Accountable Care Organization (ACO)

How DuPage Med­ical Group is work­ing to improve your health care

DuPage Med­ical Group is par­tic­i­pat­ing in DuPage Med­ical Group ACO, an Account­able Care Orga­ni­za­tion (ACO).

Shared Sav­ings Pro­gram Pub­lic Reporting

What’s an ACO?

ACOs:

  • Are groups of doc­tors, hos­pi­tals and/​or oth­er health care providers that work togeth­er to improve the qual­i­ty and expe­ri­ence of care you receive. Our prac­tice chose to be part of an ACO because we think it will help us pro­vide bet­ter care for our patients.
  • Don’t lim­it your choice of health care providers.
  • Your Medicare ben­e­fits aren’t chang­ing. You’ll have the right to vis­it any doc­tor, hos­pi­tal, or oth­er provider that accepts Medicare at any time, just like you do now.
  • Are eval­u­at­ed by Medicare to see how well each ACO meets these goals every year. Those ACOs that do a good job can earn a finan­cial bonus. ACOs that earn a bonus may use the pay­ment to invest more in your care or share part of it with your providers. Some­times, ACOs may owe a penal­ty if their care increas­es costs.
  • Aren’t a Medicare Advan­tage plan, an all in one” alter­na­tive to Orig­i­nal Medicare, offered by Medicare-approved pri­vate com­pa­nies. An ACO isn’t an HMO plan or insur­ance plan of any kind. 

How can I make the most of get­ting care from an ACO?

  • Ask your clin­i­cian about sign­ing up for our secure online por­tal that gives you 24-hour access to your per­son­al health infor­ma­tion, includ­ing lab results and provider rec­om­men­da­tions. This will help you make informed deci­sions about your health care, track your treat­ment, and mon­i­tor your outcomes.
  • Let Medicare know who you con­sid­er your pri­ma­ry clin­i­cian or main doc­tor”. Your pri­ma­ry clin­i­cian is the health care provider you believe is respon­si­ble for coor­di­nat­ing your over­all care. If you choose a pri­ma­ry clin­i­cian, that clin­i­cian may have more tools or ser­vices to help with your care. We can tell you more about how to do this.
  • Con­tin­ue to let Medicare share your health care infor­ma­tion to help us bet­ter coor­di­nate and improve the qual­i­ty of your care. If you don’t want Medicare to share your health care infor­ma­tion, call 1 – 800-MEDICARE (1−800−633−4227). Tell them that your health care provider is part of an ACO and you don’t want Medicare to share your health care infor­ma­tion. TTY users can call 1−877−486−2048.

What does this mean for my care?

  • Giv­ing health care providers the option of work­ing with a group like DuPage Med­ical Group ACO is one of the ways Medicare helps us bet­ter coor­di­nate your care and give you bet­ter qual­i­ty care.
  • To help us coor­di­nate your health care bet­ter, Medicare shares infor­ma­tion about your care with your providers, like dates and times you vis­it­ed a health care provider, your med­ical con­di­tions, and a list of past and cur­rent prescriptions.
  • Shar­ing your data helps make sure all the providers involved in your care have access to your health infor­ma­tion when and where they need it. This infor­ma­tion helps DuPage Med­ical Group ACO give you bet­ter, more coor­di­nat­ed care by keep­ing track of the care and tests that you’ve already had. It may also make it eas­i­er to spot poten­tial prob­lems before they’re more seri­ous – like drug inter­ac­tions that can hap­pen if one doc­tor isn’t aware of what anoth­er has prescribed.

Ques­tions?

  • For more details about our ACO, ask the front desk for a copy of the ACO ben­e­fi­cia­ry notice.
  • If you have ques­tions or con­cerns, call us at 630−348−3412,or we can talk about them dur­ing your vis­it in our office. You can also call 1 – 800-MEDICARE or vis­it: Medicare​.gov/​a​c​o​s​.html.

ACO Name and Location

Nation­al Physi­cian Admin­is­tra­tive Ser­vices, LLC

1100 West 31st Street Suite 300

Down­ers Grove, IL 60515 

ACO Pri­ma­ry Contact

Luke Croswell

630−456−7174

Orga­ni­za­tion­al Information

ACO par­tic­i­pants:

ACO Par­tic­i­pants

ACO Par­tic­i­pant in Joint Venture

DuPage Med­ical Group LTD

N

David G. Ver­mil­lion, MD, SC

N

David L Ellens, MD, FACP, LLC

N

Dr. Diana Burda

N

Dr. Matthew Brandon

N

Dr. Praghati Challa

N

Elgin IM

N

Ever­green

N

Mid­west Geri­atrics LLC

N

North­west Spe­cial­ty Med­i­cine, PC

N

North­west Health Care Associated

N

Primed

N

South­West Med­ical Affiliates

N

South­west Physi­cians Group

N

Tin­ley Pri­ma­ry Care

N

West­brook IM

N

Wom­ens Well­ness World

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/​DBA, if applicable

Mer­rick

Paul

Chair

1

ACO Par­tic­i­pant Representative

DuPage Med­ical Group, LTD

Pacetti

Mike

Vot­ing Member

1

ACO Par­tic­i­pant Representative

DuPage Med­ical Group, LTD

Kwiecin­s­ki

Michael

Vot­ing Member

1

ACO Par­tic­i­pant Representative

DuPage Med­ical Group, LTD

Phillip

Math­ew

Vot­ing Member

1

ACO Par­tic­i­pant Representative

DuPage Med­ical Group, LTD

Bod­di­pal­li

Vive­ka

Vot­ing Member

1

ACO Par­tic­i­pant Representative

DuPage Med­ical Group, LTD

Dun­gan

Dave

Vot­ing Member

1

ACO Par­tic­i­pant Representative

DuPage Med­ical Group, LTD

Hurteau

Andrea

Vot­ing Member

1

ACO Par­tic­i­pant Representative

DuPage Med­ical Group, LTD

Poland

Robert

Vot­ing Member

1

Medicare Ben­e­fi­cia­ry Representative

N/A

Aubey

Josh

Com­pli­ance Officer

Non-Vot­ing

ACO Par­tic­i­pant Representative

DuPage Med­ical Group, LTD

Key ACO clin­i­cal and admin­is­tra­tive leadership:

ACO Exec­u­tive: Luke Croswell

Med­ical Direc­tor: Michael Kwiecin­s­ki, MD

Com­pli­ance Offi­cer: Josh Aubey

Qual­i­ty Assurance/​Improvement Offi­cer: Luke Croswell

Asso­ci­at­ed com­mit­tees and com­mit­tee leadership:

Com­mit­tee Name

Com­mit­tee Leader Name and Position

Qual­i­ty Assur­ance & Uti­liza­tion Man­age­ment Committee

Dave Dun­gan, MD, Chair

Oper­a­tions Committee

Luke Croswell, Chair

Types of ACO par­tic­i­pants, or com­bi­na­tions of par­tic­i­pants, that formed the ACO:

  • ACO pro­fes­sion­als in a group prac­tice arrangement.

Shared Sav­ings and Losses

Amount of Shared Savings/​Losses:

  • First Agree­ment Period
    • Per­for­mance Year 2020, $0

Shared Sav­ings Distribution:

  • First 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

Qual­i­ty Per­for­mance Results

2019 Qual­i­ty Per­for­mance Results: Our ACO did not par­tic­i­pate in Shared Sav­ings Pro­gram in the 2019 per­for­mance year, there­fore this sec­tion is not applic­a­ble at this time.

ACO #

Mea­sure Name

Rate

ACO Mean

N/A

N/A

N/A

N/A

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