ACO Name and Location

Advanced Doctors ACO, LLC

1155 S. Congress Avenue, Suite B
West Palm Beach, FL 33406

ACO Primary Contact

Contact Name:
Nick Martin
Primary Contact Phone Number:
(561) 323-7594
Primary Contact Email Address: [email protected]

Public Reporting PDF
ACO Participants ACO Participant in Joint
Venture
AUDWIN B NELSON MD P A N
BASSETTI & ASSOCIATES M.D., P.A N
BETSY E. WOOD DO PA N
Calvino Family Medicine, PLLC N
CENTRAL FLORIDA MEDICAL & DIAGNOSTIC CLINIC, PA N
Compassion First Healthcare Pa N
DAVID S BALLESTAS MD PA N
DR. ROGERS MEDICAL GROUP PA N
ERIC S PALOSKY, DO PA N
FAMILY CARE PHYSICIAN GROUP N
FAMILY MEDICAL GROUP PA N
FLORIDA EAST COAST MEDICAL GROUP INC N
GARY WRIGHT MD PA N
GULF COAST INTERNIST, LLC. N
HEARTLAND MEDICAL INC N
HIGHLANDS HEALTH AND WELLNESS CENTER LLC N
JORGE I ZELEDON MD PA N
KAREN N PHILLIPPS MD PA N
KEITH KAPPELER N
KENNETH PILGREEN N
LOUIS DIVALENTIN MD N
MCGREGOR MEDICAL AND WELLNESS, LLC N
MINA B BHATT MD PA N
OKEECHOBEE FAMILY PRACTICE P A N
PALM HARBOR INTERNAL MEDICINE AND PEDIATRICS PA N
PATEL PULMONARY PA N
PAVAN K ANAND MD PA N
PINELLAS INTERNAL MEDICINE SPECIALISTS, PA N
Premier Health, Llc N
SOUTH CAROLINA INTERNAL MEDICINE ASSOCIATES AND
REHABILITATION,L.L.C.		 N
SUN ‘N LAKE MEDICAL GROUP,PA N
Suncoast Primary Care Llc N
SUNERGY PHYSICIANS LLC N
Three Rivers Medical Associates Pa N

ACO Governing Body

ACO ID: A4794
ACO Legal Business Name: Advanced Doctors ACO, LLC

Member First Name
Member Last Name
Member Title/Position
Member Voting Power
Membership Type
ACO Participant TIN Legal Business Name
1
Audwin
Nelson
Chairman
1
ACO Participant Representative
Audwin B Nelson MD P A
2
Dennis
Bassetti
Physician
1
ACO Participant Representative
Bassetti & Associates M.D., P.A.
3
Tamyra
Rogers
Physician
1
ACO Participant Representative
Dr. Rogers Medical Group PA
4
Ray
Tangunan
Physician
1
ACO Participant Representative
Heartland Medical Inc
5
Marie
Toussaint
Physician
1
ACO Participant Representative
Highlands Health and Wellness Center LLC
6
Mina
Bhatt
Physician
1
ACO Participant Representative
Mina B Bhatt MD PA
7
Daniel
Montero
Physician
1
ACO Participant Representative
Family Medical Group PA
8
Wilfredo
Corredera
Physician
1
ACO Participant Representative
Family Medical Group PA
9
Pavan
Anand
Physician
1
ACO Participant Representative
Pavan K Anand Md Pa
10
Kavita
Rao
Physician
1
ACO Participant Representative
Gulf Coast Internist, Llc
11
Clare
Padilla
Medicare Beneficiary
1
Medicare Beneficiary Representative
12
Jeff
Morrison
Director
1
Other
13
Colin
Campbell
CFO
1
Other

Key ACO clinical and administrative leadership

Position
Name
ACO Executive
David Klebonis
Medical Director
Dr. Lori Lane
Compliance Officer
David Klebonis
Quality Assurance/Improvement Officer
David Klebonis

Associated Committees and Committee Leadership

Committee Name
Committee Leader Name and Position
Executive Committee
David Klebonis, Chairman
Finance Committee
Dr. Marie Toussaint, Chairman
Quality, Utilization, Clinical Protocols & Patient Safty Committee
Dr. Ray Tangunan, Chairman
Membership, Physician Engagement & Continuing Education Committee
Dr. Deepak Patel, Chairman
Patient Engagement, Continuing Education & Information Technology Committee
Dr. Marie Toussaint, Chairman
Compliance, Managed Care & Law
David Klebonis, Chairman

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

  • ACO professionals in a group practice arrangement
  • A network of individual practices of ACO professionals.
  • Federally Qualified Health Center (FQHC)

Shared Savings and Losses

Amount of Shared Savings/Losses

Second Agreement Period

— Performance Year 2022 $4,859,586.00

First Agreement Period

— Performance Year 2021 $0

— Performance Year 2020 $1,171,682.73

How Shared Savings Are Distributed

  • Second Agreement Period
    • Performance Year 2022
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 65%
  • First Agreement Period
    • Performance Year 2021
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2020
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources: 20%
      • Proportion of distribution to ACO participants: 65%
2022 Quality Performance Results:

Quality performance results are based on CMS Web Interface.

ACO Quality Measure Measure Name Collection Type Rate ACO Mean
Measure #: 001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control CMS Web Interface 7.12 10.71
Measure #: 134 Preventative Care and Screening: Screening for Depression and Follow-up Plan CMS Web Interface 72.29 76.97
Measure #: 236 Controlling High Blood Pressure CMS Web Interface 80.29 76.16
Measure #: 318 Falls: Screening for Future Fall Risk CMS Web Interface 77.82 87.83
Measure #: 110 Preventative Care and Screening: Influenza Immunization CMS Web Interface 75.79 77.34
Measure #: 226 Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS Web Interface 53.57 79.27
Measure #: 113 Colorectal Cancer Screening CMS Web Interface 77.71 75.32
Measure #: 112 Breast Cancer Screening CMS Web Interface 73.89 78.07
Measure #: 370 Depression Remission at Twelve Months CMS Web Interface 24.32 16.03
Measure #: 438 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease CMS Web Interface 87.78 86.37
Measure #: 321 CAHPS for MIPS CMS Web Interface N/A N/A
Measure #: 479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups Administrative Claims 0.1596 0.1510
Measure #: 484 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions [1] Administrative Claims 30.09 30.97
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS Survey 89.92 83.96
CAHPS-2 How Well Providers Communicate CAHPS for MIPS Survey 93.71 93.47
CAHPS-3 Patient’s Rating of Provider CAHPS for MIPS Survey 93.70 92.06
CAHPS-4 Access to Specialists CAHPS for MIPS Survey 81.88 77.00
CAHPS-5 Health Promotion and Education CAHPS for MIPS Survey 63.90 62.68
CAHPS-6 Shared Decision Making CAHPS for MIPS Survey 63.67 60.97
CAHPS-7 Health Status and Functional Status CAHPS for MIPS Survey 73.22 73.06
CAHPS-8 Care Coordination CAHPS for MIPS Survey 86.15 85.46
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS Survey 93.18 91.97
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS Survey 28.98 25.62

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

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-day Rule Waiver:
    • Yes, our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR 425.612.
  • Waiver for Payment for Telehealth Services:
    o Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR §
    425.612(f) and 42 CFR § 425.613.