ACO Realizing Equity, Access, and Community Health (REACH) Model

ACO Realizing Equity, Access, and Community Health (REACH) Model Information

 

Accountable Care Organization (ACO) name and location

UT Southwestern Accountable Care Network dba Southwestern Health Resources Accountable Care Network
1601 Lyndon B, Johnson Freeway, Suite 200
Farmers Branch, Texas 75234

Mailing address: 

1601 Lyndon B. Johnson Freeway, Suite 200
Farmers Branch, Texas 75234

Hours of operation:

  • Monday: 8 a.m. – 5 p.m.
  • Tuesday: 8 a.m. – 5 p.m.
  • Wednesday:  8 a.m. – 5 p.m.
  • Thursday: 8 a.m. – 5 p.m.
  • Friday: 8 a.m. – 5 p.m.
     

Phone: 214-389-7272

 

ACO primary contact

Michelle Mirkovic, Program Director, Regulatory and Value-Based Care
Email: michelle.mirkovic@southwesternhealth.org

 

Accountable Care Organization information

Southwestern Health Resources Accountable Care Network (SWHRACN) represents a model of health care delivery based on a strategy to better align physicians, hospitals, and payers in order to provide better access to care, better clinical quality, and control costs. In January 2022, SWHRACN was selected to participate in Global and Professional Direct Contracting (GPDC) Model through the Centers for Medicare and Medicaid Services (CMS) as a Direct Contracting Entity (DCE).  That model changed for the 2023 performance year to ACO Realizing Equity, Access, and Community Health (REACH). SWHRACN works with CMS through the ACO REACH Model to provide high-quality care in a cost-efficient manner with a patient-centered approach. SWHRACN shares the following information regarding its participation as an ACO:

Southwestern Health Resources Accountable Care Network Governing Body

  • Steven Leach, M.D., Voting Member and Chairman, UT Southwestern Medical Center, ACO participant representative
  • Donna Casey, M.D., Voting Member, Franklin Leroy Casey, P.A., ACO participant representative
  • Donald Fowler, M.D., Voting Member, Texas Health Physicians Group, ACO participant representative
  • Temple Howell-Stampley, M.D., Voting Member, UT Southwestern Medical Center, ACO participant representative
  • Mara Cunningham, D.O., Voting Member, UT Southwestern Medical Center, ACO participant representative
  • Shawn Parsley, D.O., Voting Member, Texas Health Physicians Group, THPG group representative
  • Randall Todd Richwine, D.O., Voting Member, Texas Health Physicians Group, ACO participant representative
  • Twinkle Anne Myint, M.D., Voting Member, Texas Health Physicians Group, ACO participant representative
  • Donald Zale, Voting Member, Medicare Beneficiary Representative, Retired
  • Stacey Malcolmson, Voting Member, Consumer Advocate, President and CEO of The Senior Source

 

Key Clinical and Administrative Leadership

  • Senior Executive Officer:  Jenny Reed, Southwestern Health Resources Clinically Integrated Network
  • Chief Medical Officer/Governing Body Medical Director:  Robert DeMartini, M.D., Southwestern Health Resources Clinically Integrated Network
  • Chief Market, Payor Relations, and Finance Officer:  Brian Felty, Southwestern Health Resources Clinically Integrated Network
  • Governing Body Secretary:  Stacy Cantu, Texas Health Resources
  • Vice President & Chief Legal Officer/Assistant Governing Body Secretary:  Randall Smith, Southwestern Health Resources Clinically Integrated Network

 

Southwestern Health Resources Accountable Care Network Committees and Committee Leaders

  • Network Quality and Performance Committee: William Daniel, M.D. and Winjie Miao Co-Chairs
  • Finance Committee: Rick McWhorter, Chair
  • Credentials Committee: Steven Bloom, M.D., Chair
  • Clinical Integration Committee: Eric Zeikus , M.D., Chair
  • Audit and Compliance Committee:  Holly Crawford, Chair
  • Network Strategy Committee: Laura Irvine and Marcia Schneider

 

Accountable Care Organization Composition

Physician-led partnership between UT Southwestern Medical Center, Texas Health Physicians Group, community physicians, and other health care providers organized to improve health care in communities we serve.

 

Shared Savings and Losses

SWHRACN is obligated under its ACO REACH Model participation agreement with CMS to secure potential shared losses and other monies owed under the ACO REACH Model with a financial guarantee.

Amount of Savings and Losses

  • Medicare Shared Savings Program (SSP) Performance Year 2014: $2,945,035 (Amount of Shared Savings)
  • Medicare Shared Savings Program (SSP) Performance Year 2015: $14,188,861 (Amount of Shared Savings)
  • Medicare Shared Savings Program (SSP) Performance Year 2016: $17,464, 034 (Amount of Shared Savings)
  • Next Generation ACO Model (NGACO) Performance Year 2017: $29,868,673 (Amount of Shared Savings)
  • Next Generation ACO Model (NGACO) Performance Year 2018: $37,122,892 (Amount of Shared Savings)
  • Next Generation ACO Model (NGACO) Performance Year 2019:  $50,626,938 (Amount of Shared Savings)
  • Next Generation ACO Model (NGACO) Performance Year 2020:  $30,945,618 (Amount of Shared Savings)
  • Next Generation ACO Model (NGACO) Performance Year 2021:  $8,084,378 (Amount of Shared Savings)
  • Global and Professional Direct Contracting (GPDC) Performance Year 2022: $27,083,733 (Amount of Shared Savings)
  • ACO Realizing Equity, Access, and Community Health (REACH) Performance Year 2023:  $37,945,187 (Amount of Shared Savings)

 

Savings Distribution

Medicare Shared Savings Program (SSP) Agreement period beginning 2014, Performance Years 2014, 2015, 2016:

  • Proportion invested in infrastructure: 19 percent
  • Invested in redesigned care processes/resources: 22 percent
  • Proportion of distribution to ACO participants: 59 percent
     

Next Generation ACO Model (NGACO) Agreement period beginning 2017, Performance Years 2017, 2018, 2019, 2020, 2021:

  • Proportion invested in infrastructure: 19 percent
  • Invested in redesigned care processes/resources: 22 percent
  • Proportion of distribution to ACO participants: 59 percent
     

Global and Professional Directing Contracting (GPDC) Model Performance Year 2022:

  • Proportion invested in infrastructure:  19 percent
  • Proportion invested in redesigned care processes/resources:  22 percent
  • Proportion of distribution to DCE participants:  59 percent
     

ACO Realizing Equity, Access, and Community Health (REACH) Model Performance Year 2023:

  • Proportion of shared savings invested in infrastructure:  52 percent
  • Proportion of shared savings distributed to ACO participants:  48 percent

 

ACO Quality Performance Results

 

To learn more about the ACO REACH Model

 

For ACO REACH participants ONLY – reporting violations and concerns

To report suspected violations or compliance related concerns, please contact the Compliance Helpline at the following:

Phone: 1-877-507-7319
Email: swhrcompliance@southwesternhealth.org