ACO REACH High-Needs
The ACO REACH (Accountable Care Organization Realizing Equity, Access, and Community Health) Model is an initiative introduced by the Centers for Medicare & Medicaid Services (CMS) in the Medicare program.
ACO REACH is a value-based program, meaning the providers are rewarded/reimbursed for the quality of care provided and the health outcomes of patients, rather than the number of services rendered.
Under the ACO REACH Model, participating accountable care organizations (ACOs) collaborate with community-based organizations and local stakeholders to implement strategies that address the specific needs of high-needs patients. The model is intended to help beneficiaries with complex healthcare needs, including those facing challenges related to social determinants of health, such as housing instability, food insecurity, and limited access to transportation.
ACO Name & Location
CareConnectMD DCE, LLC
Doing business as:
CareConnectMD At Home
Address: 3090 Bristol Street, Suite 200, Costa Mesa, CA 92626
ACO Primary Contact
Contact: Kim Phan
Email: kphan@careconnectmd.com
Phone: 888-878-0009
Physical Location/Mailing Address:
3090 Bristol Street, Suite 200, Costa Mesa, CA 92626
JOINT VENTURES
No joint ventures between or among the ACO and any of its ACO Participant Providers or Preferred Providers at this time.
ORGANIZATIONAL INFORMATION
Key Clinical & Administrative Leaders
| Name | Title | Employer |
|---|---|---|
| Kim Phan | CEO | CareConnectMD Inc. |
| William Simson | CFO | CareConnectMD Inc. |
| Megan Lenthe | CTO | CareConnectMD Inc. |
| Mary McCormack | SVP of Operations | CareConnectMD Inc. |
| Allen Bauzon | VP of Legal | CareConnectMD Inc. |
| Rashed Behroz | Compliance Officer | CareConnectMD Inc. |
| Lilianne Idylle, DO | Chief Medical Officer | CareConnectMD Inc. |
Governing Body
| Name | Title | Employer |
|---|---|---|
| Lilliane Idylle, DO | ACO REACH Governing Body Member | CareConnectMD Inc. |
| Rafaelito Victoria, MD | ACO REACH Governing Body Member | Victoria Medical, Inc. |
| Orlando Collado, MD | ACO REACH Governing Body Member | GN Medical Associates, Inc. |
| Kim Phan | ACO REACH Governing Body Member | CareConnectMD Inc. |
| Diane Chau | Patient Advocate | Consultant/Diane Chau, MD |
| Angie Hoff, NP | ACO REACH Governing Body Member | At Your Door Visiting Healthcare Services |
| Edward Plyler, MD | ACO REACH Governing Body Member | Geriatric Consultants, PLLC |
| Rosemary Engle | Medicare Beneficiary | ACO REACH Beneficiary |
SHARED SAVINGS & LOSSES
Performance Year 3 (2023):
| Gross Savings | $13,523,351.38 |
| Gross Savings Rate | 29.5% |
| Net Savings | $11,399,285.67 |
| Net Savings Rate | 24.9% |
| Proportion of Shared Savings Invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries | 80% |
| Proportion of Shared Savings distributed to Participant Providers and Preferred Providers | 20% |
Performance Year 2 (2022):
| Gross Savings | $5,149,547.74 |
| Gross Savings Rate | 21.5% |
| Net Savings | $4,576,839.66 |
| Net Savings Rate | 19.1% |
| Proportion of Shared Savings Invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries | 90% |
| Proportion of Shared Savings distributed to Participant Providers and Preferred Providers | 10% |
Performance Year 1 (2021):
| Gross Savings | $3,033,768.96 |
| Gross Savings Rate | 30.49% |
| Net Savings | $563,055.58 |
| Net Savings Rate | 5.66% |
| Proportion of Shared Savings Invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries | 90% |
| Proportion of Shared Savings distributed to Participant Providers and Preferred Providers | 10% |
QUALITY MEASURES PERFORMANCE
Performance Year 3 (2023):
| Risk-Standardized, All-Condition Readmission | 18.99 |
| Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) | 59.12 |
| Days at Home for Patients with Complex, Chronic Conditions (High Needs ACO REACH Only) | 311.09 |
| PY 2023 Total Quality Score | 85% |
| Met Continuous Improvement/Sustained Exceptional Performance | Yes |
| High Performers Pool | Yes |
Performance Year 2 (2022):
| Risk-Standardized, All-Condition Readmission | 20 |
| Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) | 55.78 |
| Days at Home for Patients with Complex, Chronic Conditions (High Needs DCEs only) | 304.44 |
| PY 2022 Total Quality Score | 100% |
Performance Year 1 (2021):
| Risk-Standardized, All-Condition Readmission | 19.61 |
| Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) | 57.95 |
| Days at Home for Patients with Complex, Chronic Conditions (High Needs DCEs only) | 325.24 |
| PY 2021 Total Quality Score | 100% |
CONTACTS
CareConnectMD:
Address: 3090 Bristol Street, Suite 200, Costa Mesa, CA 92626
Email: info@careconnectmd.com
Phone: 888-878-0009
Beneficiaries Support Line:
888-874-0818
Anonymous Reporting Hotline:
A service provided by Lighthouse Services LLC
Phone: 1-833-401-0002
Or visit www.lighthouse-services.com/careconnectmd
Contact Medicare:
ACO REACH Model Team
Email: ACOREACH@CMS.hhs.gov
Phone: 1-888-734-6433 (Option 3) from 8:30am - 7:30pm ET