech Park
365 Plantation Street, 3rd Floor
Worcester, MA 01605 

ACO Primary Contact

Caryn Sweeney
Phone: 774-445-2326
email us

ACO Participants

ACO Participants

ACO Participants in Joint Venture

Aesclepion Healthcare LLC

N

Associates in Otolaryngology Head and Neck Surgery, PC

N

Athol Memorial Hospital, Inc

N

Benjamin Grajales, MD

N

Center for Digestive Wellness PC

N

Central Mass Nephrology

N

Charles A. Birbara, MD

N

Charlton Family Practice

N

Community Healthlink, Inc

N

Community Neuroscience Services, LLC

N

Complete Family Medicine, PLLC

N

Curewell Gastroenterology, PC

N

D'Ambrosio Eye Care, Inc

N

Family Foot Care Center PC

N

Family Health Center of Worcester, Inc

N

Family Medical & Maternity Care PC

N

Focused Primary Care, PC

N

Gardner Family Medicine, Inc

N

Glen Bombardier

N

Harrington Memorial Hospital, Inc

N

Heart Rhythm Specialists of Central Massachusetts, PC

N

Henry Heywood Memorial Hospital

N

Heywood Medical Group, Inc

N

Holyoke Medical Center, Inc

N

Hugh Cooper

N

James M. Shenko, MD, PC

N

Lawrence M Dubuske MD

N

Leominster Dermatology LLP

N

Leominster Medical Associates

N

Leominster Primary Care LLC

N

Longview Orthopaedic Center, LLC

N

Marlboro Internal Medicine, PC

N

Mass Lung & Allergy PC

N

Medpractice PC

N

Mercy Family Practice PC

N

Milford Regional Medical Center Inc

N

Mountain View Family Practice, PC

N

Nancy D. Berube, MD PC

N

New England Hospitalists, PC

N

New England Medical Imaging, PC

N

North Worcester Gastroenterology, PC

N

Northeast Allergy, Asthma & Immunology, PC

N

Orthopaedic Associates of Marlboro, PC

N

Partners in Internal Medicine, PC

N

Paul Dufault

N

Primary Physician Partners

N

R. Leslie Shelton, MD, PC

N

Richard V. Montilla, MD, PC

N

Robert Byrne

N

Stephen Child

N

Sturbridge Professional Services, PC

N

Tad Baum, MD, PC

N

Tricia Vorderstrasse MD PC

N

UMass Memorial HealthAlliance Clinton Hospital, Inc

N

UMass Memorial Medical Center, Inc

N

UMass Memorial Medical Group, Inc

N

Vedere Pathology, PC

N

Vitreo-Retinal Associates PC

N

Vladas Litani, MD

N

Western Mass Physician Associates, Inc

N

William Brodkin

N

William Friedman

N

Worcester Eye Consultants, PC

N

Worcester Physicians and Nurses Services LLC

N

Zbigniew Dombek, MD

N

ACO Governing Body

Member Name

Member Title/Position

Member's Voting Power (as a %)

Membership Type

ACO Participant Legal Business Name, if applicable

Francesco Aiello, MD

Voting Member

7.14%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Charles Cavagnaro, MD

Voting Member

7.14%

ACO Participant Representative

UMass Memorial HealthAlliance Clinton Hospital, Inc.

Eric Dickson, MD

Chairman Voting Member

7.14%

ACO Participant Representative

UMass Memorial Medical Group, Inc.; UMass Memorial Medical Center, Inc.

John Greenwood

President Voting Member

7.14%

Other - ACO President

N/A

Barbara Kupfer

Voting Member

7.14%

Medicare Beneficiary Representative

N/A

Lalita Matta, MD

Voting Member

7.14%

ACO Participant Representative

Marlboro Internal Medicine, PC

Edward Moore

Voting Member

7.14%

ACO Participant Representative

Harrington Memorial Hospital, Inc.

Justin Precourt, RN

Voting Member

7.14%

ACO Participant Representative

UMass Memorial Medical Center, Inc.

Jennifer Reidy, MD

Voting Member

7.14%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Francis Sweeney, MD

Voting Member

7.14%

ACO Participant Representative

Heywood Medical Group, Inc., Henry Heywood Memorial Hospital

Joahd Touré, MD

Voting Member

7.14%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Stephen Tosi, MD

Voting Member

7.14%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Matthew Trainor, MD

Voting Member

7.14%

ACO Participant Representative

UMass Memorial Medical Group, Inc.

Kartik Viswanathan, MD 

Voting Member

7.14%

ACO Participant Representative

Holyoke Medical Center, Inc

Due to rounding, ‘Member’s Voting Power’ may not equal 100 percent.

 

Key ACO Clinical and Administrative Leadership:

  • ACO Executive: John Greenwood
  • Medical Director: Sarah McGee, MD
  • Compliance Officer: Jennifer Heil
  • Quality Assurance/Improvement Officer: Tracey Wilkie

Associated Committees and Committee Leadership

Committee Name

Committee Leader Name

Position

Finance Committee

Jeanne Shirshac

Chair

Quality Improvement Committee

Kastoori Iyengar, MD

Chair

Utilization/Care Management Committee

Sarah McGee, MD

Chair

Compliance Committee

Jennifer Heil

Chair

Governance Committee

John Greenwood

Chair

Types of ACO Participants or Combinations of Participants, That Formed the ACO:

  • ACO professionals in a group practice arrangement
  • Hospital employing ACO professionals
  • Networks of individual practices of ACO professionals

Shared Savings and Losses
Amount of Shared Savings/Losses:

  • Third Agreement Period
    • Performance Year 2024, $11,889,404
    • Performance Year 2023, $5,282,468
    • Performance Year 2022, $5,181,428
       
  • Second Agreement Period
    • Performance Year 2021, $0
    • Performance Year 2020, $6,732,247
    • Performance Year 2019, $0
    • Performance Year 2018, $0
       
  • First Agreement Period
    • Performance Year 2017, $9,105,746
    • Performance Year 2016, $0
    • Performance Year 2015, $0
       

Shared Savings Distribution:

  • Third Agreement Period
    • Performance Year 2024
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
         
    • 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: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
         
  • Second Agreement Period
    • Performance Year 2021
      • 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 2020
      • Proportion invested in infrastructure: 21%
      • Proportion invested in redesigned care processes/resources: 29%
      • Proportion of distribution to ACO participants: 50%
         
    • Performance Year 2019
      • 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 2018
      • 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 2017
      • Proportion invested in infrastructure: 26%
      • Proportion invested in redesigned care processes/resources: 24%
      • Proportion of distribution to ACO participants: 50%
         
    • 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
         
    • 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

 

 

Quality Performance Results

2024 Quality Performance Results:

Quality performance results are based on CMS Web Interface.

Measure #

Measure Name

Collection Type

Rate

ACO Mean

Measure #001

Diabetes: Hemoglobin A1c (HbA1c) Poor Control [1]

Web Interface

8.93

9.44

Measure #134

Preventative Care and Screening: Screening for Depression and Follow-up Plan

Web Interface

78.28

81.46

Measure #236

Controlling High Blood Pressure

Web Interface

80.37

79.49

Measure #318

Falls: Screening for Future Fall Risk

Web Interface

92.37

88.99

Measure #110

Preventative Care and Screening: Influenza Immunization

Web Interface

81.28

68.60

Measure #226

Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention

Web Interface

91.30

79.98

Measure #113

Colorectal Cancer Screening

Web Interface

79.01

77.81

Measure #112

Breast Cancer Screening

Web Interface

86.72

80.93

Measure #438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

Web Interface

91.27

86.50

Measure #370

Depression Remission at Twelve Months

Web Interface

10.11

17.35

Measure #479

Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups [1]

 

Administrative Claims

0.1583

0.1517

Measure #484

Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1]

Administrative Claims

38.62

37.00

CAHPS-1

Getting Timely Care, Appointments, and Information

CAHPS for MIPS Survey

85.37

83.70

CAHPS-2

How Well Providers Communicate

CAHPS for MIPS Survey

94.20

93.96

CAHPS-3

Patient’s Rating of Provider

CAHPS for MIPS Survey

92.20

92.43

CAHPS-4

Access to Specialists

CAHPS for MIPS Survey

73.38

75.76

CAHPS-5

Health Promotion and Education

CAHPS for MIPS Survey

70.15

65.48

CAHPS-6

Shared Decision Making

CAHPS for MIPS Survey

60.32

62.31

CAHPS-7

Health Status and Functional Status

CAHPS for MIPS Survey

76.44

74.14

CAHPS-8

Care Coordination

CAHPS for MIPS Survey

86.16

85.89

CAHPS-9

Courteous and Helpful Office Staff

CAHPS for MIPS Survey

93.40

92.89

CAHPS-11

Stewardship of Patient Resources

CAHPS for MIPS Survey

27.27

26.98

 

• For Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [Quality ID #001], Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [Measure #479], and Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], a lower performance rate indicates better measure performance.

 

• For Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], patients are excluded if they were attributed to Qualifying Alternative Payment Model (APM) Participants (QPs). Most providers participating in Track E and ENHANCED track ACOs are QPs, and so performance rates for Track E and ENHANCED track ACOs may not be representative of the care provided by these ACOs' providers overall. Additionally, many of these ACOs do not have a performance rate calculated due to not meeting the minimum of 18 beneficiaries attributed to non-QP providers.

For previous years’ Financial and Quality Performance Results, please visit Data.cms.gov.
 

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