Sunshine ACO, LLC.

Public Reporting



ACO Name and Location

Sunshine ACO LLC
3420 Carmen Ave
Rancho Viejo, Texas 78575

ACO Primary Contact

Primary Contact Name

Rod Miller

Primary Contact Phone Number

618-696-0933

Primary Contact Email Address

rod.miller@sunshine-aco.com

Organizational Information

ACO participants:

ACO Participants

ACO Participant in Joint Venture (Enter Y or N)

Carlos Rosas MD PA

N

Family Care Specialists, LLC

N

Luis Reynoso MD PA

N

Juan Garcia

N

C L Anderson Jr MD PA

N

Medical Associates of Brownsville

N

Miguel Angel Molinas MD PA

N

Alberto Edmundo Almeida MDPA

N

Graciela Leija MD PA

N

Shridhar Kotta MD PA

N

Roxana Pagan-Maldonado MDPA

N

Diana Lozano MD PA

N

Yasmin S Maldonado MD PA

N

 


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

Anderson

C. Lynn

President

1

ACO Participant

C. Lynn Anderson, MD PA

Leija

Graciela

First Vice President

1

ACO Participant

Graciela Leija, MD PA

Kotta

Shridhar

Second Vice President

1

ACO Participant

Shridhar Kotta, MD PA

Rosas

Carlos

Secretary

1

ACO Particpant

Carlos Rosas MD PA

Guevara

Jorge

Treasurer

1

ACO Participant

Medical Associates of Brownsville

Lozano

Diana

Medical Director

1

ACO Participant

Diana Lozano MD PA

Peggy

Klinger

Medicare Beneficiary Representative

1

Medicare Beneficiary

N/A


 

Key ACO clinical and administrative leadership:

C. Lynn Anderson

ACO Executive

Diana Lozano

Medical Director

Diana Lozano

Compliance Officer

Yasmin Maldonado

Quality Assurance/Improvement Officer

 

Associated committees and committee leadership:

Committee Name

Committee Leader Name and Position

Executive Committee

C. Lynn Anderson, M.D. , Chair

Clinical Committee

Diana Lozano, M. D., Chair

Finance Committee

Jorge Guevara, M.D., Chair

Data and Technology

Shridhar Kotta, M.D. Chair

 

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

  • Second Agreement Period
    • Performance Year 2017, $1,602,273

  • First Agreement Period

    • Performance Year 2016, $3,627,676
    • Performance Year 2015, $4,156,716
    • Performance Year 2014, $2,732,839

Shared Savings Distribution

  • Second Agreement Period

    • Performance Year 2017

      • Proportion invested in infrastructure: 5%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 80%

  • First Agreement Period

    • Performance Year 2016

      • Proportion invested in infrastructure: 5%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 80%

    • Performance Year 2015

      • Proportion invested in infrastructure: 5%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 80%

    • Performance Year 2014

      • Proportion invested in infrastructure: 5%
      • Proportion invested in redesigned care processes/resources: 15%
      • Proportion of distribution to ACO participants: 80%

 

Quality Performance Results

2017 Quality Performance Results:

ACO#

Measure Name

Rate

ACO Mean

ACO-1

CAHPS: Getting Timely Care, Appointments, and Information

80.10

80.60

ACO-2

CAHPS: How Well Your Providers Communicate

90.40

93.13

ACO-3

CAHPS: Patients’ Rating of Provider

91.49

92.31

ACO-4

CAHPS: Access to Specialists

85.14

83.32

ACO-5

CAHPS: Health Promotion and Education

66.29

62.30

ACO-6

CAHPS: Shared Decision Making

74.24

75.85

ACO-7

CAHPS: Health Status/Functional Status

68.64

73.05

ACO-34

CAHPS: Stewardship of Patient Resources

23.98

25.68

ACO-8

Risk Standardized, All Condition Readmission

15.07

15.01

ACO-35

Skilled Nursing Facility 30-day All-Cause Readmission measure (SNFRM)

18.95

18.46

ACO-37

All-Cause Unplanned Admissions for Patients with Heart Failure

75.49

79.16

ACO-38

All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions

54.59

61.74

ACO-43

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

1.78

1.93

ACO-11

Use of Certified EHR Technology

100.00

98.48

ACO-12

Medication Reconciliation

53.43

75.32

ACO-13

Falls: Screening for Future Fall Risk

90.10

74.38

ACO-44

Imaging Studies for Low Back Pain

61.29

67.32

ACO-14

Preventive Care and Screening: Influenza Immunization

80.00

72.52

ACO-15

Pneumonia Vaccination Status for Older Adults

81.48

72.92

ACO-16

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up

81.31

70.69

ACO-17

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

94.25

90.48

ACO-18

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

79.29

61.98

ACO-19

Colorectal Cancer Screening

71.22

64.58

ACO-20

Breast Cancer Screening

77.87

70.05

ACO-42

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

86.10

79.89

ACO-27

Diabetes Mellitus: Hemoglobin A1c Poor Control

13.31

16.74

ACO-41

Diabetes: Eye Exam

63.57

50.37

ACO-28

Hypertension (HTN): Controlling High Blood Pressure

86.49

71.47

ACO-30

Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

93.90

86.86

 




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



 


Note: In the Quality Performance Results file(s) above, search for “Sunshine ACO LLC” or "Sunshine ACO LLC" to view the quality performance results. This ACO can also be found by using the ACO ID A-2011 in the public use files on data.cms.gov.


Payment Rule Waivers


  • Yes, our ACO does use the SNF 3-Day Rule Waiver.