ACO name and location

Baylor Quality Health Care Alliance LLC
2301 N Washington Ave
Dallas, TX 75246

ACO primary contact

Sarah Habeeb
Sarah.Habeeb@BSWHealth.org

Organizational information

ACO participants

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 All Saints Medical Center

N

Baylor Medical Center at Irving

N

Baylor Medical Center at Waxahachie

N

Baylor Medical Centers at Garland and McKinney

N

Baylor Regional Medical Center at Grapevine

N

Baylor Regional Medical Center at 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



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

Aval-Na’Ree

Green

MD, Voting Member, Secretary

11%

ACO Participant Representative

Scott & White Memorial Hospital

James

Graham

MD, Voting Member, Vice Chair

11%

ACO Participant Representative

Hillcrest Baptist Medical Center

W. Stuart

Johnston

MD, Voting Member

11%

ACO Participant Representative

Baylor Scott & White – Plano

Joseph

Kilianski

MD, Voting Member

11%

Other

N/A

Kimberly

McMillin

MD, Voting Member, Chair

11%

ACO Participant Representative

Baylor Scott & White – Plano

Leigh

Nordstrom

MD, Voting Member

11%

ACO Participant Representative

Baylor Scott & White Medical Center - Waxahachie

Alberto

Parra

MD, Voting Member

11%

Other

N/A

Mohanakrishnan

Sathyamoorthy

MD, Voting Member

11%

Other

N/A

Suneel

Vallabhaneni

MD, Voting Member

11%

ACO Participant Representative

Scott & White Memorial Hospital

Clarence

Miller

Business Consultant

0%

Medicare Beneficiary Representative

N/A

Key ACO clinical and administrative leadership

  • ACO Executive: Jennifer Reed
  • Medical Director: Dr. Michael Massey     
  • Compliance Officer: Alyssa Moore 
  • Quality Assurance/Improvement Officer: Melissa Arana

Associated committees and committee leadership

Committee Name

Committee Leader Name and Position

Quality Improvement Committee

 

Mike Massey MD, Chair; James Graham MD, Vice-Chair

Compliance Committee

Keith Newman MD, Chair

Membership and Standards Committee

Joseph Kilianski MD, 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 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 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

2022 quality performance results

Quality performance results are based on CMS Web Interface

Measure #

Measure Name

Collection Type

Rate

ACO Mean

001

Diabetes: Hemoglobin A1c Poor Control

CMS Web Interface

8.02

10.71

134

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

CMS Web Interface

92.55

76.97

236

Controlling High Blood Pressure

CMS Web Interface

75.23

76.16

318

Falls: Screening for Future Fall Risk

CMS Web Interface

99.04

87.83

110

Preventative Care and Screening: Influenza Immunization

CMS Web Interface

84.19

77.34

226

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

CMS Web Interface

90.62

79.27

113

Colorectal Cancer Screening

CMS Web Interface

84.27

75.32

112

Breast Cancer Screening

CMS Web Interface

88.61

78.07

438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

CMS Web Interface

91.89

86.37

370

Depression Remission at Twelve Months

CMS Web Interface

8.75

16.03

321

CAHPS for MIPS

CAHPS for MIPS Survey

N/A

N/A

479

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

Administrative Claims

15.26

15.10

484

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

Administrative Claims

31.36

30.97

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.