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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2024 ACO Participants & Preferred Providers:
ABEL ROJAS-PARRA
ADAM NASSERY
ADDISON MIZNER MEDICAL LLC
ADOLFO MARTINEZ
AGAPE HEALTH MEDICAL CENTER LLC
AGAPEMD LLC
AGATHE FRANCK
ALANA HOFFMAN
ALANNA COSTELLO
ALBERT HUMPHREY
ALEJANDRO GONZALEZ PEREZ
ALEXANDRA SPERLING
ALISON GLASSMAN
AMANDEEP DHILLON
AMELIA BELL-HAWKINS
AMIEL LEVIN
AMIEL LEVIN MD PA
AMY ARREAZA
AMY IANNONE
ANDREA MCINTOSH
ANDREAS AHLAS
ANDREW GRANELLO
ANGEL PAGAN
ANGELA VILLATORO
ANIRUDH SHARMA
ANJANI HAGAN
ANN RADCLIFFE
ANNA CHERIYAN
ANTONIO MORA
ANTONIO MORA MD PA
ARAM SARKISYAN
ARASH KHOSROVI-EGHBAL
ARCADIA MEDICAL ASSOCIATES PA
ARENA MEDICAL GROUP LLC
ARIANA LUNDQUIST
ARIANE CLERVEAU BEAUBOEUF
ARIEL BRITO GONZALEZ
ARLENIS BARROSO PEREZ
ASHTON CHASE
AUDREY LIU
AUDREY ROBERSON
AUDRIE ANNE BESOYAN
BARBARA ANN SCHERER MD PA
BARBARA SCHERER
BARRY STREIT
BEHNAM BIRGANI
BEHNAM BIRGANI DO PA
BHAKTI KHATRI
BIANCA TRISTAN
BIRJIS ALAM
BIRJIS K ALAM M D P A
BRENDA NGUYEN
BRIAN GOLDFARB
BRIANNA MYERS
BRUCE MANN
CABRERA MEDICAL SERVICES INC
CARLOS DELGADO
CARLOS DELGADO MD PA
CARLOS DOMINGUEZ
CARLOS F VALLEJO MD PA
CARLOS L DOMINGUEZ MD PA
CARLOS NAVARRO
CARLOS RIVEROS
CARMEN CABEZA ROMERO
CAROL STEWART-HAYOSTEK
CARRIE WOODS
CATHERINE HAYS
CATHERINE MCDONALD
CENTRAL FLORIDA MEDICAL ASSOCIATES, INC
CENTRAL MEDICAL GROUP PA
CHARLA SPERRING
CHARLES IKE
CHARLES LIEBER
CHARLES YANES
CHARLES YANES MD PA
CHEYENNE RINCONES
CHRISTIAN GONZALEZ
CHRISTIAN GONZALEZ MD LLC
CHRISTOPHER CORRIVEAU
CHRISTOPHER FINNILA
CHRISTOPHER NEVINS
CHRISTY SANDERS
CINDY MARIKA
CINDY MARIKA D O P A
CLINICA SIERRA VISTA
COLLIER HEALTH SERVICES, INC
CR MEDICAL GROUP INC
CYNTHIA WILLIAMS
DANIEL JURICH
DANIEL SCHATZ
DANIELLE NEUMAN
DAVID NEUMAN
DAWN STOECKER-SIMON
DEBORAH NICASIO
DELFINO GARCIA
DEVAUGHN BELL
DIPESH DERAY
DOUGLAS WEINER
DR JORGE TRAVIESO MD PA
DR WENTWORTH JARRETT PA
DUYEN TRAN
E&J FAMILY HEALTH CENTER LLC
EDGARDO COLON-PINEIRO
EDUARDO A. REYES MD PA
EDUARDO MENDEZ
EDUARDO REYES
EDWIN CABAHUG
EMERALD HILLS MEDICAL CENTER INC
EMILY ROBB
ENRIQUE C FERNANDEZ MD PA
ENRIQUE FERNANDEZ
ENRIQUE VILLA
ERICA O DONNELL
ESMERALDA SCOTT
EUFEMIA CANDO
FELIX CHION FONG
FELIX E GUZMAN MD PA
FELIX GUZMAN
FERISHTA GOUSSE
FLORIDA PRIMARY CARE PARTNERS LLC
FRANCES CAMILLE RABANAL
FRANK OLIVER
GABRIEL VILLACHICA
GILBERT LEUNG
GILBERT LEUNG MD PA
GREGORY SINGLETON
GULNARA TALDIBAEVA-PUGLIESE
HAMMOCK MEDICAL CENTER INC
HANG MUNSAYAC
HARNEK SINGH
HEATHER REBRO
HECTOR ARREAZA
HERMINIA HAWKINS
HIN CHRISTINE LEE
HOLLIE DEWITT
HUMBERTO C MACHADO JR MD PA
HUMBERTO MACHADO
INCARE LLC
INTEGRATIVE PRIMARY CARE OF EL PASO PLLC
IRVING AYALA-RODRIGUEZ
ISRAEL CABRERA
IVAN CASTANO
IVAN MUNOZ-ALMARAZ
JACQUELINE MAJELLA UY
JAMES POWERS
JAMES PRINE
JAMES S. PRINE, M.D. PA
JASDEEP GILL
JASON BECK
JASON GAJRAJ
JASPREET SAINI
JAVIER HERNANDEZ
JEAN-BAPTISTE PIERRE
JEANNETTE DE LA TORRE
JEFFREY CARA
JENNIFER GUSS
JENNIFER MEYER
JERRY LEVENTHAL
JESSE OLIVER
JESSICA TRAN
JESSIE JEAN MARIE
JF PRIMARY CARE MD PA
JHONATAN LEAL MENDOZA
JOEL ISOM
JOHN BANCROFT HYLTON M.D,P.A
JOHN HYLTON
JOHN PAULSEL
JOHN YEE
JONATHAN HERNANDEZ
JONATHAN MAGID
JONATHAN YOUSEF
JORGE ACOSTA
JORGE BARCENAS
JORGE FLEITES
JORGE M BARCENAS MD PA
JORGE PALOMINO VARGAS
JORGE PEREZ
JORGE TRAVIESO
JOSE A COBIELLA MD PA
JOSE COBIELLA
JOSE HERNANDEZ
JOSE M TORRES AND ASSOCIATES MD PA
JOSE RIZADY FLORES
JOSE TORRES
JOSEFINA HERNANDEZ
JOSEPH ARENA
JOSEPH GUERNSEY
JOSEPHINE CLINGAN
JOSEPHINE GABRILLO
JOT PREET SAHI
JUAN CAMAYD
JUAN OROZCO
JUAN PEREZ-ESPINOSA
JULIAN MARQUEZ
JULIAN MARQUEZ MD PA
JULIO GONZALEZ
JULIO ROSALES
JULIUS SANCHEZ
JUVENAL E MARTINEZ MD PA
JUVENAL MARTINEZ
KALILA BANKS
KARI TANNENBAUM
KATHERINE SCHLAERTH
KATIE NUNEZ
KELLY OBRIEN
KENNETH MIDONECK
KETTY CHERY
KEVIN BENDER
KEVIN OUMA
KHALID RAUF
KRISTEN MOTLEY
KRYSTAL BERMUDEZ
KULBIR GILL
KULJIT SIDHU
LAKERA DUNCOMBE-JONES
LAURA SEVERYN
LAURA ZITON
LAZARA HURTADO INFANTE
LENNI FUGAZY
LENNIE ORNELAZ
LESLIE HURWITZ
LIFETIME FAMILY URGENT CARE LLC
LOPEZ MEDICAL PRACTICE LLC
LUZ LUQUE
MANUEL BORREGO
MANUEL PEREZ-ESPINOSA MD PA
MARCO A NOVA MD PA
MARCO NOVA
MARCOS ZARAGOZA
MARGARITA STEWART
MARIA CECILIA ROSALES
MARIA DE LA PENA
MARIA MUSTELIER
MARIE JOSEPH
MARLENE GONZALEZ
MARLOWE MARINAS
MARSHA CHENG
MARTIN POLIAK
MARTIN WHITE
MATTHEW BEARE
MATTHEW LENZ
MAYRA TOVAR CASTRO
MCDAVID M MAHAFFEY MD PA
MCDAVID MAHAFFEY
MED-CARE MEDICAL CENTER INC
MEDICAL CLINIC OF HOUSTON, LLP
MEDICAL SPECIALTY GROUP OF SOUTH FLORIDA LLC
MELANIE CLARO
MELESSA MATTIS
MELVIN GALINATO
MERCEDES J VAZQUEZ MD PA
MERCEDES VAZQUEZ
MICHELLE THOMAS
MICHELLE WEINER
MIGUEL DIAZ
MILIE MARIE TOLENTINO
MIRNA WAIDELE PA C INC
MONICA DE LA TORRE
NAMDEEP GREWAL
NANCY BOULOUTE
NATASHA WILLIAMSON
NAVEEN PADDU
NEERAJ JUNEJA
NEIGHBORMD OF ATLANTA LLC
NEIGHBORMD OF NEWNAN LLC
NEIGHBORMD OF SOUTH ATLANTA LLC
NYKIA PEACE
ODALYS PENA
OLGA LOPEZ
OLGA MEAVE
OLIVIA HAYOSTEK
ORESTES A PAVIA SANCHEZ
ORMOND INTERNAL MEDICINE LLC
PAOLO MIMBELLA
PATRICIA VANDIEPEN
PAUL M. SCHWARTZ MD PA
PAUL MURRY
PAUL SCHWARTZ
PAULA BEDO
PERSONAL PHYSICIAN CARE P A
PERSONAL PHYSICIAN MANAGEMENT GROUP OF HALLANDALE, INC
PHILLIP DAVIS
PHILLIP G DAVIS M D P A
PRAMJEET AHLUWALIA
PRISCILLA LUONG
RADHIKA BAWA
RAMIRO CORO
RAMIRO CORO MD PA
RAMON LEON
RAMON LEON MD LLC
REGITHA SEBASTIAN
REINIER RAMIREZ
RENATO SEGURA
RICARDO DOMINGUEZ
RICARDO DOMINGUEZ MD PA
RICHARD MARQUES
RICHARD SEIDELMAN
RIDDHI BODANI
RIZWANA SHAIKH
ROBERTO URQUIZA
ROBERTO URQUIZA M D P A
ROBERTO VELAZQUEZ AMADOR
ROLANDO PADRO
ROSA ESPINOSA
ROYAL CARE MEDICAL CENTER INC
RUSSELL RADOFF
RYLAN MCQUADE
SABIA ST FLEUR
SABITHA PABBATHI
SAMANTHA LINDSAY
SAMANTHA S LINDSAY MD PA
SAMIR DAWOD RAJIHA
SAMUEL CLARKE
SANDEE BRISTOW
SARAH GEIGER
SARAH PRESLAR
SERGIO GARCIA
SG PRIMARY CARE MD, LLC
SHARON LI
SHAZIA AHMED
SHELLEY BURGE
SHEREN LEUNG
SHILKA BABU
SIMON WONG
SIMRANJEET KAUR
SLAVISA MARKOVIC
SOPHIE TANG
STEVEN FIELDS
STEVEN FIELDS MD PA
STEVEN MORRIS
STEVEN MORRIS M D P A
STEVEN SAITO
SUCCURA DAVIS
SUKHDEEP DHALIWAL
SUNDAY IRENE
SUNSHINE FAMILY HEALTHCARE, LLC
SUSAN RASHID
SUZANNE LASEK NESSELQUIST
SYED AHMED
TANA PARKER
TEJAL SHAH
TERRANCE MCGILL
THOMAS LUX
TIFFANY BRYANT
TONY UONG
TXONG HER
UKAMAKA ONYIA
UNITED MEDICAL SPECIALTIES INC
VANGUARD MEDICAL GROUP, LLC
VERNA MARQUEZ
VICENTE F. FRANCO M.D.,P.A.
VICENTE FRANCO
VICTOR MARTINEZ
VICTOR STEWART
VIERGELA JOSEPH
VOLUSIA MEDICAL CENTER LLC
WA VUE
WAEL ALOKEH
WELLCARE MEDICAL CLINIC LLC
WENTWORTH JARRETT
WILLIAM SHAPSE
YUNIOR MARTINEZ DUENAS
ZACHARY MIRSKY
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
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
XL- CARE AGENCY, INC. OF COLLIER
Hospice
VITAS HEALTHCARE CORPORATION OF FLORIDA
VITAS HEALTHCARE CORPORATION OF GEORGIA
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Infusion Pharmacy
MED-CARE INFUSION SERVICES INC
Labs
BIO-REFERENCE LABORATORIES INC
FLORIDA CLINICAL LABORATORY INC
LABORATORY CORPORATION OF AMERICA
LABORATORY CORPORATION OF AMERICA HOLDINGS
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC
QUEST DIAGNOSTICS INCORPORATED
UNILAB CORPORATION
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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.
