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NorthShore Physician Associates Value Based Care, LLC.

Welcome to NorthShore Physician Associates Value Based Care, LLC.,
an Accountable Care Organization
NorthShore Physician Associates Value Based Care (NPA VBC) is an Accountable Care Organization (ACO) that was formed as a wholly owned subsidiary of NorthShore Physician Associates (NPA). The NPA is the population health oversight and operational vehicle for the broader NorthShore University HealthSystem (NorthShore).

NorthShore Physician Associates Value Based Care's Mission is to drive the highest level of value for the patients of our community through clinically integrated care. More specifically, the mission is to develop and deliver care delivery models for the patients we serve that result in:
  • Equitable quality of care and health outcomes
  • Efficient and cost-effective care
  • High levels of engagement between NorthShore University HealthSystem and its physician partners
What is an ACO?
An Accountable Care Organization (ACO) is a group of doctors and other healthcare providers who agree to work together with Medicare to give you the best possible care. ACOs may take different approaches to giving you coordinated care. Some ACOs may have special nurses that help you set up appointments or make sure your medications are in order when you enter or leave a hospital. Other ACOs may help your doctors get you equipment for monitoring your medical conditions better at home, if you need it. Most ACOs use advanced systems that let them more carefully coordinate your care, and make sure your doctor has the most up-to-date information about your health.

The goal of the ACO is to support your doctor in caring for you by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions over and over. Working together, your doctors can do more to follow your health, make sure you get the best possible care, and may hire additional staff to help meet your unique care needs, depending on what works best for you.

Doctors and other healthcare providers choose to participate in an ACO because they're committed to providing you with a better care experience. They may also be financially rewarded for offering you better, more coordinated care. If your doctor chooses to participate in an ACO, you'll see a poster with information displayed in the office or hospital.

An ACO isn't a Medicare Advantage Plan or Health Maintenance Organization (HMO). You're still in Original Medicare, and your Medicare benefits, services, rights and protections won't change. And you still have the right to use any doctor or hospital that accepts Medicare at any time, the same way you do now.
ACO Name and Location
NorthShore Physician Associates Value Based Care, LLC
Previous Names: N/A
1301 Central Street
Suite 301
Evanston, Illinois 60201
ACO Primary Contact

Primary Contact Name

Diane Montanez

Primary Contact Phone Number

847-982-4103

Primary Contact Email Address

DMontanez@northshore.org


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).
Organizational Information
ACO Participants
ACO ParticipantsACO Participant in Joint Venture (Enter Y or N)

ABK Medical Center Ltd

N

Advanced Internal Medicine Associates, Inc

N

Advanced Primary Care SC

N

Anuj Lal, MD, Ltd

N

Argiro Zofakis, Ltd

N

Brikha Medical Center

N

C.J. Ireland, DO, SC

N

Covenant Medical Group, LLC

N

Deerfield Medical Associates, SC

N

Denenberg Medical, SC

N

Dangremond & Jaharis, LLC (DBA Winnetka Family Medicine)

N

East West Internal Medicine Associates, P.C.

N

Family Doctors of Round Lake, PC

N

Family Medical, Ltd (DBA Dr. Elena Edwards)

N

First Clinic, SC

N

Gabriel I. Berlin, M.D. LLC

N

Glen Medical Associates, SC

N

Gregory Kaczmarek

N

Gregory Kaczmarek, MD, LLC

N

Joseph P. Wyse, MD, Ltd

N

L. Scott Kanter, MD

N

Medical Health Clinic Ltd

N

Mohammad Siddiqui, MD, Ltd

N

NorthShore University HealthSystem

N

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

N

North Sheridan Family Medicine (DBA Julia Gorelik, MD)

N

North Shore Associates in Gynecology and Obstetrics, SC

N

Robin Wind, MD, SC (DBA Wind Medical Group)

N

Sheilendr Khipple, MD

N

Smriti Goel, MD, SC

N

Stephen J. Clark, MD, PC

N

Stephen Kashian, MD

N

Vadim Edelstein MD Ltd

N

Vandana Jain, MD, SC

N

Winnetka Avenue Physicians SC

N

ACO Governing Body
MemberMember's Voting PowerMembership TypeACO Participant TIN Legal Business Name/DBA, if Applicable
Last NameFirst NameTitle/Position

Hensing

Thomas

NPA VBC Medical Director

1

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Murtos

Kristen

ACO Executive; Chief Administrative and Strategy Officer

1

ACO Participant Representative

NorthShore University HealthSystem

Fisk

Benjamin

NPA VBC Executive Director

1

Other

 

Halasyamani

Mahalakshmi

Chief Medical Officer

1

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Boyle

Christopher

Utilization Management Physician Lead

1

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Chon

Chris

Affiliate Physician

1

ACO Participant Representative

First Clinic, SC

Denham

Ervin

Employed Physician

1

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Kaul

Karen

Clinical Chairman

1

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Revis

John

Employed Physician

1

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Wallman

Gregory

Affiliate Physician

1

ACO Participant Representative

Covenant Medical Group, LLC

MacGregor

Scott

Employed Physician

1

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Kirkorsky

Deborah

VP, Medical Group

1

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Mermel

Donna

 

1

Medicare Beneficiary Representative

 

Hensing

Thomas

Associate Chief Quality Officer for Ambulatory Care

0

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Oshman

Lauren

Employed Physician

0

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Bauer

Tyler

VP, Medical Group

0

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Rahija

David

President, Skokie Hospital

0

ACO Participant Representative

NorthShore University HealthSystem

Braund

Victoria

Employed Physician

0

ACO Participant Representative

NorthShore University HealthSystem Faculty Practice Associates (DBA NorthShore Medical Group)

Smith

Steven

NPA VBC Information Technology Executive

0

Other

 

Jones

Harry

NPA VBC Compliance Officer

0

Other

 

Eminger

Tricia

NBA VBC Operations Executive

0

Other

 

Key ACO Clinical and Administrative Leadership

ACO Executive

Kristen Murtos

Medical Director 

Thomas Hensing, M.D.

Compliance Officer

Harry Jones

Quality Assurance/Improvement Officer

Mahalakshmi Halasyamani, MD

Associated Committees and Committee Leadership
Committee NameCommittee Leader Name and Position

Quality Committee

Mahalakshmi K. Halasyamani, M.D., Chief Medical Officer

Ambulatory Care Quality Council

Thomas A. Hensing, M.D., Associate Chief Quality Officer for Ambulatory Care

Hospitals Quality Council

Gregory A. Wallman, DO, NPA VBC Participant & Board Member
Mahalakshmi K. Halasyamani, M.D., Chief Medical Officer
John Tressa, Chief Nursing Officer

Operations Committee

Benjamin Fisk, NPA VBC Executive Director

Finance Committee

Ervin Woody Denham, M.D., ACO Participant

Compliance Committee

Harry Jones, NPA VBC Compliance Officer

Types of ACO Participants or Combinations of Participants that Formed the ACO
  • Partnerships or joint venture arrangements between hospitals and ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses
  • First Agreement Period
    • Performance Year 2018, $0
  • Second Agreement Period
    • Performance Year 2019, $0
Note: Our ACO participated in multiple performance years during Calendar Year 2019. Shared savings/losses amount reported for Performance Year 2019 therefore represents net shared savings or losses across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

Shared Savings Distribution
  • First Agreement Period
    • 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
  • Second Agreement Period
    • Performance Year 2019
      • 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

2019 Quality Performance Results:

ACO#Measure NameRateACO Mean

ACO-1

Getting Timely Care, Appointments, and Information

82.67

85.86

ACO-2

How Well Your Providers Communicate

94.35

94.11

ACO-3

Patients’ Rating of Provider

93.20

92.69

ACO-4

Access to Specialists

77.46

81.54

ACO-5

Health Promotion and Education

60.62

60.44

ACO-6

Shared Decision Making

58.14

62.78

ACO-7

Health Status/Functional Status

77.14

73.79

ACO-34

Stewardship of Patient Resources

23.12

26.17

ACO-8

Risk Standardized, All Condition Readmission

14.58

14.86

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

62.59

58.15

ACO-43

Ambulatory Sensitive Condition Acute Composite (AHRQ Prevention Quality Indicator (PQI) #91)

1.64

1.87

ACO-13

Falls: Screening for Future Fall Risk

89.78

84.04

ACO-14

Preventive Care and Screening: Influenza Immunization

86.75

74.77

ACO-17

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

86.36

78.04

ACO-18

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

62.68

70.40

ACO-19

Colorectal Cancer Screening

78.44

70.76

ACO-20

Breast Cancer Screening

73.99

73.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

78.88

82.17

ACO-27

Diabetes: Hemoglobin A1c Poor Control

12.32

13.88

ACO-45

Courteous and Helpful Office Staff

93.97

92.84

ACO-28

Controlling High Blood Pressure

75.70

75.04

ACO-46

Care Coordination

87.22

86.89

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size. In addition, the Centers for Medicare & Medicaid Services (CMS) waived the requirement for ACOs to field a CAHPS for ACOs survey data.

For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.

Payment Rule Waivers
  • None
 
ACO Participation Waiver Protection Arrangements

NorthShore University HealthSystem (NS), an ACO participant, has entered into agreements with certain primary care physician practices participating in the NorthShore Physician Associates Value Based Care ACO (NPA VBC) commencing on or after August 1, 2018, pursuant to which NS furnishes certain electronic medical record (EMR) and practice management software and support to primary care physicians in an effort to achieve a more consolidated EMR platform amongst the ACO participants. NPA VBC’s governing body made a bona fide determination that the furnishing of such EMR and practice management software and support will allow all ACO participating primary care physicians and the ACO to utilize an interconnected EMR, which are reasonably related to, and will continue to further, the purposes of the Medicare Shared Savings Program by:

  • Promoting accountability for the quality, cost, and overall care for Medicare beneficiaries;
  • Allowing for the managing and coordinating of care for Medicare fee-for service beneficiaries through the ACO; and
  • Encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients, including Medicare beneficiaries.