Integrated Care Services and the Medicare Shared Savings Program
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BMC Integrated Care Services and the Medicare Shared Savings Program

BMC Integrated Care Services (BMCICS) promotes the highest quality of coordinated patient care, patient safety and cost effective care among its participating providers through our integrated and coordinated managed care contracts and related medical management programs.

Medicare Designates BMCICS as an Accountable Care Organization (ACO).

BMCICS provides information to physicians and their staff on our managed care contracts, their requirements and their implementation processes.

Our medical management program supports our providers in promoting high-quality, efficient care by:

  • Minimizes variations in practice by monitoring, quality and effectiveness
  • Monthly quality reports
  • Provides prior authorizations for medically necessary or medically appropriate care
  • Conducts provider and member surveys
  • Credentials and re-credentials providers

Provider FAQ
Beneficiary FAQ

Contact Information

Phone: 617.478.3525
Fax: 617.897.0860
[email protected]


Public Reporting

ACO Name and Location

BMC Integrated Care Services, Inc.
One Boston Medical Center Place
Boston, Massachusetts 02118

ACO Primary Contact

Primary Contact Name Jessica Pagani
Primary Contact Phone Number

617-638-0996

Primary Contact Email Address

[email protected]

ACO Participants

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Trustees of Boston University

Y

Child Health Foundation of Boston, Inc.

Y

Mattapan Community Health Center, Inc.

Y

Manet Community Health Center Inc.

Y

Codman Square Health Center, Inc

Y

South Boston Community Health Center, Inc.

Y

Boston University Mallory Pathology Associates, Inc.

Y

Internal Medical Associates-EBNHC

Y

Boston University Obstetrics and Gynecology Foundation, Inc.

Y

Bumc Otolaryngologic Foundation Inc

Y

Boston University Affiliated Physicians, Inc.

Y

Boston University General Surgical Associates, Inc.

Y

Boston University Medical Center Radiologists, Inc.

Y

Boston Emergency Physician Foundation, Inc.

Y

Boston University Medical Center Urologists, Inc.

Y

Boston University Neurosurgical Associates, Inc.

Y

Boston Medical Center Corporation

Y

Boston University Dermatology, Inc.

Y

Boston University Family Medicine, Inc.

Y

Boston University Orthopaedic Surgical Associates, Inc.

Y

Boston University Psychiatry Associates, Inc.

Y

Boston University Neurology Associates, Inc.

Y

Dorchester House Multi-Service Center

Y

Upham's Corner Health Committee, Inc.

Y

Evans Medical Foundation Inc

Y

Boston University Radiation Oncology, Inc.

Y

Boston University Medical Center Anesthesiologists Inc

Y

Boston University Eye Associates Inc

Y

Harbor Health Services Inc

Y

ACO Governing Body

Member

Member's Voting Power

Membership Type

ACO Participant TIN Legal Business Name/DBA, if Applicable

Last Name

First Name

Title/Position

Orlando

Charles

Director

10%

ACO Participant Representative

Boston Medical Center Corporation

Bell

Alastair

Director

10%

ACO Participant Representative

Boston Medical Center Corporation

Davidoff

Ravin

President

10%

ACO Participant Representative

Boston Medical Center Corporation

Creevy

William

Director

10%

Other: President of Boston University Medical Group

Boston University Medical Group

Jacobs

Alice

Director

10%

ACO Participant Representative

Boston University Medical Group

Henderson

David

Director

10%

ACO Participant Representative

Boston University Medical Group

Halpin

William

Director

10%

ACO Participant Representative

South Boston Community Health Center, Inc.

Lopes

Manuel

Director

10%

ACO Participant Representative

East Boston Community Health Center, Inc.

Trivedi

Jagdeep

Director

10%

ACO Participant Representative

Upham's Corner Health Committee, Inc.

Chobanian

Aram

Director

10%

Medicare Beneficiary Representative

N/A

Key ACO Clinical and Administrative Leadership

Michael Olsen

ACO Executive

Rebecca Grochow Mishuris

Interim Medical Director

Craig Bennett

Compliance Officer

Rebecca Grochow Mishuris

Quality Assurance/Improvement Officer

Associated Committees and Committee Leadership

Committee Name

Committee Leader Name and Position

Finance/Budget Committee of Boston Accountable Care Organization Inc.,

William Creevy, MD – President of Boston University Medical Group

Quality, Clinical, Information Technology & Informatics Committee of Boston Accountable Care Organization

Charlie Williams, MD – Medical Director of HealthNet – ACO Medical Director

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

  • Second Agreement Period
    • Performance Year 2019, $ 2,352,403
    • Performance Year 2018, $1,905,632
  • First Agreement Period
    • Performance Year 2017, $0
    • Performance Year 2016, $0
    • Performance Year 2015, $4,217,885

Shared Savings Distribution

  • Second Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2018
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 80%
  • 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: 0%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 100%

Quality Performance Results

2019 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

84.67

85.86

ACO-2

CAHPS: How Well Your Providers Communicate

94.51

94.11

ACO-3

CAHPS: Patients’ Rating of Provider

94.58

92.69

ACO-4

CAHPS: Access to Specialists

80.56

81.54

ACO-5

CAHPS: Health Promotion and Education

67.47

60.44

ACO-6

CAHPS: Shared Decision Making

60.61

62.78

ACO-7

CAHPS: Health Status/Functional Status

73.72

73.79

ACO-34

CAHPS: Stewardship of Patient Resources

23.76

26.17

ACO-45

CAHPS: Courteous and Helpful Office Staff

91.06

92.84

ACO-46

CAHPS: Care Coordination

86.34

86.89

ACO-8

Risk Standardized, All Condition Readmission

15.54

14.86

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

67.35

58.15

ACO-43

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

1.93

1.87

ACO-13

Falls: Screening for Future Fall Risk

83.71

84.04

ACO-14

Preventive Care and Screening: Influenza Immunization

76.25

74.77

ACO-17

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

64.60

78.04

ACO-18

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

69.39

70.40

ACO-19

Colorectal Cancer Screening

73.53

70.76

ACO-20

Breast Cancer Screening

82.41

73.84

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

87.75

82.17

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

14.06

13.88

ACO-40

Depression Remission at Twelve Months

3.30

13.58

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

64.79

75.04

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low sample size.

Note: In the Quality Performance Results file(s) above, search for “BMC Integrated Care Services, Inc.” to view the quality performance results. This ACO can also be found by using the ACO ID A2666 in the public use files on 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.

Patient Advisory Committee – BMC Integrated Care Services, Inc. 

The needs and desires of the patient population of BMC Integrated Care Services is at the forefront of our work. To that end, the BMC Integrated Care Services, as a part of its governance structure, has a Patient Advisory Committee. The purpose of the Committee is to assist the Board in meeting its responsibilities to ensure that the interest of the ACO’s patients, and their families, are met. The Committee has appointed a consumer representative to sit on the BMC Integrated Care Services’ Board of Directors, and intends to recommend a consumer or consumer advocate to represent patients with disabilities to the Board or one of its Committees, in the near future.

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