ACO Name and Location
LTC Providers ACO, Inc 8900 E.F. Lowery Expressway Suite A Texas City, TX 77591
ACO Name and Location
LTC Providers ACO, Inc 8900 E.F. Lowery Expressway Suite A Texas City, TX 77591
Organizational Information
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
|---|---|
| NORA I VALDES MD, PA | Y |
| COASTAL BEND FAMILY MEDICINE PA | Y |
| YUN KIM | Y |
| BELINDA GONZALEZ MD PA | Y |
| CORNELIA L AGENT MD PA | Y |
| EDMUNDO GARCIA | Y |
| THOMAS-SPANN CLINIC, P.A. | Y |
| LENA BRUCE | Y |
| INTERNAL MEDICINE ASSOCIATES OF GALVESTON PA | Y |
| YUN KIM | Y |
ACO governing body
| Member | Member's Voting Power | Membership Type | ACO Participant TIN Legal Business Name/DBA, if Applicable | ||
|---|---|---|---|---|---|
| Last Name | First Name | Title/Position | |||
| Walt | Crowder | CEO | 20 | Community Stakeholder | n/a |
| Orel | Everett | Board Member | 20 | ACO Participant Representative | THOMAS-SPANN CLINIC, P.A |
| Francisco | Barrera | Board Member | 20 | ACO Participant Representative | Francisco Barrera M.D |
| Edmundo | Garcia | Board Member | 20 | ACO Participant Representative | Edmundo Garcia |
| David | Vanderheiden | Board Member | 15 | ACO Participant Representative | Coastal Bend Family Medicine PA |
| Steven | Johnson | Beneficiary Representative | 5 | Medicare Beneficiary Representative | N/A |
Key ACO Clinical and Administrative Leadership
ACO Executive: Walt Crowder Medical Director: Edmundo Garcia Compliance Officer: David Vanderheiden Quality Assurance/Improvement Officer: Lena Bruce
Associated Committees and Committee Leadership
| Committee Name | Committee Leader Name and Position |
|---|---|
| Quality Assurance and Improvement Committee | Lena Bruce |
| Compliance Committee | David Vanderheiden |
| Operations and Finance Committee | Walt Crowder |
| Provider Network Development Committee | Walt Crowder |
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
| Committee Name | Committee Leader Name and Position |
|---|---|
| Quality Assurance and Improvement Committee | Lena Bruce |
| Compliance Committee | David Vanderheiden |
| Operations and Finance Committee | Walt Crowder |
| Provider Network Development Committee | Walt Crowder |
Shared Savings and Losses
Amount of Shared Savings/Losses
- First Agreement Period
- Performance Year 2020, $0
Shared Savings Distribution
- First Agreement Period
- Performance Year 2020
- Proportion invested in infrastructure: 20%
- Proportion invested in redesigned care processes/resources: 10%
- Proportion of distribution to ACO participants: 70%
Quality Performance Results
2020 Quality Performance Results
| Measure Number | Measure Name | ACO Performance Rate* | Current Year Mean Performance Rate (SSP ACOs) |
|---|---|---|---|
| ACO-43 | Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) | 0.81 | 0.95 |
| ACO-13 | Falls: Screening for Future Fall Risk | 100.00 | 84.97 |
| ACO-14 | Preventive Care and Screening: Influenza Immunization | 80.43 | 76.03 |
| ACO-17 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100.00 | 81.67 |
| ACO-18 | Preventive Care and Screening: Screening for Depression and Follow-up Plan | 66.08 | 71.46 |
| ACO-19 | Colorectal Cancer Screening | 81.14 | 72.59 |
| ACO-20 | Breast Cancer Screening | 87.58 | 74.05 |
| ACO-42 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 77.29 | 83.37 |
| ACO-27 | Diabetes: Hemoglobin A1c Poor Control (>9%) | 14.68 | 14.70 |
| ACO-28 | Controlling High Blood Pressure | 70.21 | 72.87 |
Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. The Centers for Medicare & Medicaid Services (CMS) also waived the requirement for ACOs to field a CAHPS for ACOs survey for PY 2020 through the Physician Fee Schedule Final Rule for Calendar Year 2021. Additionally, CMS reverted ACO-8 Risk-Standardized, All Condition Readmission and ACO-38 Risk-Standardized Acute Admission Rates for Patients with Multiple Chronic Conditions to pay-for-reporting, given the impact of the coronavirus disease 2019 (COVID-19) public health emergency (PHE) on these measures.
For Previous Years’ Financial and Quality Performance Results, Please Visit data.cms.gov.
Note: In the Quality Performance Results file(s) above, search for “ LTC Providers ACO, Inc” to view the quality performance results. This ACO can also be found by using the ACO ID A4765 in the public use files on 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.