UMC Accountable Care Organization
Organizational Information
Annual Wellness Visits

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 Participants

ACO Participants :

Eileen Talusan-Garcia, M.D., P.A.

ACO Participant in Joint Venture :

ACO Participants :

SWAT SURGICAL ASSOCIATES LLP

ACO Participant in Joint Venture :

ACO Participants :

David R. Long, M.D., P.A.

ACO Participant in Joint Venture :

ACO Participants :

Ayman Karkoutly, M.D., P.A.

ACO Participant in Joint Venture :

ACO Participants :

UMC Physicians

ACO Participant in Joint Venture :

ACO Participants :

Texas Tech University Health Sciences Center Lubbock

ACO Participant in Joint Venture :

ACO Governing Body

Last Name :

Mulkey

First Name :

Zachary

Title/Position :

Member's Voting Power – Expressed as a percentage or number :

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 :

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 :

Member's Voting Power – Expressed as a percentage or number :

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 :

Member's Voting Power – Expressed as a percentage or number :

Membership Type :

Participant

ACO Participant Legal Business Name/DBA, if Applicable :

UMC Physicians

Last Name :

Sheets

First Name :

Randall

Title/Position :

Member's Voting Power – Expressed as a percentage or number :

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 :

Member's Voting Power – Expressed as a percentage or number :

Membership Type :

Participant

ACO Participant Legal Business Name/DBA, if Applicable :

Ayman Karkoutly, MD, PA

Last Name :

Buscemi

First Name :

Dolores

Title/Position :

Member's Voting Power – Expressed as a percentage or number :

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 :

Member's Voting Power – Expressed as a percentage or number :

Membership Type :

Participant

ACO Participant Legal Business Name/DBA, if Applicable :

UMC Physicians

Last Name :

MacKay

First Name :

Brendon

Title/Position :

Member's Voting Power – Expressed as a percentage or number :

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 :

Member's Voting Power – Expressed as a percentage or number :

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 :

Membership Type :

Beneficiary

ACO Participant Legal Business Name/DBA, if Applicable :

N/A

Last Name :

Sallee

First Name :

Caleb

Title/Position :

Member's Voting Power – Expressed as a percentage or number :

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 :

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 :

Marketing

Committee Leader Name and Position :

Brendan MacKay, 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

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

For 2018 Quality Performance Results please visit: https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/2018-Shared-Savings-Program-SSP-Accountable-Care-O/v47u-yq84/data

Note: In the Quality Performance Results file(s) above, search for “UMC Accountable Care LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A3895 in the public use files on data.cms.gov.

Payment Rule Waivers

No, our ACO does not use the SNF 3-Day Rule Waiver.

For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1.800.MEDICARE (1.800.633.4227). TTY users should call 1.877.486.2048.

Are you due for an Annual Medicare Wellness Visit?

You 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.

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