ACO name and location
Baylor Quality Health Care Alliance LLC
301 N Washington Ave
Dallas, TX 75246
ACO primary contact
Sarah Habeeb
Sarah.Habeeb@BSWHealth.org
Organizational information
| ACO Participants | ACO Participant in Joint Venture (Y/N) |
|---|---|
| Baylor Heart & Vascular Center LLP | N |
| Baylor Scott & White Medical Center – Centennial | N |
| Baylor Scott & White Medical Centers – Capitol Area | N |
| Baylor Scott & White All Saints Medical Center – Fort Worth | N |
| Baylor Scott & White Medical Center – Irving | N |
| Baylor Scott & White Medical Center – Waxahachie | N |
| Baylor Scott & White Medical Center – McKinney | N |
| Baylor Scott & White Medical Center – Grapevine | N |
| Baylor Scott & White Medical Center – Plano | N |
| Baylor University Medical Center | N |
| HealthTexas Provider Network | N |
| Hillcrest Baptist Medical Center | N |
| Hillcrest Family Health Center | N |
| Hillcrest Physician Services | N |
| Lake Pointe Operating Company LLC | N |
| Scott & White Clinic | N |
| Scott & White Hospital - Brenham | N |
| Scott & White Hospital – College Station | N |
| Scott & White Hospital – Marble Falls | N |
| Scott & White Hospital – Round Rock | N |
| Scott & White Hospital – Taylor | N |
| Scott & White Memorial Hospital | N |
| Texas Heart Hospital of the Southwest LLP | N |
| 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 |
|---|---|---|---|---|---|
| Aval-Na’Ree | Green | MD, Voting Member, Secretary | 9.09% | ACO Participant Representative | Scott & White Memorial Hospital |
| James | Graham | MD, Voting Member, Vice Chair | 9.09% | ACO Participant Representative | Hillcrest Baptist Medical Center |
| W. Stuart | Johnston | MD, Voting Member | 9.09% | ACO Participant Representative | Baylor Scott & White Medical Center – Plano |
| Joseph | Kilianski | MD, Voting Member | 9.09% | ACO Participant Representative | Baylor Scott & White Medical Center - Grapevine |
| Kimberly | McMillin | MD, Voting Member, Chair | 9.09% | ACO Participant Representative | Baylor Scott & White Medical Center – Plano |
| Leigh | Nordstrom | MD, Voting Member | 9.09% | ACO Participant Representative | Baylor Scott & White Medical Center - Waxahachie |
| Alberto | Parra | MD, Voting Member | 9.09% | ACO Participant Representative | Baylor All Saints Medical Center |
| Mohanakrishnan | Sathyamoorthy | MD, Voting Member | 9.09% | ACO Participant Representative | Baylor All Saints Medical Center |
| Suneel | Vallabhaneni | MD, Voting Member | 9.09% | ACO Participant Representative | Scott & White Memorial Hospital |
| Clarence | Miller | Business Consultant | 9.09% | Medicare Beneficiary Representative | N/A |
| Jennifer | Mitzner | CFO | 9.09% | Other | N/A |
Key ACO clinical and administrative leadership
- ACO Executive: Akila Malik
- Medical Director: Dr. Robert Waterhouse
- Compliance Officer: Alyssa Moore
- Quality Assurance/Improvement Officer: Melissa Arana
| Committee Name | Committee Leader Name and Position |
|---|---|
| Quality Improvement Committee | Mike Massey MD, Chair; James Graham MD, Vice-Chair |
| Compliance Committee | Alan Jones MD, Chair |
| Membership and Standards Committee | Joseph Kilianski MD, Chair, Dominic Lucia MD, Co-Chair |
Types of ACO participants or combinations of participants that formed the ACO
- Partnerships or joint venture arrangements between hospitals and ACO professionals
- Networks of individual practices of ACO professionals
Shared savings and losses
Amount of shared savings/losses
Fourth agreement period
- Performance year 2023, $79,111,511
- Performance year 2022, $61,442,789
Third agreement period
- Performance year 2021, $61,050,959
- Performance year 2020, $47,128,683
- Performance year 2019-A, $20,420,593
Second agreement period
- Performance year 2019, $13,907,640
- Performance year 2018, $18,761,481
First agreement period
- Performance year 2017, $0
- Performance year 2016, $0
- Performance year 2015, $0
Shared savings distribution
Fourth agreement period
Performance year 2023
- Proportion invested in infrastructure: 12%
- Proportion invested in redesigned care processes/resources: 8%
- Proportion of distribution to ACO participants: 80%
Performance year 2022
- Proportion invested in infrastructure: 15%
- Proportion invested in redesigned care processes/resources: 42.5%
- Proportion of distribution to ACO participants: 42.5%
Third agreement period
Performance year 2021
- Proportion invested in infrastructure: 16%
- Proportion invested in redesigned care processes/resources: 42%
- Proportion of distribution to ACO participants: 42%
Performance year 2020
- Proportion invested in infrastructure: 11% Proportion invested in redesigned care processes/resources: 45%
- Proportion of distribution to ACO participants: 44%
Second agreement period
Performance year 2019
- Proportion invested in infrastructure: 20%
- Proportion invested in redesigned care processes/resources: 40%
- Proportion of distribution to ACO participants: 40%
Performance year 2018
- Proportion invested in infrastructure: 16%
- Proportion invested in redesigned care processes/resources: 42%
- Proportion of distribution to ACO participants: 42%
First agreement period
Performance year 2017
- 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 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
Quality performance results are based on CMS Web Interface
| Measure # | Measure Name | Collection Type | Reported Performance Rate | Current Year Mean Performance Rate (SSP ACOs) |
|---|---|---|---|---|
| 001 | Diabetes: Hemoglobin A1c Poor Control | CMS Web Interface | 4.80 | 9.84 |
| 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 91.47 | 80.97 |
| 236 | Controlling High Blood Pressure | CMS Web Interface | 79.00 | 77.80 |
| 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 99.77 | 89.42 |
| 110 | Preventative Care and Screening: Influenza Immunization | CMS Web Interface | 74.66 | 70.76 |
| 226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 95.24 | 79.29 |
| 113 | Colorectal Cancer Screening | CMS Web Interface | 87.16 | 77.14 |
| 112 | Breast Cancer Screening | CMS Web Interface | 91.36 | 80.36 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 90.17 | 87.05 |
| 370 | Depression Remission at Twelve Months | CMS Web Interface | 9.46 | 16.58 |
| 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups | Administrative Claims | 15.52 | 15.53 |
| 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions | Administrative Claims | N/A | 83.63 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | CAHPS for MIPS Survey | 82.87 | 83.68 |
| CAHPS-2 | How Well Providers Communicate | CAHPS for MIPS Survey | 93.46 | 93.69 |
| CAHPS-3 | Patient's Rating of Provider | CAHPS for MIPS Survey | 91.93 | 92.14 |
| CAHPS-4 | Access to Specialists | CAHPS for MIPS Survey | 73.82 | 75.97 |
| CAHPS-5 | Health Promotion and Education | CAHPS for MIPS Survey | 67.10 | 63.93 |
| CAHPS-6 | Shared Decision Making | CAHPS for MIPS Survey | 63.80 | 61.60 |
| CAHPS-7 | Health Status and Functional Status | CAHPS for MIPS Survey | 76.16 | 74.12 |
| CAHPS-8 | Care Coordination | CAHPS for MIPS Survey | 87.19 | 85.77 |
| CAHPS-9 | Courteous and Helpful Office Staff | CAHPS for MIPS Survey | 91.79 | 92.31 |
| CAHPS-11 | Stewardship of Patient Resources | CAHPS for MIPS Survey | 34.66 | 26.69 |
For previous year's Financial and Quality Performance Results, please visit data.cms.gov.
Payment rule waivers
- Skilled Nursing Facility (SNF) 3-day Rule Waiver:
- Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.
- Waiver for Payment for Telehealth Services:
- Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.