Total Care ACO, LLC d/b/a Orange Accountable Care of New York

ACO Name and Location

Total Care ACO, LLC
Previous Names: N/A
14750 NW 77th Ct
Suite 308
Miami Lakes, FL 33016

ACO Primary Contact

Primary Contact Name Lissette Exposito, RN, BSN, MHSA, President & CEO
Primary Contact Phone Number 786.363.8500
Primary Contact Email Address Lisstte.Exposito@orangecaregroup.com

 

Organizational Information

ACO participants:

ACO Participants ACO Participant in Joint Venture (Enter Y or N)
JAVID YADEGAR MD PLLC N
Naushin Siddiqui Physician Pc N
WALFORD LINDO MD N
Maurice Alwaya, M.D. N
Ira Hollander N
Chenna Reddy N
Aron Rubin N
George Moskowitz N
Victor Goldbetter N
GERALD VALME MD PC N
Nabat Medical PC N
Bernard Rimler N
Benzion Sacolick N
Catalina Rosca-Sipot N
EUGENE GIBILARO MD N
Ezra Israel N
Alan Levenson N
Robert Husney N
Ira Steinmetz N
Howard Rosenfeld MD N
GERALD VALME N
Michael Josovitz N
Tarek Hegazi N
David Ziemba N
George Apergis N
Elliot Lederman N
Joseph Slomowits, MD N
Yefim Ornstein N
Marcel Pintea, MD N
Barry Buls N
Anthony Bertelle N
Larry Neuman N
EMANUEL SCHIOWITZ DO PC N
C B Reddy PC N
Harry Shapiro, Md Alan P Goldman, Md Steven C Tawil, Md, Pc N
WALFORD B. LINDO, M.D.PC N
Ocean Parkway Family Practice Associates PC N
Ira M. Steinmetz, M.D., P.C. N
Robert Moskowitz N
Jonathan Klahr N
Michael Josovitz, MD N
Benjamin Lifshitz N
COMPREHENSIVE GERIATRIC MEDICINE PC N
Monogram Medical PC N
David Inslicht N
BERNARD RIMLER MD N
BENJAMIN LIFSHITZ MD N
Michael Koegel N
Murray Werzberger N
David Hersh N
ALAN NISSENBAUM MD N
Michael Fuchs N
Rahel Elias N
Aaron Greenberg N
Lance Austein N
Anthony Bertelle MD PC N
Arkadiy Izrailov N
DEBORAH RIMLER MD N
Aline Benjamin MD N
I & R Medical, Pc N
MEDICAL CARE PLLC N
SAMSON MEDICAL PC N
NINA KUSHNER MEDICAL PC N
C&Y Medical PC N
Brooklyn Care Medical PC N
Rimma Gelbert Medical Pc N
GEORGE MOSKOWITZ MD PC N
Mitchell E Lipton MD PC N
Cortes Medical Care P.C. N
Bay Ridge Medical LLC N
Pintea Cardio-Vascular Medicine P.C. N
Heart Health of the South Shore PC N
Avenue L Medical PC N
American Medical Diagnostics PLLC N
George Apergis MD PC N
Ahava Medical of Brooklyn PC N
JONATHAN S LEIBOWITZ MD PC N
Yefim Ornstein M.D. P.C. N
Ariel Medina N
MODERN MEDICAL PLLC N

 

 

ACO governing body:

Member Member’s Voting Power – Expressed as a percentage or number Membership Type ACO Participant Legal Business Name/DBA, if Applicable
Last Name First Name Title/Position
Exposito Lissette President, CEO, & Board Chair 11% Board Chair and Voting Member  
Rosenstock, MD Paul Board Member 11% ACO Participant and Voting Member Comprehensive Geriatric Medicine PC
Rimler, MD Deborah Board Member 11% ACO Participant and Voting Member Deborah Rimler MD
Leibowitz, MD Jonathan Board Member/Medical Director 11% ACO Participant and Voting Member Jonathan S Liebowitz MD PC
Greenberg, MD Aaron Board Member 11% ACO Participant and Voting Member Aaron Saul Greenberg MD
Moskowitz, MD George Board Member 11% ACO Participant and Voting Member George Moskowitz MD PC
Steinmetz, MD Ira Board Member 11% ACO Participant and Voting Member Ira Steinmetz MD PC
Gibilaro, MD Eugene Board Member 11% ACO Participant and Voting Member Eugene Gibilaro MD
Schiowitz, MD Avi Board Member 11% ACO Participant and Voting Member Emanuel Schiowitz DO PC
DelValle Elizabeth Board Member 1% ACO Patient and Medicare Beneficiary Representative  

 

Key ACO clinical and administrative leadership:

Lissette Exposito ACO Executive
Jonathan Leibowitz Medical Director
Marc Troisi Compliance Officer
Ana Rodriguez Quality Assurance/Improvement Officer

 

 

Associated committees and committee leadership:

Committee Name Committee Leader Name and Position
Quality and Informatics Pablo Quintela, MD, Chair
Patient Experience Raphael Ruiz, Chair
Finance and Contracting Frank Exposito, Co-Chair

Pablo Quintela, MD, Co-Chair

 

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

  • Critical Access Hospital (CAH) billing under Method II
  • Federally Qualified Health Center (FQHC)
  • ACO professionals in a group practice arrangement
  • Hospital employing ACO professionals
  • Partnerships or joint venture arrangements between hospitals and ACO professionals
  • Networks of individual practices of ACO professionals
  • Rural Health Clinic (RHC)

 

Shared Savings and Losses

Amount of Shared Savings/Losses

  • First Agreement Period
    • Performance Year 2017, $2,804,738
    • Performance Year 2016, $3,242,894
    • Performance Year 2015, $3,304,770

 

Shared Savings Distribution

  • First Agreement Period
    • Performance Year 2017
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2016
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2015
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%

 

Quality Performance Results

2017 Quality Performance Results:

ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 79.69 80.60
ACO-2 CAHPS: How Well Your Providers Communicate 92.95 93.13
ACO-3 CAHPS: Patients’ Rating of Provider 92.49 92.31
ACO-4 CAHPS: Access to Specialists 82.16 83.32
ACO-5 CAHPS: Health Promotion and Education 64.35 62.30
ACO-6 CAHPS: Shared Decision Making 74.52 75.85
ACO-7 CAHPS: Health Status/Functional Status 69.06 73.05
ACO-34 CAHPS: Stewardship of Patient Resources 27.06 25.68
ACO-8 Risk Standardized, All Condition Readmission 15.61 15.01
ACO-35 Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM) 17.70 18.46
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 59.73 53.95
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 71.60 79.16
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 55.29 61.74
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.48 1.93
ACO-11 Use of Certified EHR Technology 88.37 98.48
ACO-12 Medication Reconciliation 86.42 75.32
ACO-13 Falls: Screening for Future Fall Risk 78.10 74.38
ACO-44 Imaging Studies for Low Back Pain 79.17 67.32
ACO-14 Preventive Care and Screening: Influenza Immunization 66.90 72.52
ACO-15 Pneumonia Vaccination Status for Older Adults 49.01 72.92
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up 75.20 70.69
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 90.32 90.48
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 63.06 61.98
ACO-19 Colorectal Cancer Screening 50.75 64.58
ACO-20 Breast Cancer Screening 67.68 70.05
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 60.23 79.89
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 17.74 16.74
ACO-41 Diabetes: Eye Exam 62.39 50.37
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 72.66 71.47
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 59.76 86.86

 

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

 

Note: In the Quality Performance Results file(s) above, search for “Total Care ACO, LLC” or “Orange Accountable Care of New York” to view the quality performance results. This ACO can also be found by using the ACO ID A07769 in the public use files on data.cms.gov.

Payment Rule Waivers

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

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