Meridian Accountable Care Organization

ACO Name and Location

Meridian Accountable Care Organization
1350 Campus Parkway
Neptune, NJ 07753

ACO Primary Contact

Navneet Kathuria, M.D., MPH, MBA
Vice President, Population Health and Clinical Quality
ACO@meridianhealth.com
(732) 751-7500

Organizational Information

ACO Participants

  • Achilles Foot And Ankle Associates, PA
  • Adult And Geriatric Medicine
  • Adult Medical Oncology Hematology Group
  • Advanced Digestive Center, Inc
  • Advanced Radiology Solutions
  • Alfred Wolkomir MD
  • Allaire Foot & Ankle, LLC
  • Allergy & Asthma Associates, Inc
  • American Heart Center, PC
  • Andrew L. Simon M.D., F.A.C.S, P.A.
  • Angelo Chinnici
  • Ani Orthopaedics, P.C.
  • Antonios Tsompanidis DO
  • Associates In Foot And Ankle Surgery
  • Atlantic Cardiology, LLC
  • Atlantic Hematology Oncology Associates, LLC
  • Atlantic Medical
  • Atlantic Shore Medical, PA
  • Atlantic Surgical Group
  • Atlas Medical Care, LLC
  • Babu V. Surya MD
  • Barron Emergency Physicians
  • Bayshore Emergency Medical Associates LLC
  • Brick Rheumatology, LLC
  • Bruce A Decotiis MD PA
  • Cardiology Associates Of Ocean County
  • Central Jersey Pulmonary & Medical Associates, LLC
  • Charles P Fernicola MD PC
  • Charles R. Spatz
  • Chi I. Lee MD
  • Christopher Brown
  • Coastal Cardiovascular Consultants, PA
  • Coastal Comprehensive Healthcare, LLC
  • Coastal Ear Nose And Throat LLC
  • Coastal Foot & Ankle, LLC
  • Coastal Gastroenterology Associates, P.A.
  • Comsti Medical LLC
  • Crescent Multispeciality Group LLC
  • David Cheli MD PA
  • David I. Kleinfeld MD, PA
  • Digestive Disease Specialists Of Central Jersey P.C.
  • Dominick A. Grosso DO
  • Don W Choi
  • Douglas W. Chudzik MD
  • Dr. Evan Kelner, DPM, PA
  • Ear Nose Throat And Facial Plastic Surgery Associates PC
  • East Coast Radiation Oncology Associates PA
  • Eatontown Medical Associates, PA
  • Evan Adler DPM
  • Farmingdale Medical Associates, LLC
  • Franklin P Hernando, MD, PA
  • Garden State Foot & Ankle Center, LLC
  • Gary P. Lengel MD
  • Gerald E. Pflum MD, PA
  • Golding Granado Medical Associates, LLC
  • Greater Monmouth Neurology PC
  • Gregory J. Cunningham, MD
  • Health Village Imaging
  • Heather Crawford DPM
  • Holmdel Cardiology Associates
  • Holmdel Physician Associates
  • Holmdel Pulmonary Medicine, LLC
  • Indira Bollampally MD
  • Indu Sharma MD PA
  • Internal Medicine Institute Of New Jersey, LLC
  • Iwamaye & Farber MD PA
  • Janlinn Healthcare, LLC
  • Jarahian Medical LLC
  • Jersey Medical Associates Inc
  • Jersey Shore Geriatrics Inc
  • Jersey Shore Medical And Pediatrics Associates, LLC
  • Jersey Shore Neurology Associates, PA
  • Jersey Shore Podiatric Associates
  • John A. Schmidt Jr MD, LLC
  • Joseph Mannion MD
  • Karl E. Kado, DPM
  • Kashmira Patel MD, LLC
  • Kivarkis Y. Younan MD, PA
  • Kretov Medical Arts LLC
  • L. Gualberti Girgis MD And J. Gualberti MD
  • Lawrence Frieman MD, PA
  • Lawrence J Menditto DPM PC
  • Marlboro Podiatry Center
  • Maruti Family & Sleep Medicine LLC
  • Mayur V. Patel MD, PA
  • Medical Associates Of Ocean County PA
  • Meridian Laboratory Physicians, PA
  • Meridian Obstetrics And Gynecology Associates P C
  • Meridian Pediatric Associates PC
  • Meridian Surgical Associates, PC
  • Meridian Trauma Associates, PC
  • Michael A. Weinblatt D.P.M.
  • Michael L. Sher MD, LLC
  • Monmouth Cardiology Associates, LLC
  • Monmouth Sleep & Pulmonary Associates, LLC
  • Monmouth-Ocean Neurology
  • Navesink Medical Associates LLC
  • Navesink Surgical Associates
  • Neptune Internal Medicine, LLC
  • Neurology Associates Of Central Jersey
  • Neuropsychology & Counseling Associates, LLC
  • New Jersey Urologic Institute P.A.
  • Nirmala D. Sanakkayala MD
  • NJ Acute Care Specialists Professional Corporation
  • Northern Monmouth County Medical Associates, PC
  • Northern Ocean County Medical Associates, PC
  • Oakhurst Medical Group
  • Ocean County Retina PC
  • Ocean Foot And Ankle, PC
  • Ocean Medical MD, PA
  • Ocean Pulmonary Associates, PA
  • Orthopaedic And Spine Institute Of NJ PC
  • Owen Carolan MD, LLC
  • Pacita C. Sy, MD, LLC
  • Paul J Silbert
  • Physicians Home & Health Services
  • Pineland Associates In Obstetrics-Gynecology, PA
  • Plover Inpatient Services LLC
  • Premier Healthcare Associates, PC
  • Primary Care And Preventive Medicine PA
  • Ramtown Medical Center, LLC
  • Rao Gourkanti, MD
  • Raymond Masterson MD
  • Red Bank Radiologists
  • Richard Eichel, MD LLC
  • Robert E Sussman DPM PC
  • Robinson-Gallaro Gastroenterology Associates LLC
  • Sagar Y. Patel MD, LLC
  • Saint Barbara Medical LLC
  • Samra Plastic And Reconstructive Surgery, LLC
  • Sandip Parikh, MD
  • Shivendra Pandey MD PC
  • Shore Cardiac Anesthesiology Associates, Inc.
  • Shore Endocrinology Associates LLC
  • Shore Eye Associates
  • Shore Heart Group, PA
  • Shore Nephrology PA
  • Shore Radiation Oncology, LLC
  • Somc Medical Group, P.C.
  • Southern Ocean County Surgical Association, LLC
  • Southern Ocean Oral Surgery & Implant Center, Inc.
  • Southern Ocean Otolaryngology, PA
  • Srinivas Pavuluri MD
  • Stafford Medical, PA
  • Stafford Surgical Specialists, LLC
  • Sukhwinder K. Hundle MD
  • Susan E Dick MD
  • Sushil K Mehandru MD PA
  • Tarun Shah
  • The Institute Of Orthopaedic Surgery And Sports Medicine, P.A.
  • The Youth Fountain
  • Total Patient Care LLC
  • Tristate Spine And Pain, LLC
  • Two River Physician Associates
  • University Radiology Group PC
  • Urology Associates, PA
  • V.K. Perkari M.D. LLC
  • Vein Center For Women PC
  • William Adams
  • William C. Anania, DPM, PC
  • Yong Shi MD, LLC

No participants are involved in a joint venture between ACO professionals and hospitals.

ACO Governing Body

Member Name Voting Right Member Role Member Type ACO Participant Legal Business Name

John K. Lloyd, FACHE

Voting Member

Chair

ACO Participant Representative

Hackensack Meridian Health

Michael Aaron, D.O.

Voting Member

Member

ACO Participant Representative

Shore Heart Group, PA

James Clarke, M.D.

Voting Member

Medical Director

ACO Participant Representative

Hackensack Meridian Health

Steven Daniels, M.D.

Voting Member

Member

ACO Participant Representative

Monmouth Cardiology Associates, LLC

Lawrence Frieman, M.D.

Voting Member

Member

ACO Participant Representative

Frieman Ophthalmology

Dominick Grosso, D.O.

Voting Member

Member

ACO Participant Representative

Dominick Grosso, D.O., LLC

John Gumina, M.D.

Voting Member

Member

ACO Participant Representative

Meridian Medical Group – Primary Care Pc

Navneet Kathuria, M.D.

Non-Voting Member

Executive Director

ACO Participant Representative

Hackensack Meridian Health

Kenneth Kronhaus, M.D.

Voting Member

Member

ACO Participant Representative

Jersey Coast Family Medicine

Thomas Lake, M.D.

Voting Member

Member

ACO Participant Representative

Atlantic Surgical Group

Joseph Lemaire

Voting Member

Member

ACO Participant Representative

Hackensack Meridian Health

Raymond Masterson, M.D.

Voting Member

Member

ACO Participant Representative

Meridian Medical Group – Primary Care Pc

Mark Pass, M.D.

Voting Member

Member

ACO Participant Representative

Jersey Shore Geriatrics, Inc.

Robert Penney, M.D.

Voting Member

Vice-Chair

ACO Participant Representative

Holmdel Obstetrics And Gynecology, PA

Peter Reinhart

Voting Member

Member

ACO Participant Representative

Hackensack Meridian Health

Michael Rothberg, M.D.

Voting Member

Member

ACO Participant Representative

SOMC Medical Group, Pc

Robert Sweeney, D.O.

Voting Member

Chair, Quality Committee

ACO Participant Representative

Hackensack Meridian Health

Ashokvardan Veldanda, M.D.

Voting Member

Member

ACO Participant Representative

Stafford Medical, PA

Neal Winzelberg, M.D.

Voting Member

Member

ACO Participant Representative

Coastal Gastroenterology Associates, PA

Patrick Young

Voting Member

Member

ACO Participant Representative

Hackensack Meridian Health

Janet Eng

Voting Member

Member

Medicare Beneficiary Representative

Shrikrishna Mate, M.D.

Voting Member

Member

Community Stakeholder Representative

Pediatric Medical Group Central Jersey

Arthur Vasen, M.D.

Voting Member

Member

Community Stakeholder Representative

Seaview Orthopaedic & Medical Associates

Denis Fitzgerald, M.D.

Voting Member

Chair, Membership Committee

Other (Other Entity Representative)

Regional Cancer Care Associates, LLP

Key Clinical and Administrative Leadership

  • ACO Executive: Dr. Navneet Kathuria
  • Medical Director: Dr. James Clarke
  • Compliance Official: Mr. Peter Hughes
  • Quality Assurance/Improvement Officer: Dr. Raymond Masterson

ACO Committees and Committee Leadership

  • Meridian ACO Board: Mr. John Lloyd, Chair
  • Meridian ACO Membership Committee: Dr. Denis Fitzgerald, Chair
  • Meridian ACO Quality Committee: Dr. Robert Sweeney, Chair

ACO Composition

Meridian ACO is composed of partnerships or joint venture arrangements between hospitals and ACO professionals.

Shared Savings and Losses

Amount of Shared Savings and Losses

  • Agreement period beginning 2013, Performance Year 1: $7,296,256
  • Agreement period beginning 2013, Performance Year 2014: $0
  • Agreement period beginning 2013, Performance Year 2015: $0
  • Agreement period beginning 2016, Performance Year 2016: $TBD

Shared Savings Distribution

Agreement period beginning 2013, Performance Year 1

  • Proportion invested in infrastructure: 12%
  • Invested in redesigned care processes/resources: 0%
  • Proportion of distribution to ACO participants: 88%
  • Primary Care: 65%
  • Specialists: 17.5%
  • Hospitals: 17.5%

Payment Rule Waivers

No, our ACO does not utilize the SNF 3-Day Rule Waiver.

Quality Performance Results

Measure
number
Measure Name 2015 reporting period
ACO performance rate Mean performance rate (SSP- ACOs)
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 79.04 80.61
ACO-2 CAHPS: How Well Your Providers Communicate 93.36 92.65
ACO-3 CAHPS: Patients' Rating of Provider 92.00 91.94
ACO-4 CAHPS: Access to Specialists 83.48 83.61
ACO-5 CAHPS: Health Promotion and Education 60.66 59.06
ACO-6 CAHPS: Shared Decision Making 74.90 75.17
ACO-7 CAHPS: Health Status/Functional Status 74.23 72.30
ACO-34 CAHPS: Stewardship of Patient Resources* 22.19 26.87
ACO-8 Risk Standardized, All Condition Readmission 14.17 14.86
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)*
Readmission
17.74 18.07
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes* 49.20 54.60
ACO-37  All-Cause Unplanned Admissions for Patients with Heart Failure* 67.34 76.96
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 53.58 62.92
ACO-9 Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 0.88 1.11
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) 1.01 1.04
ACO-11 Percent of Primary Care Physicians who Successfully Meet Meaningful Use
Requirements
75.00% 80.14%
ACO-39 Documentation of Current Medications in the Medical Record* 29.89% 84.07%
ACO-13 Falls: Screening for Future Fall Risk 62.12% 56.46%
ACO-14 Preventive Care and Screening: Influenza Immunization 58.10% 62.03%
ACO-15 Pneumonia Vaccination Status for Older Adults 48.65% 63.73%
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up 64.48% 71.15%
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 94.29% 90.16%
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 56.96% 45.25%
ACO-19 Colorectal Cancer Screening 63.56% 60.06%
ACO-20 Breast Cancer Screening 60.80% 65.67%
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and
Follow-Up Documented
74.69% 70.04%
ACO-40 Depression Remission at Twelve Months* N/A N/A
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 16.64% 20.38%
ACO-41 Diabetes: Eye Exam* 33.27% 41.05%
ACO-28 Hypertension: Controlling High Blood Pressure 74.04% 69.62%
ACO-30 Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic 81.34% 83.82%
ACO-31 Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 79.38% 87.22%
ACO-33 Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) 71.84% 77.73%

CAHPS = Consumer Assessment of Healthcare Providers and Systems, PQI = Prevention Quality Indicator, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.
*= Measure required beginning Reporting Year 2015.
N/A= Reporting on the depression remission measure is not required for 2015, as indicated by N/A

 

Measure Number Performance Measure
2012 Reporting Period
ACO Performance Rate Mean Performance Rate for all ACOs
2013 Reporting Period
ACO Performance Rate Mean Performance Rate for all ACOs
2014 Reporting Period
ACO Performance Rate Mean Performance Rate for all ACOs
ACO #1 Getting Timely Care, Appointments, and Information
Not in operations Not in operations
   
80.01 80.13
ACO #2 How Well Your Doctors Communicate
Not in operations Not in operations
   
92.23 92.39
ACO #3 Patients’ Rating of Doctor
Not in operations Not in operations
   
92.2 91.58
ACO #4 Access to Specialists
Not in operations Not in operations
   
81.95 83.97
ACO #5 Health Promotion and Education
Not in operations Not in operations
   
59.17 58.29
ACO #6 Shared Decision Making
Not in operations Not in operations
   
76.41 74.60
ACO #7 Health Status/Functional Status
Not in operations Not in operations
   
71.25 71.10
ACO #8* Risk Standardized, All Condition Readmissions
Not in operations Not in operations
13.73 14.90
14.08 15.15
ACO #9* ASC Admissions: COPD or Asthma in Older Adults
Not in operations Not in operations
1.06 1.17
0.87 1.08
ACO #10* ASC Admission: Heart Failure
Not in operations Not in operations
1.17 1.20
1.23 1.19
ACO #11 Percent of PCPs who Qualified for EHR Incentive Payment
Not in operations Not in operations
63.12% 66.21%
75.84% 76.71
ACO #12 Medication Reconciliation
Not in operations Not in operations
   
9.89% 82.61
ACO #13 Falls: Screening for Fall Risk
Not in operations Not in operations
   
61.40% 45.60
ACO #14 Influenza Immunization
Not in operations Not in operations
   
56.71% 57.51
ACO #15 Pneumococcal Vaccination
Not in operations Not in operations
   
47.60% 55.03
ACO #16 Adult Weight Screening and Follow-up
Not in operations Not in operations
   
60.82% 66.75
ACO #17 Tobacco Use Assessment and Cessation Intervention
Not in operations Not in operations
   
92.32% 86.79
ACO #18 Depression Screening
Not in operations Not in operations
   
51.56% 39.27
ACO #19 Colorectal Cancer Screening
Not in operations Not in operations
   
60.36% 56.14
ACO #20 Mammography Screening
Not in operations Not in operations
   
51.74% 61.41
ACO #21 Proportion of Adults who had blood pressure screened in past 2 years
Not in operations Not in operations
   
41.74% 60.24
ACO #22 Hemoglobin A1c Control (HbA1c) (<8 percent)
Not in operations Not in operations
  N/A
28.87% N/A
ACO #23 Low Density Lipoprotein (LDL) (<100 mg/dL)
Not in operations Not in operations
  N/A
N/A N/A
ACO #24 Blood Pressure (BP) <140/90
Not in operations Not in operations
  N/A
58.22% N/A
ACO #25 Tobacco Non Use
Not in operations Not in operations
  N/A
72.82% N/A
ACO #26 Aspirin Use
Not in operations Not in operations
  N/A
85.07% N/A
ACO #27* Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent)
Not in operations Not in operations
   
81.22% 20.32
ACO #28 Percent of beneficiaries with hypertension whose BP <140/90
Not in operations Not in operations
   
71.38% 68.02
ACO #29 Percent of beneficiaries with IVD with complete lipid profile and LDL control <100mg/dl
Not in operations Not in operations
   
N/A N/A
ACO #30 Percent of beneficiaries with IVD who use Aspirin or other antithrombotic
Not in operations Not in operations
   
87.90% 80.79
ACO #31 Beta-Blocker Therapy for LVSD
Not in operations Not in operations
   
75.52% 82.71
ACO #32 Drug Therapy for Lowering LDL Cholesterol
Not in operations Not in operations
   
N/A N/A
ACO #33 ACE Inhibitor or ARB Therapy for Patients with CAD and Diabetes and/or LVSD
Not in operations Not in operations
   
70.98% N/A
   


*These measures are scored such that a lower rate is indicative of better performance.

Note: ASC = ambulatory sensitive conditions, COPD = chronic obstructive pulmonary disease, PCP = primary care physician, EHR = electronic health record, IVD = ischemic vascular disease, LVSD = left ventricular systolic dysfunction, ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CAD = coronary artery disease.

For more information on how to interpret scores on the above quality performance measures, see https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/MSSP-QM-Benchmarks.pdf 

Compliance

Comply Line: 1-877-888-8030

This toll-free phone number enables any legacy Meridian team member, Meridian ACO participants, community members, contractors, providers or suppliers to get answers to compliance related issues, or to identify/report any potential ethical, legal or other suspected concerns related to the Meridian ACO. Calls to the ComplyLine are treated with the utmost confidentiality, and callers are protected from retaliation for questioning or reporting something they believe in good faith may be a problem.

Accessing Medical Records

Information needed to access medical records at each of the legacy Meridian Hospitals is available by clicking Hospitals on the main legacy Meridian website. For your convenience, the following numbers are provided:

  • Bayshore Community Hospital: 732-739-5933 / 732-739-5985
  • Jersey Shore University Medical Center: 732-776-4241
  • K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center: 732-776-4241
  • Ocean Medical Center: 732-836-4331
  • Riverview Medical Center: 732-530-2333
  • Southern Ocean Medical Center: 609-597-6011 x2121

Please contact your physician’s office or other medical provider if you require access to other medical records.

Medicare Resources

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