f/k/a Physician Leaders Direct Contracting Entity (PLDCE)
Vytalize Health REACH, LLC
2 Hudson Place, 6th Floor
Hoboken, NJ 07030
Primary Contact Name: Steven Greenspan
Primary Contact Phone Number: (844) 570-1010
Primary Contact Email Address: vytalize.aco@vytalizehealth.com
| Name | Title | Company |
|---|---|---|
| Fredrik Liljewall | Board Member | Personal Touch Holding Corp |
| Erin Thomas | Board Member | Vytalize Health, LLC |
| Michael Ruiz de Somocurcio | Board Member | Vytalize Health, LLC |
| Michael Varley | Beneficiary Representative | N/A |
| David Hoffman, Esq. | Consumer Advocate | David Hoffman & Associates |
| Dr. Yasir Abunamous | Board Member | Vytalize Health, LLC |
| Dr. Stephen Sisselman | Participant Provider | Sisselman Medical Group, PC |
| Bradley Hillard | Designated Participant Representative | Northern Ohio Medical Specialists, LLC |
| Dr. Cary Mettetal | Participant Provider | Mettetal Family Mediine |
| Robin Liebman | Beneficiary Representative | N/A |
| Jennifer Johnstun | Designated Participant Representative | Siskiyou Community Health Center |
| Name | Title | Company |
|---|---|---|
| Faris Ghawi | President | Vytalize Health LLC |
| Dr. Amer Alnajar | Chief Medical and Quality Performance Officer | Vytalize Health LLC |
| Carina Unger, Esq. | VP, People Operations | Vytalize Health LLC |
| Ken Stoll | Chief Business Officer | Vytalize Health LLC |
| Scott Mancuso | Chief Physician Officer | Vytalize Health LLC |
| Derek Kang, Esq. | Chief Compliance Officer | Vytalize Health LLC |
Amount of Shared Savings/Losses
First Agreement Period
Performance Year 2024: $3,172,268
Performance Year 2023: $4,815,637
Performance Year 2022: $10,507,196
Shared Savings Distribution
First Agreement Period
Performance Year 2024
Proportion invested in infrastructure: 20%
Proportion invested in redesigned care processes/resources: 40%
Proportion of distribution to ACO participants: 40%
Performance Year 2023
Proportion invested in infrastructure: 20%
Proportion invested in redesigned care processes/resources: 40%
Proportion of distribution to ACO participants: 40%
Performance Year 2022
Proportion invested in infrastructure: 20%
Proportion invested in redesigned care processes/resources: 40%
Proportion of distribution to ACO participants: 40%
Quality Performance Results
2024
Total Quality Score: 42.7%
Risk-Standardized All-Condition Readmissions (ACR)
Score: 15.83 (a lower score indicates better performance)
Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) (UAMCC)
Score: 34.60 (a lower score indicates better performance)
Timely Follow-Up After Acute Exacerbations of Chronic Conditions (TFU) score.
Score: 79.49 (A higher (↑) score indicates better performance)
2023
Total Quality Score: 89.9%
Risk-Standardized All-Condition Readmissions (ACR)
Score: 15.16 (a lower score indicates better performance)
Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) (UAMCC)
Score: 33.63 (a lower score indicates better performance)
Timely Follow-Up After Acute Exacerbations of Chronic Conditions (TFU) score.
Score: 75.56 (A higher (↑) score indicates better performance)
2022
Total Quality Score: 100%
Risk-Standardized All-Condition Readmissions (ACR)
Score: 15.74 (a lower score indicates better performance)
Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) (UAMCC)
Score: 33.12 (a lower score indicates better performance)
Timely Follow-Up After Acute Exacerbations of Chronic Conditions (TFU) score.
Score: 71.29 (A higher (↑) score indicates better performance)
Footnotes:
1. In PY 2022, DCEs must meet the 30th percentile threshold on at least one of two claims-based measures (ACR or UAMCC) to receive the full 1% of the Quality Withhold tied to performance (P4P). A sliding scale is applied to DCEs that do not meet the 30th percentile threshold. Please refer to the PY 2022 Quality Measurement Methodology (QMMR) document for more details.
2. DCEs can earn up to 100% of the 1/5 of the Quality Withhold percentage tied to P4P.
3. In PY 2022, 4/5 of the 5% Quality Withhold (i.e., 4% of the financial benchmark) is tied to reporting (P4R). The 4/5 will be comprised of 2/5 connected to the claims-based quality measures and 2/5 connected to the CAHPS survey in PY 2022. See note 4 below.
4. DCEs will earn 100% of the 2/5 related to claims-based quality measure reporting (no action required by DCEs). DCEs may earn 100% of the 2/5 connected to CAHPS by authorizing a CMS-approved vendor to administer the CAHPS survey in PY 2022
