Public Reporting

ACO Name and Location

Rio Grande Valley Health Alliance, LLC.

200 S. 10th Street, Suite 407

McAllen, Texas 78501

 

ACO Primary Contact

Victoria Farias

  (956) 627-4602

  vfarias@rgvha.org

 

Organizational Information

ACO Participants:

ACO Participants ACO Participant in Joint Venture
Alcides Amador N
Alfredo Lopez, Jr., M.D., P.A. N
Alfredo V. Gonzalez, M.D.,P.A. N
Dona E. Cooper-Dockery, M.D., P.A. N
Eduardo Guzman MD PA N
Javier A. Saenz, M.D., P.A. N
La Joya”s Neighborhood Doctor, P.A. N
Luis Delgado, Jr., M.D., P.A. N
Manuel J Mercado MD PA N
Mario R. Anzaldua MD PA N
Maximiliano Hernandez MD PA N
Palm Valley Medical Clinic PA N
Rene Vela M.D.,P.A N
Samuel Garcia Jr. Md PLLC N
Sobia Nasir Md PA N
Socrates A. Garrigos M.D. P.A. N
Valley Internal Medicine Associates PLLC N
Villarreal Medical Center PA 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 and D/B/A, if applicable
Delgado Luis President 14.29% Voting Member Luis Delgado Jr., M.D., P.A.
Garcia Samuel Vice- President 14.29% Voting Member Samuel Garcia Jr., M.D., PLLC
Saenz Javier Treasurer 14.29% Voting Member Javier A. Saenz, M.D., P.A.
Anzaldua Mario Medical Director 14.29% Voting Member Mario R. Anzaldua, M.D., P.A.
Lopez Alfredo Quality Assurance/ Improvement Officer 14.29% Voting Member Alfredo Lopez Jr., M.D., P.A.
Swarup Anu Compliance Officer 14.29% Voting Member Valley Internal Medicine Associates, PLLC.
Espinosa Juan Medicare Beneficiary Representative 14.29% Voting Member  

 

Key ACO Clinical and Administrative Leadership:

ACO Executive: Victoria Farias

Medical Director: Dr. Mario Anzaldua

Compliance Officer: Dr. Anu Swarup

Quality Assurance/Improvement Officer: Dr. Alfredo Lopez, Jr.

 

Associated Committees and Committee Leadership:

 

Committee Name Committee Leader Name and Position
Executive Committee Luis Delgado, Jr, M.D., P.A., Chair
Clinical Best Practices Committee Mario Anzaldua, M.D., Chair
Finance Committee Javier A. Saenz, M.D., Chair
Health Information and Data Committee Norma Cavazos- Salas, M.D., Chair
Compliance Committee Anu Swarup, M.D., Chair
Quality Improvement and Assurance Committee Alfredo Lopez, Jr., 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:

  • Third Agreement Period
  • Performance Year 2019, $4,006,142

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.

  • Second Agreement Period
  • Performance Year 2019, $4,006,142
  • Performance Year 2018, $6,762,864
  • Performance Year 2017, $6,844,479
  • Performance Year 2016, $6,175,625
  • First Agreement Period
  • Performance Year 2015, $6,947,600
  • Performance Year 2014, $3,403,175
  • Performance Year 2013, $2,945,246

Shared Savings Distribution:

  • Third Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources:  5%
      • Proportion of distribution to ACO participants: 80%

Note: Our ACO participated in multiple performance years during Calendar Year 2019. Distribution of shared savings reported for Performance Year 2019 therefore represents the distribution of the net shared savings across all performance years in 2019 and is shown under all agreement periods in which the ACO operated during Calendar Year 2019.

  • Second Agreement Period
    • Performance Year 2019
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources:  5%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2018
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources:  5%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2017
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources:  5%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2016
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 80%

 

  • First Agreement Period
    • Performance Year 2015
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2014
      • Proportion invested in infrastructure: 15%
      • Proportion invested in redesigned care processes/resources: 5%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2013
      • 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 Quality Measure Number Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 87.61 85.86
ACO-2 CAHPS: How Well Your Providers Communicate 93.70 94.11
ACO-3 CAHPS: Patients’ Rating of Provider 92.39 92.69
ACO-4 CAHPS: Access to Specialists 81.89 81.54
ACO-5 CAHPS: Health Promotion and Education 70.23 60.44
ACO-6 CAHPS: Shared Decision Making 58.67 62.78
ACO-7 CAHPS: Health Status/Functional Status 72.37 73.79
ACO-34 CAHPS: Stewardship of Patient Resources 29.12 26.17
ACO-45 CAHPS: Courteous and Helpful Office Staff 89.82 92.84
ACO-46 CAHPS: Care Coordination 86.31 86.89
ACO-8 Risk Standardized, All Condition Readmission 15.22 14.86
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 55.79 58.15
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.56 1.87
ACO-13 Falls: Screening for Future Fall Risk 100.00 84.04
ACO-14 Preventive Care and Screening: Influenza Immunization 94.97 74.77
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 90.91 78.04
ACO-18 Preventive Care and Screening: Screening for Depression and Follow-up Plan 95.08 70.40
ACO-19 Colorectal Cancer Screening 93.15 70.76
ACO-20 Breast Cancer Screening 81.02 73.84
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 90.30 82.17
ACO-27 Diabetes: Hemoglobin A1c Poor Control (>9%) 9.45 13.88
ACO-28 Controlling High Blood Pressure 94.76 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.

 

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.

 

 

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