ACO Name and Location
Rio Grande Valley Health Alliance, LLC.
20079 Stone Oak Pkwy Ste 1105 #496
San Antonio, TX 78258
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 2020, $0
- 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 2020
- 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 2019
- Proportion invested in infrastructure: 15%
- Proportion invested in redesigned care processes/resources: 5%
- Proportion of distribution to ACO participants: 80%
- Performance Year 2020
- 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%
- Performance Year 2019
- 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
- Performance Year 2015
Quality Performance Results
2020 Quality Performance Results:
ACO Quality Measure Number Measure Name Rate ACO Mean ACO-8 Risk Standardized, All Condition Readmission 15.56 15.07 ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 40.82 49.50 ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 0.71 0.95 ACO-13 Falls: Screening for Future Fall Risk 100.00 84.97 ACO-14 Preventive Care and Screening: Influenza Immunization 96.28 76.03 ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 92.31 81.67 ACO-18 Preventive Care and Screening: Screening for Depression and Follow-up Plan 93.50 71.46 ACO-19 Colorectal Cancer Screening 93.25 72.59 ACO-20 Breast Cancer Screening 86.17 74.05 ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 92.71 83.37 ACO-40 Depression Remission at Twelve Months 13.33 13.99 ACO-27 Diabetes: Hemoglobin A1c Poor Control (>9%) 7.26 14.70 ACO-28 Controlling High Blood Pressure 94.55 72.87 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.
- Second Agreement Period