MSSP
ACO Name and Location
Banner Health Network
2901 N Central
Suite 160
Phoenix, AZ 85012
ACO Primary Contact
Kynda Wolfrum, Sr. Director, Government Operations
Phone: 970-810-8706
Email: Kynda.Wolfrum@bannerhealth.com
Organizational Information
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
|---|---|
| Accredited Family Healthcare PC | N |
| ADAM S. NALLY, D.O., P.C. | N |
| Advent Internal Medicine PLLC | N |
| AFFILIATED INTERNAL MEDICINE ASSOCIATES LLC | N |
| ALLIED MEDICAL ASSOCIATES PLC | N |
| AMARDEEP S MAJHAIL MD PC | N |
| ANTONIO T UVAS PLLC | N |
| ANTONIO V YU JR MD PC | N |
| Apex Internal Medicine, P.C. | N |
| ARIZONA INTERNAL MEDICINE & PEDIATRICS CORP. | N |
| Arizona Internal Medicine Associates LLC | N |
| ARIZONA PREFERRED PRIMARY CARE,PLC | N |
| Banner - - University Primary Care Physicians LLC | N |
| Banner Health | N |
| Banner Primary Care Physicians Arizona Llc | N |
| BENDEL CLINIC PLLC | N |
| Bestcare Internal Medicine PLLC | N |
| Blair T Butterfield PC | N |
| Brown Road Family Medicine PLLC | N |
| CENTRAL ARIZONA MEDICAL ASSOCIATES | N |
| Community Hospital Association Inc | N |
| Consultants In Internal Medicine PC | N |
| DESERET FAMILY MEDICINE AT GREENFIELD PLC | N |
| DESERET MEDICAL ASSOCIATES PLC | N |
| Desert View Family Medicine Pllc | N |
| Dipti Patel PLLC | N |
| Drew Durbin DO PLLC | N |
| ESTRELLA INTERNAL MEDICINE & GERIATRICS CLINIC, PLC | N |
| ESTRELLA SPECIALTY MEDICAL CARE P C | N |
| FALA MEDICAL CLINIC PLLC | N |
| FAMILY FIRST PHYSICIANS PLLC | N |
| FAMILY HEALTH CENTER OF EAST VALLEY PLLC | N |
| GOLD CANYON INTERNAL MEDICINE | N |
| GOOD HEALTH MEDICAL, PLLC | N |
| Good Years Family Medicine LLC | N |
| GRAND CANYON FAMILY MEDICINE PC | N |
| Greenfield Family Medicine LLC | N |
| HEALTHFIRST PRIMARY CARE, PLLC | N |
| Healthy Life Family Medicine Plc | N |
| Innovative Family Health Practices LLC | N |
| ISHA GUPTA MD PLLC | N |
| JAMES G LIEBER MD PLC | N |
| Karen Leber | N |
| Kyrene Internal Medicine Pllc | N |
| LEADING HEALTHCARE CLINIC OF GOODYEAR, LLC | N |
| M ZUHDI JASSER MD PC | N |
| MADHURI DHUPATI M.D. & ASSOCIATES PC | N |
| MAXWELL GROUP | N |
| Medcubed PLLC | N |
| MESA FAMILY PHYSICIANS, PLC | N |
| Monaliza Setudehnia MD PLLC | N |
| NEENA K UPPAL MD PC | N |
| NESTOR N. NAZARENO MD PC | N |
| NORTERRA FAMILY MEDICINE, PLLC | N |
| Ofelia Popluca | N |
| Paul S. Charnetsky, M.D. P.C. | N |
| Pete S Coury Md Pllc | N |
| Phoenix West Internal Medicine Llc | N |
| Pinakin G Bhakta MD PC | N |
| Pinnacle Family Medicine, Plc | N |
| Pradip Patel MD PC | N |
| S P GILL MD PC | N |
| SARITA S. SHARMA, M.D., INTERNAL MEDICINE P.L.L.C. | N |
| Southwest Internal Medicine Llc | N |
| Sun City Internal Medicine | N |
| Sunrise Internal Medicine PC | N |
| SUNRISE MEDICAL ASSOCIATES LLC | N |
| SURPRISE MEDICAL CONSULTANTS LLC | N |
| TESAI,PLC | N |
| THOMPSON MEDICAL GROUP | N |
| Valley Internal Medicine and Pediatrics PC | N |
| VERSATILE MEDICINE PLLC | N |
| Wabash Medical Associates P C | N |
| WESTSIDE INTERNAL MEDICINE PC | N |
| WESTSIDE PRIMARY CARE ASSOCIATES PLLC | N |
ACO Governing Body
| Last Name | First Name | Title/Position | Member's Voting Power Expressed as a percentage | Membership Type | ACO Participant Legal Business Name/DBA, if Applicable |
|---|---|---|---|---|---|
| Engstrom | David | Manager | 7.14% | ACO Participant Representative | Pinnacle Family Medicine |
| Bader | Karen | Chair | 7.14% | ACO Participant Representative | Desert View Family Medicine LLC |
| Bessel | Marjorie | Manager | 7.14% | ACO Participant Representative | Banner Health |
| Birdi | Shiva | Manager | 7.14% | ACO Participant Representative | Banner Primary Care Physicians Arizona LLC |
| Caplan | Joseph | Manager | 7.14% | Other: Specialty Network | N/A |
| Sickler | Donna | Manager | 7.15% | ACO Participant Representative | Banner Health |
| Piette | Randy | Manager | 7.15% | ACO Participant Representative | Maxwell Group |
| Ritchie | Thomas | Manager | 7.14% | Other: Specialty Network | N/A |
| Sodhi | Amandeep | Manager | 7.14% | ACO Participant Representative | Westside Internal Medicine |
| Valenzuela | David | Manager | 7.14% | ACO Participant Representative | Banner Primary Care Physicians Arizona LLC |
| Weissman | Jerry | Beneficiary | 7.14% | N/A | N/A |
| Werner | Todd | Manager | 7.15% | ACO Participant Representative | Banner Health |
| Zismann | Nancy | Manager | 7.15% | ACO Participant Representative |
Banner Primary Care Physicians Arizona LLC |
| Dickerson | Staci | Manager | 7.14% | ACO Participant Representative | Banner Health |
Key ACO Clinical and Administrative Leadership
ACO Executive: Kynda Wolfrum, RN, MSN
Medical Director: Ed Clarke, M.D.
Compliance Officer: Sean Reneau
Quality Assurance/Improvement Officer: Sandra Robles-Caraveo
Associated Committees and Committee Leadership
Compliance Committee - Sean Reneau, Compliance Officer
Medical Executive Committee - Dr. Ed Clarke, VP, CMO Insurance Division
Types of ACO Participants, or Combinations of Participants,that formed the ACO
• Networks of individual practices of ACO professionals
Shared Savings and Losses:
Amount of Shared Savings/Losses
-
Fourth Agreement Period
-
Performance Year n/a, $ n/a
-
-
Third Agreement Period
-
Performance Year n/a, $ n/a
-
-
Second Agreement Period
-
Performance Year 2023, $11,105,925
-
Performance Year 2022, $22,965,884
-
-
Performance Year 2021, $25,580,704
-
Performance Year 2020, $12,893,795.33
-
Performance Year 2019, $3,908,104
-
First Agreement Period
-
Performance Year 2019, $3,908,104
-
Performance Year 2018, $4,471,259
-
Performance Year 2017, $0
-
Note: Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
Shared Savings Distribution:
-
Fourth Agreement Period
-
Performance Year N/A
-
Proportion invested in infrastructure:
-
Proportion invested in redesigned care processes/resources:
-
Proportion of distribution to ACO participants:
-
-
-
Third Agreement Period
-
Performance Year N/A
-
Proportion invested in infrastructure:
-
Proportion invested in redesigned care processes/resources:
-
Proportion of distribution to ACO participants:
-
-
-
Second 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: 25%
-
Proportion invested in redesigned care processes/resources: 25%
-
Proportion of distribution to ACO participants: 50%
-
-
Performance Year 2021
-
Proportion invested in infrastructure: 25%
-
Proportion invested in redesigned care processes/resources: 25%
-
Proportion of distribution to ACO participants: 50%
-
-
Performance Year 2020
-
Proportion invested in infrastructure: 25%
-
Proportion invested in redesigned care processes/resources: 25%
-
Proportion of distribution to ACO participants: 50%
-
-
Performance Year 2019
-
Proportion invested in infrastructure: 25%
-
Proportion invested in redesigned care processes/resources: 25%
-
Proportion of distribution to ACO participants: 50%
-
-
-
First Agreement Period
-
Performance Year 2019
-
Proportion invested in infrastructure: 25%
-
Proportion invested in redesigned care processes/resources: 25%
-
Proportion of distribution to ACO participants: 50%
-
-
Note: Our ACO participated in multiple performance years during Calendar Year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.
Quality Performance Results
2023 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)/th> |
|---|---|---|---|---|
| 001 | Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) | CMS Web Interface | 4.62 | 9.84 |
| 134 | Preventive Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 86.30 | 80.97 |
| 236 | Controlling High Blood Pressure | CMS Web Interface | 81.61 | 77.80 |
| 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 93.99 | 89.42 |
| 110 | Preventive Care and Screening: Influenza Immunization | CMS Web Interface | 83.26 | 70.76 |
| 226 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 81.82 | 79.29 |
| 113 | Colorectal Cancer Screening | CMS Web Interface | 86.69 | 77.14 |
| 112 | Breast Cancer Screening | CMS Web Interface | 88.02 | 80.36 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 86.75 | 87.05 |
| 370 | Depression Remission at Twelve Months | CMS Web Interface | 10.53 | 16.58 |
| 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [1] | Administrative Claims | 0.1522 | 0.1553 |
| 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] | Administrative Claims | -- | 35.39 |
For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.
Payment Rule Waivers
Skilled Nursing Facility (SNF) 3-day Rule Waiver:
Yes, our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR 425.612