Baylor St. Luke's Health Network ACO

Shared Savings Program The Centers for Medicare & Medicaid Services (CMS) has established a Medicare Shared Savings Program (Shared Savings Program) to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs. Eligible providers, hospitals, and suppliers may participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO). The Shared Savings Program is designed to improve beneficiary outcomes and increase value of care by: Promoting accountability for the care of Medicare FFS beneficiaries Requiring coordinated care for all services provided under Medicare FFS Encouraging investment in infrastructure and redesigned care processes The Shared Savings Program will reward ACOs that lower their growth in health care costs while meeting performance standards on quality of care and putting patients first. Participation in an ACO is purely voluntary.

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ACO Name and Location

CHI St. Luke's Health Network, LLC
6624 Fannin, Suite 1100, Houston, TX 77030

ACO Primary Contact

Royd Hernandez
956-460-6345
Royd.Hernandez@CommonSpirit.org

Organizational Information

ACO participants:

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Adnan Afzal, Md, PA

N

Angiocardiac Care of Texas, PA

N

Baylor College of Medicine

N

Baylor St Lukes Medical Group

N

Comprehensive Cardiovascular Care of the Woodlands, PA

N

Conrado J Ordonez, MD PA.

N

Cyfair Headache and Neurological Clinic

N

Fred Bakht, MD PA

N

Houston Southwest Colon & Rectal Clinic, PLLC

N

Houston Neurocare, PA

N

Inpatient Infectious Disease Consultants

N

Karan S Bhalla, MD PLLC

N

LeCure Family Practice, PA

N

Lockhart Medical Services, PA

N

Medical Clinic of Bellaire, PA

N

Pasadena Surgical Association

N

Pulmonary Critical Care And Sleep Medicine Consultants, LLP

N

SF Hartley DPM PC

N

Sim Family Clinic, PA

N

Naureen Alim, MD, PLLC

N

Texas Avenue Medical Clinic

N

The Center For Family Medicine Wellness & Aesthetics, PA

N

The Schrader Clinic, PA

N

Capital Infectious Diseases Associates

N

William Burns

N

Yai-Yun Cheng, MD

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

Bigler

Peter

Physician

1 vote

ACO Participant

Baylor St. Luke's Medical Group

Lembcke

Bradley

CMO

1 vote

ACO Participant

Baylor St. Luke's Medical Group

McDeavitt

James

Chair

1 vote

ACO Participant

Baylor College of Medicine

Markos

Ferenc

Physician

1 vote

ACO Participant

Baylor College of Medicine

Zoorob

Roger

Physician

1 vote

ACO Participant

Baylor College of Medicine

Roper

Margaret

Voting Member

1 vote

ACO Participant

Baylor College of Medicine

Spatz

Edward

Medicare Beneficiary

1 vote

Community Stakeholder

n/a

Key ACO clinical and administrative leadership:

ACO Executive: Royd Hernandez
Medical Director: Bradley Lembcke, MD
Compliance Officer: Christy Knox
Quality Assurance/Improvement Officer: Tracy Maddox

Associated committees and committee leadership:
Committee Name Committee Leader Name and Position

N/A

 

Types of ACO participants, or combinations of participants, that formed the ACO:
  • Hospital employing ACO professionals
  • Partnerships or joint venture arrangements between hospitals and ACO professionals
  • Networks of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:
  • Second Agreement Period
    • Performance Year 2020, $8,512,151
    • Performance Year 2019, $4,996,168
    • Performance Year 2018, $0
  • First Agreement Period
    • Performance Year 2017, $0
    • Performance Year 2016, $0
    • Performance Year 2015, $0
Shared Savings Distribution

  • Second Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 36.02%
      • Proportion invested in redesigned care processes/resources: 26.13%
      • Proportion of distribution to ACO participants: 37.85%
    • Performance Year 2019
      • Proportion invested in infrastructure: 56.66%
      • Proportion invested in redesigned care processes/resources: 0.00%
      • Proportion of distribution to ACO participants: 43.34%
    • 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
  • First Agreement Period
    • Performance Year 2017
      • 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 2016
      • 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 2015
      • 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

2020 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-13

Falls: Screening for Future Fall Risk

98.30

84.97

ACO-14

Preventive Care and Screening: Influenza Immunization

74.38

76.03

ACO-17

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

91.67

81.67

ACO-18

Preventive Care and Screening: Screening for Depression and Follow-up Plan

76.52

71.46

ACO-19

Colorectal Cancer Screening

75.38

72.59

ACO-20

Breast Cancer Screening

71.25

74.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

85.06

83.37

ACO-27

Diabetes: Hemoglobin A1c Poor Control (>9%)

14.88

14.70

ACO-28

Controlling High Blood Pressure

71.10

72.87

For Previous Years’ Financial and Quality Performance Results, 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.
  • Waiver for Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR § 425.612(f) and 42 CFR § 425.613.


  • Fraud and Abuse Waivers
  • ACO Pre-Participation Waiver:
    • NA




  • 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.