MSSP
ACO Name and Location
Banner Health Network
2901 N Central
Suite 160
Phoenix, AZ 85012
ACO Primary Contact
Nicole Dorsey, ACO Senior Manager
Phone: (602)-418-7175
Email: Nicole.Dorsey@bannerhealth.com
Organizational Information
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
|---|---|
| Adam S. Nally, D.O., PC | N |
| Affiliated Internal Medicine Associates LLC | N |
| Alfonso A Tan MD PC | N |
| Amardeep S Majhail MD PC | N |
| Antonio T Uvas PLLC | N |
| Antonio V Yu JR MD PC | N |
| Arizona Internal Medicine & Pediatrics Corp | N |
| Airzona Preferred Primary Care, PLC | N |
| Artisan Primary Care PLLC | N |
| Accredited Family Healthcare PC | N |
| Advent Internal Medicine PLLC | N |
| Apex Internal Medicine, P.C. | N |
| Arizona Internal Medicine Associates LLC | N |
| Arvind Mahadevan | N |
| Banner -- University Primary Care Physicians LLC | N |
| Banner Health | N |
| Banner Primary Care Physicians Arizona LLC | N |
| Bestcare Internal Medicine PLLC | N |
| Blair T Butterfield PC | N |
| Brown Road Family Medicine PLLC | N |
| Central Arizona Medical Associates | N |
| Clinic For Chest Diseases PLLC | N |
| Chandler Primary Care | N |
| Christopher Stalberg MD PLLC | N |
| Community Hospital Association Inc | N |
| Consultants In Internal Medicine PC | N |
| D&V Soni Md Pc | N |
| Deseret Medical Associates PLC | N |
| Dan Hoag, D.O., Plc | N |
| Desert Rose Medical Consultants PC | N |
| Desert View Family Medicine Pllc | N |
| Dipti Patel PLLC | N |
| Drew Derbin DO PLLC | N |
| Estrella Internal Medicine & Geriatrics Clinic, PLC | N |
| Estrella Specialty Medical Care P C | N |
| F7 Medical Llc | N |
| Family First Physicians PLLC | N |
| Gold Canyon Internal Medicine | N |
| Grand Canyon Family Medicine PC | N |
| Good Years Familiy Medicine LLC | N |
| Greenfield Family Medicine LLC | N |
| Healthy Life Corporation | N |
| Health Life Family Medicine Plc | N |
| Isha Gupta MD PLLC | N |
| Indigo Health Clinic PC | N |
| Innovative Family Health Practices LLC | N |
| Internal Medicine Physicians Associates PC | N |
| James G Lieber MD PLC | N |
| John Prieve DO A Professional Corporation | N |
| Jared Dayton Do Pc | N |
| Joe Hayashi Pc | N |
| Jones Family Medicine & Pain Centers Pllc | N |
| Kachina Family Practice | N |
| Karen Leber | N |
| Kyrene Internal Medicine Pllc | N |
| M Zuhdi Jasser MD PC | N |
| Madhuri Dhupati M.D & Associates PC | N |
| Maxwell Group | N |
| Mesa Family Physicians, PLC | N |
| Mohammad Jamil PC | N |
| Medcubed PLLC | N |
| Michael B Bayless & Associates LLC | N |
| Monaliza Setudehnia MD PLLC | N |
| Neena K Uppal MD PC | N |
| Nestor N. Nazareno MD PC | N |
| Newco Hatfield Medical Group PLLC | N |
| Norterra Family Medicine, PLLC | N |
| Ofelia Popluca | N |
| Patricia R Reiff Md PC | N |
| Paul S. Charnetsky, M.D. P.C. | N |
| Pete S Coury Md Pllc | N |
| Phoenix West Internal Medicine Llc | N |
| Pinkakin G Bhakta MD PC | N |
| Pinnacle Family Medicine, Plc | N |
| Pradip Patel MD PC | N |
| Rama Devineni | N |
| Richard F Fowler Md Pc | N |
| S P Gill MD PC | N |
| Sarita S. Sharma, M.D., Internal Medicine P.L.L.C | N |
| Sunrise Medical Associates LLC | N |
| Surprise Medical Consultants LLC | N |
| San Tan Primary Care PC | N |
| Scottsdale Primary Care PC | N |
| Southwest Internal Medicine Llc | N |
| Sun City Internal Medicine | N |
| Sunrise Internal Medicine PC | N |
| Sunset Family Physicians P.C. | N |
| Thompson Medical Group | N |
| Trident Clinical Pllc | N |
| Valley Internal Medicine and Pediatrics PC | N |
| Westside Internal Medicine PC | N |
| Westview Family Medicine, P.C. | N |
| Wabash Medical Associates P C | N |
ACO Governing Body
| Last Name | First Name | Title/Position | Member's Voting Power -Expressed as a percentage or number | Membership Type | ACO Participant Legal Business Name/DBA, if Applicable |
|---|---|---|---|---|---|
| Agnone | Frank | Physician | 1 | ACO Participant Representative | Internal Medicine Physicians Associates PC |
| Bader | Karen | Physician | 1 | ACO Participant Representative | Desert View Family Medicine LLC |
| Bessel | Marjorie | Chief Clinical Officer & Physician | 1 | ACO Participant Representative | Banner Health |
| Blair | Butterfield | Physician | 1 | ACO Participant Representative | Blair T Butterfield PC |
| Caplan | Joseph | Physician | 1 | Other: Specialty Network | Joseph A Caplan MD PC DBA Cardiac Solutions |
| Crispin | Nancy | Medicare Beneficiary | 1 | Other: Medicare Beneficiary | |
| Fowler | Richard | Physician | 1 | ACO Participant Representative | Richard F Fowler Md Pc |
| Gregory | Joe | BMG Western Region Admin Region & Physician | 1 | ACO Participant Representative | Banner Primary Care Physicians Arizona LLC |
| Kuhn | Becky | Banner Chief Operating Officer | 1 | ACO Participant Representative | Banner Health |
| Laraway | Dennis | Banner Chief Financial Officer | 1 | ACO Participant Representative | Banner Health |
| Piette | Randy | Physician | 1 | ACO Participant Representative | Maxwell Group |
| Rankin | Patrick | BMG CEO & Physician | 1 | ACO Participant Representative | Banner Primary Care Physicians Arizona LLC |
| Ritchie | Thomas | Physician | 1 | Other: Specialty Network | Tri-City Cardiology |
| Sodhi | Amandeep | Physician | 1 | ACO Participant Representative | Westside Internal Medicine |
| Valenzuela | David | BMG AZ East Admin Region & Physician | 1 | ACO Participant Representative | Banner Primary Care Physicians Arizona LLC |
| Werner | Todd | Banner President, AZ Community Delivery | 1 | ACO Participant Representative | Banner Health |
| Zismann | Nancy | BMG Chief Clinical Services Officer | 1 | ACO Participant Representative | Banner Primary Care Physicians Arizona LLC |
Key ACO Clinical and Administrative Leadership
Chuck Lehn, ACO Executive
Ed Clarke, M.D., Medical Officier
Adam Barker, Compliance Officer
Sandra Robles-Caraveo, Quality Assurance/Improvement Officer
Associated Committees and Committee Leadership
Finance & Business Committee - Rick Warren, BHN Chief Financial Officer
Compliance Committee - Adam Barker, Compliance Officer
Care Management Advisory Committee - Dr. Ed Clarke, Insurance Division Chief Medical Officer
Types of ACO Participants, or Combinations of Participants,that formed the ACO
• Networks of individual practices of ACO professionals
• Partnerships or joint venture arrangements between hospitals and ACO professionals
Shared Savings and Losses:
Amount of Shared Savings/Losses
-
Second Agreement Period
-
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:
-
Second 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%
-
-
-
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
2019 Quality Performance Results
| ACO# | Measure Name | Rate | ACO Mean |
|---|---|---|---|
| ACO-1 | CAHPS: Getting Timely Care, Appointments and Information | 80.77 | 85.86 |
| ACO-2 | CAHPS: How Well Your Provider Communicates | 91.81 | 94.11 |
| ACO-3 | CAHPS: Patients' Rating of Provider | 90.8 | 92.69 |
| ACO-4 | CAHPS: Access to Specialists | 78.94 | 81.54 |
| ACO-5 | CAHPS: Health Promotion and Education | 61.68 | 60.44 |
| ACO-6 | CAHPS: Shared Decision Making | 57.03 | 62.72 |
| ACO-7 | CAHPS: Health Status/Functional Status | 75.23 | 73.79 |
| ACO-34 | CAHPS: Stewardship of Patient Resources | 23.48 | 26.17 |
| ACO-45 | CAHPS: Courteous and Helpful Office Staff | 92.02 | 92.84 |
| ACO-46 | CAHPS: Care Coordination | 85.68 | 86.89 |
| ACO-8 | Risk Standardized, All Condition Readmission | 14.37 | 14.86 |
| ACO-38 | All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions | 45.41 | 58.15 |
| ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ* Prvention Quality Indicator (PQI#91)) | 1.29 | 1.87 |
| ACO-13 | Falls: Screening for Future Fall Risk | 90.67 | 84.04 |
| ACO-14 | Preventive Care and Screening: Influenz Immunization | 80.75 | 74.77 |
| ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 79.31 | 78.04 |
| ACO-18 | Preventive Care and Screening: Screening for Depression and Follow-up Plan | 74.02 | 70.4 |
| ACO-19 | Colorectal Cancer Screening | 78.47 | 70.76 |
| ACO-20 | Breast Cancer Screening | 84.66 | 73.84 |
| ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 84.71 | 82.17 |
| ACO-27 | Diabetes: Hemoglobin A1c Poor Control (>9%) | 9.68 | 13.88 |
| ACO-28 | Controlling High Blood Pressure | 74.75 | 75.04 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.
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