Introducing Monthly Capitation Payments For Your Medicare Fee-For-Service Patients
ACO Realizing Equity, Access, and Community Health (REACH) Model
Until now, monthly capitation payments for Medicare beneficiaries were only paid to doctors for their patients enrolled in managed care plans. But now, with Genuine Health Direct, you can receive capitation payments every month for your patients with traditional Medicare. Plus, our ACO will help participating doctors reduce overall healthcare costs, improve outcomes, and increase options for your patients.
Improve Your Practice By Joining Our ACO
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Monthly capitation payments
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Bonuses for Medicare savings
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Exemption from burdensome MIPS reporting requirements
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Support tools for your practice
What Is An ACO?
A REACH ACO is a new care delivery model introduced by the Centers for Medicare and Medicaid Services (CMS). Accountable Care Organizations like Genuine Health Direct contract with CMS to deliver healthcare to fee-for-service Medicare beneficiaries aligned with participating physicians. CMS pays a monthly capitation fee to Genuine Health Direct, and in turn, we are responsible for delivering the full scope of patient care – at full financial risk.
When we provide high-quality care for less than what CMS would have paid through traditional Medicare, we keep 100% of the savings and share those savings with our participating physicians.
A New Way To Share In The Savings
Through Genuine Health Direct, primary care physicians can enjoy the stability, reliability, and consistency of monthly capitation payments for their aligned Medicare patients. When you join our ACO, say goodbye to claims denials and collections, and say hello to year-round support to facilitate voluntary alignment for your Medicare patients.
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Click here for Frequently Asked Questions about Genuine Health Group.
ACO Public Reporting
ACO Name and Location
Genuine Health Direct
806 South Douglas Road, Suite 700
Coral Gables, FL 33134
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ACO Primary Contact
Stephany Nino
(786) 878-5505
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Organizational Information
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2025 ACO Participants & Preferred Providers:
ADAM NASSERY
ADDISON MIZNER MEDICAL LLC
ADNAN SAMMOUR
ADOLFO MARTINEZ
ADRIANA HEALTHCARE PLLC
ADRIANA O NEAL
AGAPE HEALTH MEDICAL CENTER LLC
AGAPEMD, LLC
AGATHE FRANCK
ALANA HOFFMAN
ALBERT HUMPHREY
ALEJANDRO ROCA
ALEX COHEN
ALEXA SPERLING
ALEXANDER PLANA
ALISON GLASSMAN
ALLISON THOMAS
AMELIA BELL-HAWKINS
AMIEL LEVIN
AMIEL LEVIN MD PA
AMY IANNONE
ANDREA MCINTOSH
ANDREW GRANELLO
ANGEL PAGAN
ANGELA ROBISON
ANITA PUNJABI BAJPAI
ANTONIO MORA
ANTONIO MORA MD PA
ARAM SARKISYAN
ARCADIA MEDICAL ASSOCIATES PA
AREADNE SOLER
ARENA MEDICAL GROUP LLC
ARIANE CLERVEAU BEAUBOEUF
ARMANDO A. FERNANDEZ MD, PA
ARMANDO FERNANDEZ
ARTURO MARTINEZ ALFONSO
AUDREY LIU
AUDREY ROBERSON
BARBARA ANN SCHERER MD PA
BARBARA M MUINA MD PA
BARBARA MUINA
BARBARA SCHERER
BARRY STREIT
BERNHARD BRIJBAG
BERNHARD BRIJBAG, D.O., P.A
BIRJIS ALAM
BIRJIS K ALAM MD PA
BLEDAR HAXHIU
BRENDA NGUYEN
BRIDGET VERA
BRUCE MANN
BRYAN LUBANSKY
CABRERA MEDICAL SERVICES INC
CARLOS DELGADO
CARLOS DELGADO MD PA
CARLOS DOMINGUEZ
CARLOS L DOMINGUEZ MD PA
CARLOS NAVARRO
CARLOS RIVEROS
CARY BORTNICK
CATHERINE HAYS
CECILIA PERNAS
CENTRAL FLORIDA MEDICAL ASSOCIATES, INC
CENTRAL MEDICAL GROUP PA
CHARLA SPERRING
CHARLES LIEBER
CHARLES YANES
CHARLES YANES MD PA
CHEYENNE RINCONES
CHRISTIAN GONZALEZ
CHRISTIAN GONZALEZ MD LLC
CHRISTIAN REYNES
CHRISTINA HILL
CHRISTOPHER CORRIVEAU
CINDY MARIKA
CINDY MARIKA DO PA
CLAUDIA CUEVAS
CLAUSETTE EMMANUEL
CLINICA HISPANA II, P.A.
CLINICA HISPANA PA
COLLIER HEALTH SERVICES, INC
COLONY INTERNAL MEDICINE ASSOCIATES PA
CR MEDICAL GROUP INC
CRISANTO DELGADO
DANIELLE NEUMAN
DAVID MORRIS
DAVID NEUMAN
DAVID SALTZMAN
DE VALLE & ASSOCIATES PHYSICIANS PLLC
DEBORAH NICASIO
DEBRA FRIEDRICH
DEERFIELD BEACH MEDICAL CLINIC, P.A.
DIANA LIMON
DINA BIELSKI
DIONNE YAMOUT
DIPESH DERAY
DIVIJANI PUTTAGUNTA
DOCTORS HEALTH GROUP OF SOUTH FLORIDA INC
DOUGLAS GUEVARA
DOUGLAS WEINER
DR FRANK J ARANDA LLC
DR JORGE TRAVIESO MD PA
DR WENTWORTH JARRETT PA
DR. JENNIFER JOHNSON-CALDWELL, M.D.,P.A.
EDGARDO R. REYES-AYALA, M.D. P.A.
EDGARDO REYES AYALA
EDUARDO A. REYES MD PA
EDUARDO MENDEZ
EDUARDO REYES
EMERALD HILLS MEDICAL CENTER INC
ENRIQUE C FERNANDEZ MD PA
ENRIQUE FERNANDEZ
ERICA O DONNELL
EUFEMIA CANDO
FABIAN RODRIGUEZ
FAMILY MEDICAL CLINIC KENDALL LLC
FARAH HORTA BONNIN
FELIX CHION FONG
FELIX E GUZMAN MD PA
FELIX GUZMAN
FLORIDA HEALTH CARE OF BREVARD
FLORIDA PRIMARY CARE PARTNERS LLC
FRANK ARANDA
FRANK OLIVER
GEORGIA VARNER
GILBERT LEUNG
GILBERT LEUNG MD PA
GLADYS NOGUEIRAS
GOPI BHAKTA
GREGORY SINGLETON
GULNARA TALDIBAEVA-PUGLIESE
HAMMOCK MEDICAL CENTER INC
HARVEY KLEINER
HARVEY S. KLEINER, D.O., PA
HIN CHRISTINE LEE
ICIE MULLIS
INCARE LLC
INTEGRATIVE PRIMARY CARE OF EL PASO PLLC
ISRAEL CABRERA
IVAN CASTANO
JAIME ARANGO CIFUENTES
JANETH SAWH
JANKA BAIZA
JASON GAJRAJ
JAY JONES
JEAN-BAPTISTE PIERRE
JEANNETTE DE LA TORRE
JEFFREY A LOMAN MD PA
JEFFREY GOUDREAU
JEFFREY LOMAN
JENNIFER HONG
JENNIFER JOHNSON CALDWELL
JERRY LEVENTHAL
JESSIE JEAN MARIE
JF PRIMARY CARE MD PA
JOAN WILLIAMSON
JOEL ISOM
JOHN BANCROFT HYLTON M.D,P.A
JOHN HYLTON
JOHN MATTEI
JOHN YEE
JONATHAN PEACH
JONATHAN YOUSEF
JORGE ACOSTA
JORGE BARCENAS
JORGE FLEITES
JORGE M BARCENAS MD PA
JORGE PEREZ
JORGE TRAVIESO
JORGE WECER
JOSE A COBIELLA MD PA
JOSE COBIELLA
JOSE HERNANDEZ
JOSE M TORRES AND ASSOCIATES MD PA
JOSE TORRES
JOSEFINA HERNANDEZ
JOSEPH ARENA
JOSEPH GANEY
JOSEPH GUERNSEY
JOSUE LIMAGE
JUAN CAMAYD
JUAN OROZCO
JUAN PEREZ-ESPINOSA
JUDITH RAUSCH
JULIAN MARQUEZ
JULIAN MARQUEZ MD PA
JULIO GONZALEZ
JULIO ROSALES
JUVENAL E MARTINEZ MD PA
JUVENAL MARTINEZ
KARI TANNENBAUM
KELECHI AZUOGU
KELVIN ONG
KENNETH MIDONECK
KERRI ADAMY
KETTY CHERY
KEVIN BENDER
KOMAL PRAVIN-PATEL
LARITZA REYES MARTI
LAURA SEVERYN
LAURA ZITON
LAZARA HURTADO INFANTE
LENNI FUGAZY
LESLIE HURWITZ
LIFETIME FAMILY URGENT CARE LLC
LOPEZ MEDICAL PRACTICE LLC
LORI EDUARTEZ
LUDMILA RICARDO AGUILERA
LUZ LUQUE
LYLE KALISER
MAI MEDICAL
MANATEE MEDICAL SPECIALISTS LLC
MANUEL BORREGO
MANUEL PEREZ-ESPINOSA MD PA
MARCO A NOVA MD PA
MARCO NOVA
MARCOS ZARAGOZA
MARIA DE LA PENA
MARIA MUSTELIER
MARIE JOSEPH
MARLENE GONZALEZ
MARY ANN RAUSCH
MCDAVID M MAHAFFEY MD PA
MCDAVID MAHAFFEY
MD HEALTHCARE BOCA RATON LLC
MED-CARE MEDICAL CENTER INC
MEDICAL GROUP AT SOUTH MIAMI INC
MEDICAL SPECIALISTS ASSOCIATED
MERCEDES J VAZQUEZ MD PA
MERCEDES VAZQUEZ
MEYER LANSKY
MICHAEL ARONOVICH
MICHAL MILLER
MICHELLE WEINER
MIGUEL APONTE
MIGUEL DIAZ
MIHIR FALDU
MINH MAI
MIRNA WAIDELE PA C INC
MOISES ISSA
MONICA DE LA TORRE
MT WEST HEALTH CENTER, PA
NAM NGUYEN
NANCY BOULOUTE
NATASHA WILLIAMSON
NAVEEN PADDU
NEIGHBORMD OF ATLANTA LLC
NEIGHBORMD OF NEWNAN LLC
NEIGHBORMD OF SOUTH ATLANTA LLC
NEIL FURMAN
NIXCELA ARES-VALDES
OCEANNA WHITE
ODALYS PENA
OLGA LOPEZ
OLIVIER LE GLOAHEC
ORMOND INTERNAL MEDICINE LLC
OSCAR DE VALLE
OSWALDO SANDOVAL
PADMINIE SINGH
PATRICIA VANDIEPEN
PAUL M. SCHWARTZ MD PA
PAUL MURRY
PAUL SCHWARTZ
PAULA BEDO
PEDRO CASTELLANOS
PERSONAL PHYSICIAN CARE PA
PERSONAL PHYSICIAN MANAGEMENT GROUP OF HALLANDALE, INC
PHILLIP DAVIS
PHILLIP G DAVIS MD PA
PRAMJEET AHLUWALIA
PRIMARY MEDICAL PHYSICIANS, LLC
PRISCILLA LUONG
RADHIKA BAWA
RAFAEL MESTRE
RAMIRO CORO
RAMIRO CORO MD PA
RAMON BERENGUER
RAMON LEON
RAMON LEON MD LLC
RAUSCH FAMILY PRACTICE
REGITHA SEBASTIAN
REINIER RAMIREZ
REMI DIEUJUSTE
RENATO SEGURA
RENE CASANOVA
REX MOSS
RICARDO DOMINGUEZ
RICARDO DOMINGUEZ MD PA
RICARDO MARTINEZ
RICHARD MARQUES
RICHARD SEIDELMAN
RIZWANA SHAIKH
ROBERTO URQUIZA
ROBERTO URQUIZA MD PA
ROBIN BOLIVER-CAMPBELL
RODOLFO MENDEZ CANCEL
ROLANDO PADRO
ROSA ESPINOSA
ROYAL CARE MEDICAL CENTER INC
RUTH CATIGNAS
RYAN THAI
RYLAN MCQUADE
SABIA ST FLEUR
SAMANTHA LINDSAY
SAMANTHA S LINDSAY MD PA
SAMIR DAWOD RAJIHA
SAMUEL CLARKE
SANDEE BRISTOW
SERGIO GARCIA
SG PRIMARY CARE MD, LLC
SHAZIA AHMED
SHENASI ARANDA
SHEREN LEUNG
SHIVANAND PERSAD
SIMON WONG
SIRAHAYDEE PENA-ALCANTARA
SLAVISA MARKOVIC
SOFFER HEART INSTITUTE PA
SOUTH MAIN CLINIC INC
STEPHEN GIST
STEVEN CIMERBERG
STEVEN FIELDS
STEVEN FIELDS MD PA
STEVEN MORRIS
STEVEN MORRIS MD PA
SUNSHINE FAMILY HEALTHCARE, LLC
SURJIT ATHWAL JOHAL
SUSAN FESMIRE
SYED AHMED
THE PRACTICE
TOTAL CARE MEDICAL CENTERS LLC
TOYA ALDER
UNIPLUS HEALTH, LLC
UNITED MEDICAL SPECIALTIES INC
USHA SETH
VANGUARD MEDICAL GROUP, LLC
VICENTE F. FRANCO M.D.,P.A.
VICENTE FRANCO
VICTOR MARTINEZ
VICTOR STEWART
VICTOR VILLALOBOS
VIERGELA JOSEPH
VOLUSIA MEDICAL CENTER LLC
VRAJ MEDICAL LLC
WAEL ALOKEH
WELL-BEING MEDICAL CENTER PLLC
WELLCARE MEDICAL CLINIC LLC
WENTWORTH JARRETT
WILLIAM CRIGLER
WILLIAM PENA
WILLIAM SHAPSE
XUN ZHAO
YAEL MYERS
YAMILET ALBERTO MOYA
ZVI GROSS
Home Health
ALL ABOUT YOU HOME HEALTH AGENCY, INC.
ALL WAYS HOMECARE INC
AMEDISYS HOME HEALTH OF SOUTH CAROLINA LLC.
AMEDISYS SC, LLC
ELDER ALTERNATIVES INC
FLORIDA NURSES HOME HEALTH AGENCY INC
GENUINE HEALTH HOME CARE
GEORGETOWN HOSPITAL HOME HEALTH LLC
HOME HEALTH SERVICES OF SOUTH FLORIDA, INC.
MED-CARE HOME HEALTH SERVICES, INC.
MHC AREA 6 LLC
MHC AREA 8, LLC
MHC AREA 9 LLC
RX HOME HEALTH SERVICES, INC
TRUST USA HOME HEALTH LLC
USA HOME HEALTH SERVICES INC
Hospice
VITAS HEALTHCARE CORPORATION OF FLORIDA
VITAS HEALTHCARE CORPORATION OF GEORGIA
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Infusion Pharmacy
MED-CARE INFUSION SERVICES INC
Labs
LABORATORY CORPORATION OF AMERICA
LABORATORY CORPORATION OF AMERICA HOLDINGS
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC
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ACO participants in joint ventures between ACO professionals and hospitals:
No participants are involved in a joint venture between ACO professionals and hospitals
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The current ACO REACH Model Participation Agreement is available here
ACO Governing Body
Board Member
Role
Voting %
Employer
Annette Onorati
Juvenal Martinez, MD
Gilbert Leung, MD
John Santana, CEO
Jose Torres, MD
Slater Bayliss
Natalia Jaramillo
10
20
20
20
20
5
5
Population Health Alliance, LLC
Juvenal Martinez, MD, PA
Gilbert Leung, MD, PA
OnePlus Healthcare
Jose Torres MD and Associates PA
The Advocacy Group at Cardenas Partners
MEMBER
ACO PARTICIPANT
ACO PARTICIPANT
ACO PARTICIPANT
ACO PARTICIPANT
CONSUMER ADVOCATE
MEDICARE BENEFICIARY
Key ACO clinical and administrative leadership:
ACO Executive: Roger Rodriguez – Genuine Health Group, LLC
Compliance Official: Manuel Lopez – Genuine Health Direct, LLC
Medical Director: Jarrett Wentworth, MD – Dr Wentworth Jarrett, PA
Clinical Leadership: Grace Giraldo, RN, BSN, MBA – Genuine Health Group, LLC​
Quality Improvement: Ingrid Enamorado, CRC, CPMA – Genuine Health Group, LLC
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Shared Savings and Losses​​​​​​
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Performance Year 2023: $23,454,383.12 Gross/ $14,409,374.31 Net​
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Proportion of Shared Savings invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries- 30%
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Proportion of Shared Savings distributed to ACO Participant Providers and Preferred Providers- 70%
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Performance Year 2022: $16,267,306.83 Gross/ $12,889,540.62 Net
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Proportion of Shared Savings invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries- 30%
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Proportion of Shared Savings distributed to ACO Participant Providers and Preferred Providers- 70%
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Performance Year 2021: $5,174,328.13 Gross/ $3,318,705.58 Net
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Proportion of Shared Savings invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries- 30%
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Proportion of Shared Savings distributed to ACO Participant Providers and Preferred Providers- 70%
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Quality Measure Performance​​
2023 Quality Performance Results:​
Quality performance results are based on the CMS Web Interface collection type.
Footnotes:
Points earned are calculated usin gthe Benchmark tiers CMS has set- refer to the table: Name
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The Initial Quality Score is calculated by dividing the Total Points Earned (sum of "Points Earned" column) by the Total Points Possible (sum of "Points Possible" column).
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CI/SEP points are assigned based on year over year improvement by measure and allocated by overall score. Our ACO met the requirememt and we granted that to all groups, if ACOS do not meet the requirment CMS multiples by .5
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Demographic Reporting Rate: This is your HEDR Reporting Rate based on Demographic Data reported to the Health Data Reporting Application for PY 2023.
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The total score is the sum of the initial with the HEDR earned
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The Quality withhold you earned out of max 2%
Footnotes:
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SSM = Summary survey measure
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SSM Score = The mean of the weighted patient mix adjusted linearized means for all questions in the SSM. Higher values are better.
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Benchmarks for each SSM are calculated from pooled data from MIPS, the Shared Savings Program, and NG-ACOs from 2021 and 2019 combined with PY 2022 data from all REACH ACOs. SSM points earned for each measure are based on the REACH ACO's performance compared to the benchmarks.
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The final CAHPS Composite Score used in determining a REACH ACO's Total Quality Score is calculated by dividing the total SSM points earned by the total SSM points possible. CMMI will not assign SSM points for SSMs based on data from fewer than 20 survey respondents. These SSMs will be excluded from the calculation of the CAHPS Composite Score without negatively impacting the REACH ACO's CAHPS Composite Score. For example, if an ACO has 1 SSM (out of 8) with fewer than 20 respondents, they would only be scored on the remaining 7 SSMs; thus, their total SSM points possible would be 70.
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To receive a CAHPS Composite Score, an ACO must have SSM points assigned for at least 4 out of the 8 SSMs. ACOs with fewer than 4 SSM scores will see a dash (---) in the CAHPS Composite Score field.
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The mean SSM scores are calculated across Standard and New Entrant ACOs only.
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NR = Not reported; due to case minimum requirements, SSM results are not reported if fewer than 20 respondents answered the survey questions needed to calculate the SSM.
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A dash (---) is used to indicate SSMs with zero respondents.
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N/A = Not applicable; indicated if an ACO is exempt from the CAHPS Survey. An ACO is exempt from the CAHPS Survey if it does not have enough survey eligible beneficiaries to participate in the survey.
2022 Quality Performance Results:​
Quality performance results are based on the CMS Web Interface collection type.
Footnotes:
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Volume is defined differently depending on the measure (index hospital stays for ACR and TFU, person-years for UAMCC and DAH).
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For Standard and New Entrant DCEs, the mean quality measure score for each measure is calculated across both Standard and New Entrant DCEs.
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For PY 2022, for the 1% of the Quality Withhold tied to performance, separate Quality Performance Benchmarks have been set for ACR and UAMCC. DCEs that meet the 30th percentile Quality Performance Benchmark threshold for either ACR or UAMCC will earn back the full 1% of the Quality Withhold based on their performance. The 30th percentile is therefore the highest Quality Performance Benchmark for any DCE. For example, for a DCE with a percentile rank of 75.0 for the UAMCC measure, the highest Quality Performance Benchmark met for UAMCC will be 30th and the DCE will receive a P4P Component Quality Score of 100%. DCEs that are below the 30th percentile Quality Performance Benchmark on both measures will have have their P4P Component Quality Score determined by a sliding scale based on their highest performing measure, so they can earn back a portion of the performance-based 1%. See Table 2b. below for the sliding scale thresholds for PY 2022.
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If a DCE met the 30th percentile benchmark for at least one of ACR and UAMCC measures, the P4P Component Quality Score will be 100%. If the DCE did not meet the 30th percentile benchmark for at least one measure, this cell will show the highest sliding scale threshold met based on the highest performing measure.
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N/A = not applicable; a triple-dash (---) is used to indicate no eligible data
Footnotes:
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SSM = Summary survey measure
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SSM Results = The mean of the patient mix adjusted weighted linear scores for all questions in the SSM. Higher values are better. DCEs' 2022 results are provided for informational purposes and do not impact PY 2022 Total Quality Scores.
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NR = not reported; due to patient confidentiality, percentages are not reported if fewer than 11 respondents answered the answer categories needed to calculate the SSM.
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A dash (---) is used to indicate SSMs with zero respondents.
2021 Quality Performance Results:​
Quality performance results are based on the CMS Web Interface collection type.
