UMC Accountable Care Organization

  • UMC Accountable Care Organization
  • Organizational Information
  • Annual Wellness Visits
UMC Accountable Care Organization

UMC Accountable Care Organization

ACO Name and Location

UMC Accountable Care LLC
Previous Names: N/A
602 Indiana Avenue
Lubbock, TX 79415

ACO Primary Contact

Primary Contact Name
Brickland Easton
Primary Contact Phone Number
806.775.9093
Primary Contact Email Address
brickland.easton@umchealthsystem.com

Mission / Vision:

The mission of UMC Accountable Care, LLC is: "To improve the health of the population and communities we serve by coordinating care to achieve high quality clinical outcomes, enhance the patient experience, and manage medical costs."

About UMC Accountable Care, LLC:

UMC Accountable Care, LLC was established on May 24, 2017 for the purpose of integrating medical professionals to work together to coordinate patient-centered, high quality, and efficient care under the Medicare Shared Savings Program ("MSSP"). UMC Accountable Care, LLC is dedicated to the overall improvement of its beneficiaries and will continue to evolve with the market as conditions change and meet the demands of its constituents with the appropriate care.

UMC Accountable Care, LLC consists primarily of two large physician organizations serving as Participants and a health system Provider. The two physician groups are UMC Physicians ("UMCP") and Texas Tech University Health Sciences Center ("TTUHSC") Physicians encompassing a combined total of 325 physicians and are accompanied by a Provider, University Medical Center ("UMC"). UMC Accountable Care, LLC is comprised of a governing body who will hold a fiduciary responsibility and is responsible for the oversight and strategic direction of the ACO.

Serving as a Provider to the ACO, UMC, is currently affiliated with the CMS Mandatory Comprehensive Joint Replacement ("CJR") Program which has enabled the Provider to gain much needed experience in episodic payment management, care coordination, care transition, quality improvement, and beneficiary engagement. These findings and evidence-based practices garnered from the CJR Program will be utilized in the ACO setting and disseminated to all ACO Participants. Through the efforts and coordination of care, the Provider has been able to reduce utilization and Medicare spend in the CJR program has gone down 16% for this patient population.

Organizational Information

ACO-Organizational-informationACO Participants

ACO Participants
ACO Participant in Joint Venture
ACO Participants :
Eileen Talusan-Garcia, M.D., P.A.
ACO Participant in Joint Venture :
N
ACO Participants :
SWAT SURGICAL ASSOCIATES LLP
ACO Participant in Joint Venture :
Y
ACO Participants :
David R. Long, M.D., P.A.
ACO Participant in Joint Venture :
N
ACO Participants :
Ayman Karkoutly, M.D., P.A.
ACO Participant in Joint Venture :
N
ACO Participants :
UMC Physicians
ACO Participant in Joint Venture :
N
ACO Participants :
Texas Tech University Health Sciences Center Lubbock
ACO Participant in Joint Venture :
N

ACO Governing Body

Member
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
Last Name :
Mulkey
First Name :
Zachary
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
Texas Tech University Health Sciences Center Lubbock
Last Name :
Cook
First Name :
Ron
Title/Position :
Chair
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
Texas Tech University Health Sciences Center Lubbock
Last Name :
Ragain
First Name :
Mike
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
Texas Tech University Health Sciences Center Lubbock
Last Name :
Saleem
First Name :
Kashif
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
UMC Physicians
Last Name :
Sheets
First Name :
Randall
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
Texas Tech University Health Sciences Center Lubbock
Last Name :
Karkoutly
First Name :
Ayman
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
Ayman Karkoutly, MD, PA
Last Name :
Buscemi
First Name :
Dolores
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
Texas Tech University Health Sciences Center Lubbock
Last Name :
Barker
First Name :
Craig
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
UMC Physicians
Last Name :
MacKay
First Name :
Brendon
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
Texas Tech University Health Sciences Center Lubbock
Last Name :
Fondon
First Name :
Jen
Title/Position :
RN
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Other
ACO Participant Legal Business Name/DBA, if Applicable :
N/A
Last Name :
Middlebrook
First Name :
Doyce
Title/Position :
 
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Beneficiary
ACO Participant Legal Business Name/DBA, if Applicable :
N/A
Last Name :
Sallee
First Name :
Caleb
Title/Position :
MD
Member's Voting Power – Expressed as a percentage or number :
1
Membership Type :
Participant
ACO Participant Legal Business Name/DBA, if Applicable :
SWAT Surgical Associates, LLP

 

Key ACO Clinical and Administrative Leadership

William Eubanks
ACO Executive
Zachary Mulkey
Medical Director
Lana Daniel
Compliance Officer
Jen Fondon
Quality Assurance/Improvement Officer

Associated committees and Committee Leadership

Committee Name
Committee Leader Name and Position
Committee Name :
Care Coordination
Committee Leader Name and Position :
Randall Sheets, MD, Chair
Committee Name :
Post-Acute Care
Committee Leader Name and Position :
Mike Ragain, MD, Chair
Committee Name :
Utilization
Committee Leader Name and Position :
Dolores Buscemi, MD, Chair
Committee Name :
Quality
Committee Leader Name and Position :
Zachary Mulkey, MD, Chair
Committee Name :
Quality, Regulatory, and Informatics
Committee Leader Name and Position :
Zachary Mulkey, M.D., Chair

Types of ACO participants, or combinations of participants, that formed the ACO:

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

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2018, $0

Shared Savings Distribution

  • First Agreement Period
    • 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

Quality Performance Results

2018 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 87.69 86.14
ACO-2 CAHPS: How Well Your Providers Communicate 93.66 93.93
ACO-3 CAHPS: Patients’ Rating of Provider 94.45 92.45
ACO-4 CAHPS: Access to Specialists 81.54 81.50
ACO-5 CAHPS: Health Promotion and Education 54.83 59.26
ACO-6 CAHPS: Shared Decision Making 63.96 61.94
ACO-7 CAHPS: Health Status/Functional Status 73.04 73.35
ACO-34 CAHPS: Stewardship of Patient Resources 32.22 26.26
ACO-8 Risk Standardized, All Condition Readmission 14.33 14.98
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 18.50 18.59
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 39.60 37.01
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 69.35 76.75
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 54.65 59.00
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91) 2.17 1.98
ACO-11 Use of Certified EHR Technology 99.82 98.20
ACO-12 Medication Reconciliation Post-Discharge 94.34 85.91
ACO-13 Falls: Screening for Future Fall Risk 55.71 79.73
ACO-44 Use of Imaging Studies for Low Back Pain 76.47 64.36
ACO-14 Preventive Care and Screening: Influenza Immunization 54.95 72.71
ACO-15 Pneumonia Vaccination Status for Older Adults 60.64 75.97
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 91.73 76.83
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 65.52 72.81
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 15.64 66.74
ACO-19 Colorectal Cancer Screening 54.84 68.27
ACO-20 Breast Cancer Screening 65.35 71.96
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 75.85 81.47
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 25.00 15.51
ACO-41 Diabetes: Eye Exam 35.77 52.42
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 64.86 73.10
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet 82.05 88.92

For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.

Payment Rule Waivers

  • No, our ACO does not use the SNF 3-Day Rule Waiver.
  • Waiver for Payment for Telehealth Services:
    • No, our ACO clinicians do not provide telehealth services using the flexibilities under 42 CFR 425.612(f) and 42 CFR 425.613.

Are you due for an Annual Medicare Wellness Visit?

IMG_0266You may have recently received a postcard in the mail regarding scheduling your Medicare wellness visit. You received this card because you don’t have an established primary care provider, or you see a specialist for the majority or your care. If you normally see a specialist for your healthcare needs, it is important for you to establish a relationship with a Primary Care provider. All of the providers listed below are available to do these visits. Select a provider and call their office today to get your visit scheduled!

Or if you would like to utilize our online scheduling tool, you can schedule your Annual Medicare Wellness Visit by requesting an appointment with one of the providers listed below using MyTeamCare.

Visit https://mycare.iqhealth.com/ or MyTeamCare.com to schedule your next appointment!

To learn more about MyTeamCare read our FAQ.

What To Expect At Your Visit

At your Medicare annual wellness visit, your provider may do the following:

  • Administer a health risk assessment (HRA)
  • Collect and document information about:
    • Demographics;
    • Self-assessment of health;
    • Psychosocial risks;
    • Behavioral risks;
    • Activities of daily living (ADLs), including, but not limited to dressing, bathing, and walking; and
    • Instrumental ADLs, including, but not limited to shopping, housekeeping, medication management, and the handling of finances.
  • List current providers and suppliers of health care.
  • Establish medical and family health history.
  • Document risk factors for potential depression or other mood disorders
  • Obtain and document information about:
    • Height;
    • Weight;
    • Body mass index (BMI);
    • Blood pressure; and
    • Other routine measurements appropriate to gather a thorough medical or family history.
IMG_0051

Note: This visit is not intended to address specific problem areas or chronic conditions. You will need to schedule a separate appointment for us to meet your comprehensive healthcare needs or perform any lab works/testing. If existing conditions are addressed during this visit, the corresponding co-pay and deductibles will apply.

These providers have the most availability. Call today!

Jessica Gray, MD
Southwest Medical
4004 82nd
806.792.1050

Sydni Sprecher, NP
Southwest Medical
4004 82nd
806.722.7400

Angela Hannaway, PA
Wolfforth
502 E Hwy 62/82
806.866.0158

Kayla Beier, NP
Lakeridge Medical Center
5130 82nd
806.794.9378

Other UMC clinics available for Annual Wellness Visits:

UMC Internal Medicine
808 Joliet Ave Suite 220
Lubbock, TX 79415
806.761.0566

Craig Barker, MD
6205 43rd St
Lubbock, TX 79407
806.749.2263

Freedom Clinic
5022 Ave Q
Lubbock, TX 79412
806.762.3597

Garza County Health Clinic
1104 North Ave S
Post, TX 79356
806.495.2583

I-27 Medical Center
4105 I-27
Lubbock, TX 79404
806.762.2633

Idalou Clinic
113 Walnut St
Idalou, TX 79329
806.892.2537

Internal Medicine Associates of Lubbock
3502 9th St Suite 110
Lubbock, TX 79415
806.762.8461

KingsPark Family Health Center
7501 Quaker Ave
Lubbock, TX 79424
806.788.3306

LakeRidge Medical Center
5130 82nd St
Lubbock, TX 79424
806.794.9378

Milwaukee Family Medicine
7301 Milwaukee Ave
Lubbock, TX 79424
806.761.0464

Orchard Park Family Medicine
4420 114th St
Lubbock, TX 79415
806.761.0566

Shallowater Clinic
1502 12th St A
Shallowater, TX 79363
806.832.4566

Slaton Primary Medical Clinic
130 North 7th St
Slaton, TX 79364
806.828.5822

Southwest Family Medical Center
4004 82nd St
Lubbock, TX 79423
806.792.1050

West Wind Primary Health Center
5520 4th St 
Lubbock, TX 79416
806.761.0475

Wolfforth Clinic
502 East Highway 62/82
Wolfforth, TX 79382
806.866.0158

Texas Tech clinics available for Annual Wellness Visits:

Texas Tech Internal Medicine
3601 4th st 2nd Floor
Lubbock, TX 79430
806.743.3150
Texas Tech Family Medicine
3601 4th st 1st Floor
Lubbock, TX 79430
806.743.2757
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