South Florida Enhanced Track

ACO Name and Location

Orange Accountable Care Organization of South Florida LLC
Previous Names: N/A
14750 NW 77th Court
Suite 308
Miami Lakes, FL 33016

 

ACO Primary Contact

Primary Contact Name	Lissette Exposito RN, BSN, MHSA, Founder and President
Primary Contact Phone Number	(786) 363-8500
Primary Contact Email Address	Lissette.Exposito@orangecaregroup.com

 

Organizational Information

ACO Participants:

ACO Participant	Joint Venture?
BROWARD MEDICAL ASSOCIATES OF SOUTH FLORIDA	N
CHANDRAKANT SHAH MD PA	N
Charles Yanes, M.D., P.A.	N
EAST FLORIDA PREMIUM MEDICAL CARE LLC	N
GERARDO QUINONEZ, M.D., P.A.	N
GUS ARMENAKIS MD PA	N
HECTOR M DELGADO D O P A	N
IVAN ESPAILLAT MD PA	N
JOSE GONZALEZ	N
LEVINSON AND CARDENAS, PA	N
MARTIN DAYTON DO PA	N
Milton A. Jimenez MD PA	N
PATRICIA BRAVO MD PA	N
PEDRO G. ALVAREZ, D.O., P.A.	N
QUALCARE MEDICAL GROUP INC	N
ROBERTO URQUIZA M D P A	N
ROMEO E ROJAS MD PA	N
SOUTH FLORIDA INTERNISTS GROUP PA	N
SUSSMAN & STALLER MD PA	N

ACO Governing Body:

Member First Name	Member Last Name	Member Title/Position	Member’s Voting Power (Expressed as a percentage)	Membership Type	ACO Participant Legal Business Name, if applicable
Exposito	Lissette	President, CEO & Board Chair	24%	Board Chair and Voting Member
Quintela, MD	Pablo	CMIO & Board Member	0%	Board Advisor
Jimenez, MD	Milton	Medical Director & Board Member	25%	ACO Participant & Voting Member	Milton A. Jimenez MD PA
Armenakis, MD	Gus	Board Member	25%	ACO Participant & Voting Member	GUS ARMENAKIS MD PA
Alvarez, DO	Pedro	Board Member	25%	ACO Participant & Voting Member	PEDRO G. ALVAREZ, D.O., P.A.
Oliver	Mara	Board Member	1%	ACO Patient and Medicare Beneficiary Representative

 

Key ACO Clinical and Administrative Leadership:

• ACO Executive: Lissette Exposito
• Medical Director: Milton Jimenez
• Compliance Officer: Marc Troisi
• Quality Assurance/Improvement Officer: Michael Labinski

 

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:

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

 

Shared Savings and Losses

Amount of Shared Savings/Losses:

• Second Agreement Period
  • Performance Year 2022, $1,730,829
  • Performance Year 2021, $13,112,590
• First Agreement Period
  • Performance Year 2020, $16,161,631
  • Performance Year 2019, $6,692,187
  • Performance Year 2018, $3,172,313
  • Performance Year 2017, $2,643,135

Shared Savings Distribution:

• Second Agreement Period
  • Performance Year 2022
    • Proportion invested in infrastructure: 20%
    • Proportion invested in redesigned care processes/resources: 20%
    • Proportion of distribution to ACO participants: 60%
  • Performance Year 2021
    • Proportion invested in infrastructure: 20%
    • Proportion invested in redesigned care processes/resources: 20%
    • Proportion of distribution to ACO participants: 60%
  • First Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2019
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2018
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%
    • Performance Year 2017
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 60%

 

Quality Performance Results

2022 Quality Performance Results:

Quality performance results are based on CMS Web Interface

 

Measure #	Measure Name	Rate	ACO Mean
001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control2	10.75	12.46
134	Preventative Care and Screening: Screening for Depression and Follow-up Plan	80.89	74.38
236	Controlling High Blood Pressure	84.32	74.87
318	Falls: Screening for Future Fall Risk	91.55	87.03
110	Preventative Care and Screening: Influenza Immunization	83.92	80.52
226	Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention	94.74	80.97
113	Colorectal Cancer Screening	91.19	73.63
112	Breast Cancer Screening	83.57	75.11
438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	85.23	84.24
370	Depression Remission at Twelve Months	12.50	15.50
321	CAHPS for MIPS3	N/A	N/A
479	Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups2	0.1645	0.1540
MCC1	All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions for ACOs (MCC)2	30.49	33.99

 

For previous years’ Financial and Quality Performance Results, please visit: data.cms.gov

 

Payment Rule Waivers

• Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
  • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.