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In 2015, the Northwell Health ACO chose to participate in the Medicare Shared Savings Program, with an effective start date of January 1, 2016. The Northwell Health ACO is governed by independent physicians, Northwell Health employed physicians, and a Medicare FFS beneficiary.

Northwell Health’s participation in the Medicare Shared Savings Program presents an opportunity to develop innovative approaches to health care delivery, streamline existing value-based programs, and promote wellness that will improve the health of our communities.

What is a Medicare Shared Savings Program ACO?

A Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO) is a new, national approach to health care delivery for Medicare fee-for-service (FFS) beneficiaries. Created under the 2010 Patient Protection and Affordable Care Act, a MSSP ACO works to improve quality and reduce unnecessary costs.

MSSP ACOs are not managed care organizations, do not use closed networks of providers, and do not limit a Medicare beneficiary’s ability to seek care from participating Medicare providers outside an ACO.

There is no financial downside risk or disruption to underlying Medicare fee-for-service billing. When an MSSP ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.

For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800 MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048.

Our mission

The Northwell Health ACO’s mission is to improve the health and wellness of the community through the collaborative efforts of physicians and other healthcare providers who:
  • Share a commitment to the provision of excellent healthcare services; and
  • Seek to enhance delivery of quality, coordinated and efficient care.
The Northwell Health ACO provides an opportunity to collaboratively improve patient outcomes by:

 

Northwell Health ACO annual compliance training (for participants only)

MSSP public reporting ACO Name and Location:

North Shore-LIJ MSSP ACO, LLC d/b/a Northwell Health ACO
600 Community Drive Suite 300
Manhasset, NY 11030

ACO Primary Contact:

Mr. Terry Lynam
Chief Public Relations Officer, Northwell Health
(516) 465-2640
tlynam@northwell.edu

Organizational Information: ACO Participants:

Advanced Allergy And Asthma Pllc
Advanced Internal Medicine Pc
Alan E Uliss MD PC
Allay Medical Care Pc
Anat Benjamin Md Pc
Andrew Zaager MD
Angela Azar MD PC
Anita-Kay Martin Md Pc
Atlantic Dermatologic Associates, Llp
Ausubel, Ausubel, Bienstock Physicians LLP
Bernardini, Vomero, Anselmi & Anwar MD PC
Bobby Chandok MD PLLC
Bruce Lowell
Carol A Livoti M.D.P.C
Central Suffolk Hospital
Charles Timson
City Medical Associates PC
Comprehensive Island Medical Care
Corcoran Medical Rehabilitation, PC
Country Doctors Family Medicine Hauppauge Pc
Cross County Medical Care Pc
David Arbesfeld
David B Samadi MD PC
Digestive Diseases Nutrition LLC
Doctors Medical Office Pllc
Dodis Kohan, Md Pc
Dr. Karen Schwartz MD PC
Dr. Marc Allen Medical PC
East Merrick Medical PC
East Side Primary Medical Care PC
Edward Condon Medical PC
Eye Care Ophthalmology, PC*
Family Medical Practice Of Long
Fink Family Medical, PC
Floral Park Medical PC
Florante Melchor MD FACP PLLC
George Tung MD, PC
Glen Cove Hospital
Global Rehabilitation Medical PC
Great Neck Obstetrics & Gynecology Pc
Hamilton Podiatry P C
Harold Satz M D Pc
Helen S Flamenbaum Md Pc
Hillside Medical & Pain Management, Pc
Hillside Polymedic Diagnostic & Treatment Center Inc
Hudson Medical Professional Services, PC
Huntington Hospital Association
Huntington Hospital Dolan Family Health Center
Ilene Gewirtz MD
Inga Zilberstein, MD, PLLC
Ira J. Salzman, MD PLLC
Island Medicine, PLLC
Island Musculoskeletal Care MD PC
Jamaica Family Practice & Osteopathic Medicine
Jeff D Kopelman MD, FACS, PLLC
Jeffrey Krupen MD
Joseph Devito
Joseph Loiodice M.D.
Josh Werber
Kaumudi Somnay, MD
Kew Gardens Podiatry Pc
Kip L Bodi Physician FACS PLLC
Klein Geier Lipp MD LLP*
Krishana K. Jajoo Physician PC
Lawrence Korn MD LLC
Lawrence Lippert
Lawrnece J Robinson Md Pc
Lenox Hill Hospital
Lenox Hill Hospital Medical, PC
Lenox Hill Pathology, PC
Lenox Otolaryngology Head And Neck Surgery, P.C.
Long Island Eye Surgeons, PC
Long Island Infectious Disease Associates, LLP
Long Island Jewish Medical Center
Long Island Kidney Physicians, PLLC
Long Island Medical PC
Long Island Vitreo Retinal Consultants
Luz del Carmen Cespedes MD, PLLC
Medical Help Pc
Michael B. Gold MD PC
Michael Benhuri Md PC
Michael Oliverio, DO, PC
Michael Polcino Md Pc
Mid Island Eye Physicians & Surgeons, P.C.
Millennium Medical Professionals, PLLC
Mudgil Dermatology, P.C.
Nassau Pulmonary & Critical Care Medicine, PC
New Life Medical Services Pc
North Island Ophthalmology Associates Pc
North Shore – Lij Radiology Services, Pc
North Shore Lij Internal Medicine At New Hyde Park Pc
North Shore Lij Physicians Group Pc
North Shore Long Island Jewish Healthcare Inc.
North Shore University Hospital
North Shore University Hospital At Plainview
North Shore-LIJ Cardiology at Deer Park, PC
North Shore-LIJ Heart Surgery, PC
North Shore-LIJ Internal Medicine at Lynbrook, PC
North Shore-LIJ Medical Group at North Nassau, PC
North Shore-LIJ Medical Group at Syosset, PC
North Shore-LIJ Medical PC
North Shore-LIJ Ob/GYN at Garden City, PC
North Shore-LIJ Ob/GYN, PC
North Shore-LIJ OB-GYN at New Hyde Park, PC
North Shore-LIJ Pediatrics of Suffolk County, PC
Ophthalmology Associates of Glen Cove PC
Orthopaedic Associates of Manhasset PC
Parmeshwar Mahabir
Paul B Lang, MD, PC
Paulette Stewart
Phelps Medical Services, PC
Phelps Memorial Hospital Association
Pulmonary Critical Care & Sleep Medicine of Nassau PC
Queens Professional Medical Care,P.C.
Queens Vitreo Retinal Consultants
Raber Medical PC
Rego Park Medical Associate PC
Richard C Maleski MD PC
Richard P Boughal MD PC
Robert Appel
Robert Maccabee
Roshan Kothandaram MD
Salil P Marfatia Md Pc
Scott Gross
South Shore Eye Care LLP*
Southside Hospital
Steven Blumenthal
Steven Mandel MD PC
Stewart A Levine MD PC
Sure Medical PC
Syosset Ophthalmology Associates, Llp
Terrace Medical, PC
Thomas Argyros
Thomas W Hodyl, Md Pc
United Medical Surgical, PC
Westchester Health Associates, PLLC
WGM Obstetrics and Gynecology PC
William Onyebeke MD
Women For Women Obstetrics & Gynecology, LLC

 

*Participants involved in a joint venture are identified by a * next to their names on the participant list.

 

ACO Participants in Joint Ventures Between ACO Professionals and Hospitals:

N/A

governing-body

ACO Governing Body:

Name

Member Title

Membership Type

Legal Business Name

Dr. Patrick Burns

Voting Member

ACO Participant Representative

Island Medicine, PLLC

Dr. Maria Carney

Voting Member

ACO Participant Representative

North Shore-LIJ Medical, P.C.

Dr. Barry Cohen (Co-Chair)

Voting Member

ACO Participant Representative

North Shore University Hospital

Dr. Patrick Corcoran

Voting Member

ACO Participant Representative

Corcoran Medical Rehabilitation, PC

Dr. Sandy Balwan

Voting Member

ACO Participant Representative

Lenox Hill Hospital

Dr. Steven Geier (Co-Chair)

Voting Member

ACO Participant Representative

Klein, Geier, Lipp, MD, LLP

Dr. JoAnne Gottridge

Voting Member

ACO Participant Representative

North Shore University Hospital

Dr. Mitchel Jacobs

Voting Member

ACO Participant Representative

Nassau Pulmonary & Critical Care Medicine, P.C.

Dr. Jaydeep Kadam

Voting Member

ACO Participant Representative

Long Island Medical PC

Dr. Yashodhara Kirtane

Voting Member

ACO Participant Representative

Long Island Jewish Medical Center

Dr. Mary Korpacz-Fink

Voting Member

ACO Participant Representative

Fink Family Medical, PC

Dr. Jeffrey Krupen

Voting Member

ACO Participant Representative

Jeffrey Krupen MD

Dr. Cynthia Hoey

Voting Member

ACO Participant Representative

Long Island Infectious Disease Assoc.

Dr. John Jonisch

Voting Member

ACO Participant Representative

Queens Vitreo Retinal Consultants

Dr. Joel Laxer

Voting Member

ACO Participant Representative

North Shore-LIJ Medical, P.C.

Dr. Santhosh Paulus

Voting Member

ACO Participant Representative

Glen Cove Hospital

Dr. Louis Potters

Voting Member

ACO Participant Representative

Long Island Jewish Medical Center

Dr. Mark Siegelheim

Voting Member

ACO Participant Representative

South Side Hospital

Dr. Mark Stein

Voting Member

ACO Participant Representative

South Shore Eye Care LLP

Dr. Paul Wright

Voting Member

ACO Participant Representative

North Shore University Hospital At Plainview

Mr. Leonard Stenzler

Voting Member

Medicare Beneficiary

N/A

 

Key ACO Clinical and Administrative Leadership:

ACO Executive

William Lynch, JD

Medical Director

Sandy Balwan, MD, FACP

Compliance Officer

Aaron Lund, JD, LL.M

Quality Assurance/Improvement Officer

Lisa Sokoloff, RN, MS

Associated Committees and Committee Leadership:

Performance and Distribution Committee

Chairperson:

Mark Siegelheim, MD

Members:

Patrick Corcoran, MD
Steven Geier, MD
Mitchel Jacobs, MD
Joel Laxer, MD
Louis Potters, MD

Clinical Performance and Quality Committee

Chairperson:

Yashodhara Kirtane, MD

Members:

Patrick Burns, MD
Barry Cohen, MD
Sandy Balwan, MD
Mary Korpacz-Fink, MD
Cynthia Hoey, MD
Paul Wright, MD

Network Composition and Credentialing Committee

Chairperson:

Patrick Corcoran, MD

Members:

Barry Cohen, MD
Steven Geier, MD
Jaydeep Kadam, MD
Yashodhara Kirtane, MD
Mark Siegelheim, MD

Types of ACO Participants or Combinations of Participants that Formed the ACO:

  • ACO professionals in group practice arrangements
  • Networks of individual practices of ACO professionals
  • Hospitals employing ACO professionals
  • Partnerships or Joint Venture arrangements between hospitals and ACO professionals

Shared Savings and Losses:

Amount of Shared Savings/Losses
  • Agreement period beginning 2016, Performance Year 2016:
    • To be completed after the conclusion of the performance year.
Shared Savings Distribution
  • Agreement period beginning 2016, Performance Year 2016:
    • To be completed after the conclusion of the performance year.
Payment Rule Waivers
  • No, our ACO does not utilize the SNF 3-Day Rule Waiver.

Quality Performance Results

  • To be completed after the conclusion of the performance year.

Participation waiver disclosure

The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that may otherwise limited innovation by ACOs participating in the Medicare Shared Savings Program (“MSSP”). See Final Waivers in Connection With the Shared Savings Program, 79 Fed. Reg. 62356 (Oct. 17, 2014) (“Interim Final Rule”). Pursuant to the Interim Final Rule, North Shore-LIJ MSSP ACO, Inc. (the “ACO”) seeks waiver protection for the arrangement described below:

The ACO has entered into an agreement with Northwell Health to provide a broad range of necessary management services and operational personnel to support the ACO’s operations as an ACO in the MSSP. Under the arrangement, the ACO shall compensate Northwell Health from any shared savings payments for its provision of management services, including but not limited general day-to-day operational personnel and services, financial management and accounting services, and credentialing.

The ACO’s governing body, consistent with its obligations under 42 C.F.R. § 425.106(b)(3), has made and duly authorized a bona fide determination on August 23, 2016 that the arrangement is reasonably related to the purposes of the Medicare Shared Savings Program, including, specifically, promoting accountability for the quality, cost, and overall care for a Medicare population and aiding the ACO in managing and coordinating care for Medicare fee-for-service beneficiaries.

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