ACO Name and Location
Essential Health Partners ACO, LLC
Previous Names: N/A
814 Commerce Drive
Suite 110
Oak Brook, IL 60523
ACO Primary Contact
| Primary Contact Name | Monika Dimitrova |
| Primary Contact Phone Number | (312) 560-2334 |
| Primary Contact Email Address | mdimitrova@innovista-health.com |
Organizational Information
ACO participants:
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
| ADAM W MILIK MDSC | N |
| ADVANCED EYECARE SC | N |
| ADVANCED MIDWEST INTERVENTIONAL RADIOLOGY LLC | N |
| ADVANCED MIDWEST RADIOLOGY SC | N |
| ADVANCED SURGICAL CONSULTANTS LLC | N |
| Akil Moinuddin MD SC | N |
| ALAM S MD LLC | N |
| ALAN CHEN SURGICAL ASSOCIATES, PC | N |
| ALVI MEDICAL SERVICES SC | N |
| ANTHONY S RINELLA M D S C | N |
| BASANT JHAWAR | N |
| BMI SURGERY SC | N |
| BUN SIU L CO, MD, SC | N |
| C&R MEDICAL GROUP SC | N |
| CARDINAL SURGICAL ASSOCIATES S C | N |
| CENTER FOR BRAIN AND NERVE DISORDERS S.C. | N |
| CENTER FOR NEUROLOGICAL DISEASES SC | N |
| COMPLETE FAMILY HEALTHCARE LTD | N |
| DR LUCY DEY DIABETES ENDOCRINOLOGY AND METABOLISM CLINIC PC | N |
| ELIGIJUS P LELIS MD & ASSOCIATES, SC | N |
| EM STRATEGIES,LTD. | N |
| ENT SURGICAL CONSULTANTS, LTD | N |
| FRIENDLY FAMILY MEDICAL CARE, INC. | N |
| GREATHOUSE MEDICAL GROUP SC | N |
| HEALTH SERVICES SYSTEMS, INC | N |
| HEART CARE CENTERS OF ILLINOIS, S.C. | N |
| HEDGES CLINIC SERVICE CORP | N |
| HOSPITALIST CONSULTANTS GROUP S.C. | N |
| LEMONT PRIMARY CARE, SC | N |
| MALAPATI INC | N |
| MCCAMMON CHASE TOTAL WELLNESS CENTER INC | N |
| MDRX MEDICAL P.C. | N |
| MIDWEST RESPIRATORY, LTD. | N |
| NORTHEAST ENDOCRINOLOGY CONSULTANTS, INC | N |
| PAUL KIRCHNER | N |
| PIPELINE-LAKEFRONT MEDICAL ASSOCIATES LLC | N |
| PRIMARY CARE ASSOCIATES LTD | N |
| Premier Suburban Medical Group, PLLC | N |
| PRIMARY CARE FOR U INC | N |
| PROGRESSIVE SURGICAL ASSOCIATES SC | N |
| R.K. NATESH MD PC | N |
| RODRIGUE TINFANG MD FAMILY HEALTH LTD | N |
| SILVER LINING SURGEONS, S.C. | N |
| SOUTHWEST DIABETES AND ENDOCRINOLOGY ASSOCIATES, SC | N |
| SOUTHWEST INFECTIOUS DISEASE ASSOCIATES LTD | N |
| SPRINGFIELD OB/GYN GROUP LTD | N |
| SUBURBAN GYNECOLOGY LLC | N |
| SUBURBAN WELLNESS SC | N |
ACO governing body:
| Member Last Name | Member First Name | Member Title/Position | Member's Voting Power: expressed as a percentage or number | Membership Type | ACO Participant Legal Business Name/DBA, if applicable |
| Bakhru | Vikram | Chairman/Voting Member | 6.25% | ACO Executive | N/A |
| Mills | Elizabeth | Voting Member | 6.25% | ACO Executive | N/A |
| Pryor | Vincent | Voting Member | 6.25% | ACO Executive | N/A |
| Hindo | Joseph | Voting Member | 25% | ACO Participant Representative | HEALTH SERVICES SYSTEMS, INC |
| Brownlow | William | Voting Member | 6.25% | Medicare Beneficiary Representative | N/A |
| Udovich | Christopher | Voting Member | 25% | ACO Participant Representative | HEDGES CLINIC SERVICE CORP |
| Mikolajczak | David | Voting Member | 25% | ACO Participant Representative | EM STRATEGIES,LTD. |
Key ACO clinical and administrative leadership:
| Vik Bakhru | ACO Executive |
| Joseph Hindo | Medical Director |
| Monika Dimitrova | Compliance Officer |
| Monika Dimitrova | Quality Assurance/Improvement Officer |
Associated committees and committee leadership:
| Committee Name | Committee Leader Name and Position |
| Medical Management & Quality Improvement Program Committee | Joseph Hindo, M.D. |
Types of ACO participants, or combinations of participants, that formed the ACO:
- Networks of individual practices of ACO professionals
Shared Savings and Losses
Amount of Shared Savings/Losses:
-
Fourth Agreement Period
- PerformanceYear 2022, $0.00
- Our ACO re-entered the Shared Savings Program in Performance Year2022 under agreement period 4. Shared savings/losses and shared savings distributions are therefore reported, beginning with this agreement period.
-
Third Agreement Period
- Performance Year 2021, $ 3,957,713.59
- Performance Year 2020, $ 4,309.572.68
- Performance Year 2019, $ 0
Shared Savings Distribution:
-
Fourth Agreement Period
-
Performance Year 2022
- 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 2021
- Proportion invested in infrastructure: 25%
- Proportion invested in redesigned care processes/resources: 0%
- Proportion of distribution to ACO participants: 75%
-
Performance Year 2020
- Proportion invested in infrastructure: 25%
- Proportion invested in redesigned care processes/resources: 0%
- Proportion of distribution to ACO participants: 75%
-
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
-
Performance Year 2022
Quality Performance Results
2022 Quality Performance Results:
Quality performance results are based on "CMS Web Interface" Measure Set
| Measure # | Measure Name | Rate | Collection Type | ACO Mean |
| 001 | Diabetes Mellitus: Hemoglobin A1c Poor Control | CMS Web Interface | 10.40 | 10.71 |
| 134 | Preventive Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 80.92 | 76.97 |
| 236 | Hypertension (HTN): Controlling High Blood Pressure | CMS Web Interface | 86.22 | 76.16 |
| 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 94.30 | 87.83 |
| 110 | Preventive Care and Screening: Influenza Immunization | CMS Web Interface | 86.85 | 77.34 |
| 226 | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 94.59 | 79.27 |
| 113 | Colorectal Cancer Screening | CMS Web Interface | 77.06 | 75.32 |
| 112 | Breast Cancer Screening | CMS Web Interface | 79.77 | 78.07 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 92.92 | 86.37 |
| 370 | Depression Remission at Twelve Months | CMS Web Interface | 8.11 | 16.03 |
| 321 | CAHPS for MIPS | CAHPS for MIPS | N/A | N/A |
| 479 | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups | Administrative Claims | 0.1672 | 0.1510 |
| 484 | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions | Administrative Claims | 36.58 | 30.97 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | CAHPS for MIPS | 86.53 | 83.96 |
| CAHPS-2 | How Well Your Providers Communicate | CAHPS for MIPS | 93.77 | 93.47 |
| CAHPS-3 | Patients’ Rating of Provider | CAHPS for MIPS | 93.70 | 92.06 |
| CAHPS-4 | Access to Specialists | CAHPS for MIPS | 80.48 | 77.00 |
| CAHPS-5 | Health Promotion and Education | CAHPS for MIPS | 65.43 | 62.68 |
| CAHPS-6 CAHPS: | Shared Decision Making | CAHPS for MIPS | 65.83 | 60.97 |
| CAHPS-7 | Health Status/Functional Status | CAHPS for MIPS | 73.05 | 73.06 |
| CAHPS-8 | Care Coordination | CAHPS for MIPS | 85.68 | 85.46 |
| CAHPS-9 | Courteous and Helpful Office Staff | CAHPS for MIPS | 92.08 | 91.97 |
| CAHPS-11 | Stewardship of Patient Resources | CAHPS for MIPS | 20.60 | 25.62 |
For previous years’ Financial and Quality Performance Results, please 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.