ACO Medicare
Carina Health Network has been a participant of the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) since 2017, with savings first achieved in 2019. Accountable care organizations (ACOs) participating in MSSP are required to publicly report the following information annually.
ACO Name and Location
Colorado Community Managed Care Network
Trade Name/DBA: Carina Health Network
1212 S Broadway, Suite 200
Denver, CO 80210
ACO Primary Contact
Primary Contact Phone Number: 214-868-6878
Primary Contact Email Address: brandi.apodaca@carinahealth.org
Organizational Information
ACO Participants
| ACO Participants | ACO Participant in Joint Venture (Enter Y or N) |
|---|---|
| Clinica Campesina Family Health Services | N |
| COLORADO COALITION FOR THE HOMELESS | N |
| DENVER INDIAN HEALTH AND FAMILY SERVICES INC. | N |
| HIGH PLAINS COMMUNITY HEALTH CENTER, INCORPORATED | N |
| INNER CITY HEALTH CENTER | N |
| LA CLINICA TEPEYAC, INC | N |
| MARILLAC CLINIC, INC. | N |
| MOUNTAIN FAMILY HEALTH CENTERS | N |
| NORTHWEST COLORADO VISITING NURSE ASSOCIATION | N |
| OLATHE COMMUNITY CLINIC INC | N |
| PEAK VISTA COMMUNITY HEALTH CENTERS | N |
| PUEBLO COMMUNITY HEALTH CENTER INC. | N |
| REGENTS OF THE UNIVERSITY OF COLORADO | N |
| SALUD FAMILY HEALTH | N |
| Southwest Colorado Mental Health Center Inc | N |
| Summit Community Care Clinic Inc | N |
| SUNRISE COMMUNITY HEALTH | N |
| UNCOMPAHGRE COMBINED CLINICS | N |
| UPTOWN COMMUNITY HEALTH CENTER INC | N |
| Valley-Wide Health Systems, Inc | N |
ACO Governing Body
| Member First Name | Member Last Name | Title/Position | Member’s Voting Power – Expressed as a percentage or number | Membership Type | ACO Participant TIN Legal Business Name/DBA, if Applicable |
|---|---|---|---|---|---|
| Andrew | Grimm | Board Member | 1 | ACO Participant Representative | COLORADO COALITION FOR THE HOMELESS |
| Charles | Gilford | Board Member | 1 | ACO Participant Representative | INNER CITY HEALTH CENTER |
| Cherise | Calligan | Board Member | 1 | ACO Participant Representative | UPTOWN COMMUNITY HEALTH CENTER INC |
| Chuck | Porth | Board Member | 1 | ACO Participant Representative | UNCOMPAHGRE COMBINED CLINICS |
| Jeremy | Carroll | Board Member | 1 | ACO Participant Representative | HIGH PLAINS COMMUNITY HEALTH CENTER, INCORPORATED |
| Donald | Moore | Past Board President | 1 | ACO Participant Representative | PUEBLO COMMUNITY HEALTH CENTER INC. |
| Dustin | Moyer | Board Member | 1 | ACO Participant Representative | MOUNTAIN FAMILY HEALTH CENTERS |
| Jaeson | Fournier | Board Member | 1 | ACO Participant Representative | PEAK VISTA COMMUNITY HEALTH CENTERS |
| Jessica | Anderson | Board Member | 1 | ACO Participant Representative | REGENTS OF THE UNIVERSITY OF COLORADO |
| Jania | Arnoldi | Treasurer | 1 | ACO Participant Representative | Valley-Wide Health Systems, Inc |
| Jim | Garcia | Board Member | 1 | ACO Participant Representative | LA CLINICA TEPEYAC, INC |
| John | Santistevan | Board Member | 1 | ACO Participant Representative | SALUD FAMILY HEALTH |
| Josh | Cogdill | Board Member | 1 | ACO Participant Representative | Summit Community Care Clinic Inc |
| Kay | Ramachandran | Board Member | 1 | ACO Participant Representative | MARILLAC CLINIC, INC. |
| Kaye | Hotsenpiller | Board Member | 1 | ACO Participant Representative | OLATHE COMMUNITY CLINIC INC |
| Mitzi | Moran | President | 1 | ACO Participant Representative | SUNRISE COMMUNITY HEALTH |
| Rachel | Everhart | Board Member | 1 | Community Stakeholder Representative | N/A |
| Ross | Brooks | Ex officio Board Member | 0 | Other | N/A |
| Santos | Vera | Board Member | 1 | Community Stakeholder Representative | N/A |
| Shelly | Burke | Secretary | 1 | ACO Participant Representative | Southwest Colorado Mental Health Center Inc |
| Simon | Smith | Board Member | 1 | ACO Participant Representative | Clinica Campesina Family Health Services |
| Stephanie | Einfeld | Board Member | 1 | ACO Participant Representative | NORTHWEST COLORADO VISITING NURSE ASSOCIATION |
| Dudley | Timothy | Medicare Beneficiary | 1 | Medicare Beneficiary Representative | N/A |
Key ACO Clinical and Administrative Leadership
Jason Greer, ACO Executive
Autumn Orser, MD Medical Director, Quality Assurance/Improvement Officer
Michele Grainger, Compliance Officer
Associated Committees and Committee Leadership
| Committee Name | Committee Leader Name and Position |
|---|---|
| Value-Based Care Committee | Brandi Apodaca (Chair) |
| Value-Based Care Performance Workgroup | Brandi Apodaca (Chair) |
| Value-Based Care Clinical Workgroup | Autumn Orser, MD (Chair) |
| Finance Committee | Mark Sandvik (Chair) |
| Data Privacy and Security Committee and Health Technology Network | Terry Seidel (Chair) |
Types of ACO participants, or combinations of participants, that formed the ACO
- Networks of individual practices of ACO professionals
- Federally Qualified Health Center (FQHC)
Shared Savings and Losses
Amount of Shared Savings/Losses
- Third Agreement Period
- Performance year 2026, TBD
- Performance year 2025, TBD
- Second Agreement Period
- Performance year 2024, $8,652,551.74
- First Agreement Period
- Performance Year 2019, $3,611,668.69
- Performance Year 2018, $0
- Performance Year 2017, $0
Shared Savings Distribution
- Second Agreement Period
- Performance year 2024
- Proportion invested in infrastructure: 5%
- Proportion invested in redesigned care processes/resources: 31%
- Proportion of distribution to ACO participants: 64%
- Performance year 2023
- Proportion invested in infrastructure: 5%
- Proportion invested in redesigned care processes/resources: 35%
- Proportion of distribution to ACO participants: 60%
- Performance year 2022
- Proportion invested in infrastructure: 6%
- Proportion invested in redesigned care processes/resources: 26%
- Proportion of distribution to ACO participants: 68%
- Performance year 2021
- Proportion invested in infrastructure: 6%
- Proportion invested in redesigned care processes/resources: 34%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2020
- Proportion invested in infrastructure: 6%
- Proportion invested in redesigned care processes/resources: 34%
- Proportion of distribution to ACO participants: 60%
- Performance year 2024
- First Agreement Period
- Performance Year 2019
- Proportion invested in infrastructure: 6%
- Proportion invested in redesigned care processes/resources: 34%
- Proportion of distribution to ACO participants: 60%
- Performance Year 2018
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2017
- Proportion invested in infrastructure: N/A
- Proportion invested in redesigned care processes/resources: N/A
- Proportion of distribution to ACO participants: N/A
- Performance Year 2019
Quality Performance Results
2024 Quality Performance Results
Quality performance results are based on the CMS Web Interface collection type.
| Measure # | Measure Title | Collection Type | Performance Rate | Current Year Mean Performance Rate (Shared Savings Program ACOs) |
|---|---|---|---|---|
| 321 | CAHPS for MIPS | CAHPS for MIPS Survey | 4.98 | 6.67 |
| 479* | Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups | Administrative Claims | - | 0.1517 |
| 484* | Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) | Administrative Claims | - | 37 |
| 318 | Falls: Screening for Future Fall Risk | CMS Web Interface | 64.38 | 88.99 |
| 318 | Preventative Care and Screening: Influenza Immunization | CMS Web Interface | 60.8 | 68.6 |
| 226 | Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention | CMS Web Interface | 85.42 | 79.98 |
| 113 | Colorectal Cancer Screening | CMS Web Interface | 63.21 | 77.81 |
| 112 | Breast Cancer Screening | CMS Web Interface | 63.52 | 80.93 |
| 438 | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | CMS Web Interface | 93.23 | 86.5 |
| 370 | Depression Remission at Twelve Months | CMS Web Interface | 15.32 | 17.35 |
| 001* | Diabetes: Hemoglobin A1c (HbA1c) Poor Control | CMS Web Interface | 16.6 | 9.44 |
| 134 | Preventative Care and Screening: Screening for Depression and Follow-up Plan | CMS Web Interface | 98.18 | 81.46 |
| 236 | Controlling High Blood Pressure | CMS Web Interface | 72.5 | 79.49 |
| CAHPS-1 | Getting Timely Care, Appointments, and Information | CAHPS for MIPS Survey | 73.66 | 83.7 |
| CAHPS-2 | How Well Providers Communicate | CAHPS for MIPS Survey | 90.38 | 93.96 |
| CAHPS-3 | Patient’s Rating of Provider | CAHPS for MIPS Survey | 90.04 | 92.43 |
| CAHPS-4 | Access to Specialists | CAHPS for MIPS Survey | 69.57 | 75.76 |
| CAHPS-5 | Health Promotion and Education | CAHPS for MIPS Survey | 68.7 | 65.48 |
| CAHPS-6 | Shared Decision Making | CAHPS for MIPS Survey | 62.3 | 62.31 |
| CAHPS-7 | Health Status and Functional Status | CAHPS for MIPS Survey | 67.81 | 74.14 |
| CAHPS-8 | Care Coordination | CAHPS for MIPS Survey | 84.51 | 85.89 |
| CAHPS-9 | Courteous and Helpful Office Staff | CAHPS for MIPS Survey | 92.33 | 92.89 |
| CAHPS-11 | Stewardship of Patient Resources | CAHPS for MIPS Survey | 38.16 | 26.98 |
*For Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) [Quality ID #001], Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups [Measure #479], and Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], a lower performance rate indicates better measure performance.
*For Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions (MCC) [Measure #484], patients are excluded if they were attributed to Qualifying Alternative Payment Model (APM) Participants (QPs). Most providers participating in Track E and ENHANCED track ACOs are QPs, and so performance rates for Track E and ENHANCED track ACOs may not be representative of the care provided by these ACOs’ providers overall. Additionally, many of these ACOs do not have a performance rate calculated due to not meeting the minimum of 18 beneficiaries attributed to non-QP providers.
For Previous Years’ Financial and Quality Performance Results, please visit https://data.cms.gov/medicare-shared-savings-program/performance-year-financial-and-quality-results.