Shared Savings Program Public Reporting Template

ACO Name and Location

Henry Ford Physicians Accountable Care Organization, LLC; D/B/A Mosaic ACO
One Ford Place, Suite 2E

ACO Primary Contact

Jane Thornhill
313-874-1466
[email protected]

Organizational Information

ACO Participants:

ACO Participants ACO Participant in Joint Venture
AARON M VANWAGNEN MD PLLC N
ALI ORANDI MD PLC N
ALLI MED PLLC N
ANDREW M LAFLEUR MD PLC N
ARNOLD FAMILY CHIROPRACTIC PLLC N
ARSHAD AQIL MD PLLC N
ARTHUR R VENDOLA MD PC N
BEVERLY JAREMA N
BRAD E KREMER PLLC N
BRENT J RAAP DO PC N
CARDIOLOGY GROUP OF LANSING PC N
CENTER FOR COMPLEMENTARY AND INTEGRATIVE MEDICINE N
CENTER FOR FAMILY HEALTH N
CHARLOTTE YANG N
CHERYL A COLLETTI DO PLLC N
CLAUDIA ZACHAREK MD PLC N
COVENANT MEDICAL CENTER INC N
DANIEL P FREEMAN MD PC N
DAVID HALSEY N
DECKERVILLE COMMUNITY HOSPITAL, INC N
DOMINADOR LAYNES N
DONALD C JONES MD PC N
DONNA M O'NEILL M.D. P.C. N
DR MARTINS FOOT AND ANKLE CLINIC N
DR. J. THWAINEY MD PC N
EVELYN ECCLES N
GHAZWAN ATTO MD PC N
HENRY FORD HEALTH SYSTEM N
HENRY FORD MACOMB HOSPITAL CORPORATION N
HENRY FORD WEST BLOOMFIELD HOSPITAL N
HENRY FORD WEST BLOOMFIELD PHYSICIANS N
HENRY FORD WYANDOTTE HOSPITAL N
HILLS & DALES GENERAL HOSPITAL INC N
HILLSDALE PULMONARY CRITICAL CARE AND SLEEP MEDICINE PC N
IMDAD H BUTT MD PC N
JACKSON CARDIOLOGY CONSULTANTS PLLC N
JACKSON FAMILY MEDICAL PLLC N
JACKSON OB GYN PLC N
JACKSON RADIOLOGY CONSULTANTS, P.C. N
JAMES LAFLEUR N
JILL M PAVEGLIO MD PLC N
JONESVILLE HEALTHCARE PLLC N
KIDNEY AND HYPERTENSION SPECIALISTS PLLC N
LORNA G. PINSON, MD PLLC N
LYNN VAN WAGNEN MD PC N
MARK HEINZELMANN N
MARK LEVENTER N
MARLETTE REGIONAL HOSPITAL N
MICHIGAN INSTITUTE OF NEUROLOGICAL DISEASES, PLLC N
MICHIGAN SPINE AND BRAIN INSTITUTE, PC N
MID MICHIGAN EYE CARE CENTER PC N
MID MICHIGAN GASTROENTEROLOGY CONSULTANTS PC N
MID MICHIGAN VASCULAR SURGERY, P.C. N
MINOO KHETARPAL MD PLLC N
MOLLY PARKER DO PC N
NADEEM ULLAH MD PLC N
PARMINDER JASWAL,MD,PLC N
PERSONALIZED FAMILY PRACTICE PLLC N
PHILLIP FRANTZIS N
PLASENCIA FAMILY MEDICINE PLLC N
PULMONARY CLINICS OF SOUTHERN MICHIGAN N
RAJAN PASTORIZA MD PLC N
RAJENDRA MEHTA, MD, PC N
RAKESH CHOKSHI MD PLC N
REZA KAHNAMOUEI MD PLLC N
ROBERT M DOANE MD PC N
RONALD L GONZALES MD PLLC N
SAGINAW VALLEY MEDICAL CARE PLC N
SAJEDA NUSRAT MD FAMILY MEDICINE PLLC N
SCHEURER HOSPITAL N
SPRINGCREST FAMILY PHYSICIANS, P.C. N
SUBBARAO CHAVALI N
SUMMIT PODIATRY GROUP PC N
TRICITY INTERNISTS N
VALLEY ENT ASSOCIATES PC N
W A FOOTE MEMORIAL HOSPITAL INC 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
Bruce Muma CEO/CMO/Medical Director 0% Other N/A
Robin Damschroder Treasurer 0% Other N/A
Michelle Johnson-Tijani Secretary 0% Other N/A
Ronald Gonzales Voting Member 10% ACO Participant Representative RONALD L GONZALES MD PLLC
Kevin Albosta Voting Member 10% ACO Participant Representative COVENANT MEDICAL CENTER INC
Ross Ramsey Voting Member 10% ACO Participant Representative SCHEURER HOSPITAL
Courtland Keteyian Voting Member 10% ACO Participant Representative W A FOOTE MEMORIAL HOSPITAL INC
David Kolde Voting Member 10% ACO Participant Representative W A FOOTE MEMORIAL HOSPITAL INC
Anish Wadhwa Voting Member 10% ACO Participant Representative PULMONARY CLINICS OF SOUTHERN MICHIGAN
Eunice Yu Voting Member 10% ACO Participant Representative HENRY FORD HEALTH SYSTEM
Christopher Milback Voting Member 10% ACO Participant Representative HENRY FORD MACOMB HOSPITAL CORPORATION
Akshay Khandelwal Voting Member 10% ACO Participant Representative HENRY FORD HEALTH SYSTEM
Edward Callahan Voting Member 10% Medicare Beneficiary Representative N/A

Key ACO Clinical and Administrative Leadership:

ACO Executive: Jane Thornhill
Medical Director: Bruce Muma, MD
Compliance Officer: Kevin Durell, DO
Qualified Healthcare Professional: Joyce Leon, MD

Associated Committees and Committee Leadership:

Committee Name Committee Leader Name and Position
Executive Committee Dr. Bruce Muma, Interim Chair
Clinical Integration Committee Dr. Bruce Muma, Interim Chair
Nominating and Membership Committee Dr. Bruce Muma, Interim Chair
Finance and Contracting Committee Dr. Bruce Muma, Interim Chair
Technology and Analytics Committee Dr. Bruce Muma, Interim Chair

Types of ACO Participants, or Combinations of Participants, That Formed the ACO:

ACO professionals in group practice arrangements. Partnerships or joint venture arrangements between hospitals and ACO professionals. Hospitals employing ACO professionals.

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • N/A, Henry Ford Physicians Accountable Care Organization is operating in its first agreement period and has not yet received financial reconciliation results.

Shared Savings Distribution:

  • N/A, Henry Ford Physicians Accountable Care Organization is operating in its first agreement period and has not yet received financial reconciliation results.

Quality Performance Results:

  • Henry Ford Physicians Accountable Care Organization did not participate in the Shared Savings Program in the 2020 performance year, therefore this section is not applicable at this time.

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. 

Fraud and Abuse Waivers

  • ACO Pre-Participation Waiver:

The following information describes each arrangement for which our ACO seeks protection under the ACO Pre-Participation Waiver, including any material amendment or modification to a disclosed arrangement.

Application and Operational Services:

  • Parties to the arrangement: ACO, ACO participants, ACO providers/suppliers, and vendors providing services to the ACO, ACO participants and/or ACO providers/suppliers.
  • Date of arrangement: As of January 1, 2021.
  • Items, services, goods or facility provided: The ACO entered into an arrangement pursuant to which Henry Ford Health System (an ACO participant) provided all funding for the administrative services, management services, professional services, and information technology infrastructure and services necessary to reorganize the ACO, submit an MSSP application, and qualify for participation in the MSSP. Under this arrangement the ACO participants agreed to participate in the ACO and MSSP, and provide in-kind services to and for the ACO and other ACO participants. Each of the ACO participants also participate in one of three regional networks. Each of the three regional networks has agreed to reimburse Henry Ford Health System (“HFHS”), on an equal pro rata basis, the total amount expended by HFHS for such administrative services, management services, professional services, and information technology infrastructure and services. This arrangement included the review and revision of the ACO articles of organization, operating agreement, and participation agreements; the submission of the MSSP application and supporting documentation; acquiring and providing the MSSP repayment mechanism; and completing all the MSSP signing event requirements.
  • Date and nature of any amendments to the arrangement, if applicable: None.
  • ACO Pre-Participation Waiver:

The following information describes each arrangement for which our ACO seeks protection under the ACO Participation Waiver, including any material amendment or modification to a disclosed arrangement.

Operational Services:

  • Parties to the arrangement: ACO, ACO participants, ACO providers/suppliers, and vendors providing services to the ACO, ACO participants and/or ACO providers/suppliers.
  • Date of arrangement: As of January 1, 2021.
  • Items, services, goods or facility provided:The ACO has entered into a management services agreement pursuant to which Henry Ford Physician Network (“HFPN”), will provide all administrative services, management services, professional services, and information technology infrastructure and services related to the ACO’s participation in the MSSP. Each of the three regional networks will be responsible for an equal pro rata share of the fees charged by HFHS for providing such services to the ACO under the management services agreement.
  • Date and nature of any amendments to the arrangement, if applicable: None.