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Medicare ACO Information

Medicare ACO Information

South Shore Hospital is participating in a Medicare Shared Savings Program Accountable Care Organization

What’s An Accountable Care Organization (ACO)?

  • ACOs are groups of doctors and other health care providers who voluntarily work together with Medicare to give you high quality service and care at the right time in the right setting.
  • An ACO is not a Medicare Advantage Plan, (like an HMO or PPO), or an insurance plan.
  • ACOs don’t change your Medicare benefits.

How Will An ACO Help My Doctor Coordinate My Care?

  • Your doctors will have a more complete picture of your health through talking with your other doctors.
  • To help you get better, more coordinated care, Medicare will share certain health information with us about the care you get from your doctors and other health care providers unless you ask Medicare not to share it.
  • South Shore Medical Center may continue to recommend that you see particular doctors for your specific health needs, but it’s always your choice about what doctors you see or hospitals you visit.

What Do I Need To Do?

  • If you want Medicare to share information about care you’ve received with us, there’s nothing more you need to do.
  • If you do not want Medicare to share your health care information with South Shore Physician–Hospital Organization, Inc. or other ACO providers who provide care to you, call 1-800 MEDICARE (1-800-633-4227) and tell the representative that your doctor is part of an ACO and you don’t want Medicare to share your health care information. TTY users should call 1-877-486-2048.
  • If you do not call 1-800-Medicare and request not to share your health care information, it will be shared with your ACO and with other ACOs in which any of your doctors or other healthcare providers participate for the purposes of care coordination and quality improvement.
  • If you change your mind in the future, call 1-800-MEDICARE and tell the representative what you have decided.
  • Even if you decline to share your health care information, Medicare will still use your information for some purposes, including certain financial calculations and determining the quality of care given by your health care providers participating in ACOs. Also, Medicare may share some of your health care information with the ACOs when measuring the quality of care given by healthcare providers participating in the ACOs.

Accountable Care Organization - Public Reporting Information

ACO Name & Location

South Shore Physician-Hospital Organization, Inc.
1221 Main Street, Suite 202
South Weymouth, MA  02190

ACO Primary Contact

Matt Whalen
Vice President, Managed Care
Executive Director, SSPHO
South Shore Physician Hospital Organization
1221 Main Street, Suite 202
South Weymouth, MA 01290-2455
Office: 781-624-8820
Fax: 781-340-1751
Email: matthew_whalen@sshosp.org

Formation and Composition of ACO

Partnership or joint venture arrangement between hospital and ACO professionals

ACO Participants

  • South Shore Hospital, Inc.
  • South Shore Medical Center, Inc.
  • Coastal Medical Associates
  • Maida Antigua, MD
  • Associated Eye Surgeons
  • Atlantic Primary Care, P.C.
  • Bethel Medical Group, P.C.
  • Arthur Bregoli, MD
  • Robert Chasen, DPM
  • Crown Obstetrics & Gynecology, P.C.
  • Kenneth Gilbert, MD
  • Donne Holden, MD
  • Hypertension And Kidney Center, P.C.
  • Kingsbury Primary Care, P.C.
  • Joseph M. Lenehan, MD, P.C.
  • Richard Mazzaferro, DO, P.C.
  • Thomas Morris, MD
  • South Shore Allergy & Asthma Specialists, Inc.
  • South Shore Anesthesia Associates
  • South Shore Cardiology, P.C.
  • South Shore Ob-Gyn Hanover Ob-Gyn Inc.
  • South Shore Orthopedics, LLC
  • South Shore Radiological Associates, Inc.
  • South Shore Urology, Inc.
  • South Shore Women's Health, P.C.
  • South Suburban Gastroenterology, P.C.
  • Deborah S. Wooten, MD, LLC

ACO Governing Body

SSPHO Board of Directors

  • David F. Demick, MD, Chair, ACO Participant, South Shore Anesthesia
  • Gene Green, MD, Vice Chair, ACO Participant, President/CEO, South Shore Health System
  • Pamela Whelton, Treasurer, EVP/Administrative Officer & CFO, South Shore Health System
  • Arthur Bregoli, MD, Clerk, ACO Participant
  • Michael Ayers, MD, ACO Participant, South Shore Orthopedics
  • James Brezneh, MD, ACO Participant, South Shore Anesthesia
  • William Calhoun, MD, ACO Participant, South Shore Radiology Associates
  • Douglas Grogan, MD, ACO Participant, Bethel Medical Group
  • Patricia Hopkins, MD
  • Javaid Hussain, MD, Weymouth Pediatrics
  • John Stevenson, MD, ACO Participant, SVP/Chief Health Officer, South Shore Health System
  • Matthew Weiss, MD, ACO Participant, Chief Strategy Officer, South Shore Health System

ACO Committees & Key Leadership

Key Leadership

  • Matthew Whalen, ACO Executive (Authorized Official), Executive Director, South Shore Physician Hospital Organization
  • Stephen Johnson, MD, Medical Director / Qualified Health Professional
  • Finance Committee
  • Pamela Whelton, Chair, Treasurer, EVP/Administrative Officer & CFO, South Shore Health System
  • Michael Ayers, MD, ACO Participant, South Shore Orthopedics
  • Arthur Bregoli, MD, ACO Participant
  • William Calhoun, MD, ACO Participant, South Shore Radiology Associates
  • David F. Demick, MD, ACO Participant, South Shore Anesthesia
  • Gene Green, MD, President/CEO, South Shore Health System
  • Douglas Grogan, MD, ACO Participant, Bethel Medical Group

Nominating Committee

  • David F. Demick, MD, Chair, ACO Participant, South Shore Anesthesia
  • Arthur Bregoli, MD, ACO Participant
  • William Calhoun, MD, ACO Participant, South Shore Radiology Associates
  • John Stevenson, MD, ACO Participant, SVP/Chief Health Officer, South Shore Health System
  • Pamela Whelton, Chair, Treasurer, EVP/Administrative Officer & CFO, South Shore Health System

Compliance Committee

  • Arthur Bregoli, MD, Chair, ACO Participant
  • William Calhoun, MD, ACO Participant, South Shore Radiology Associates
  • John Stevenson, MD, ACO Participant, SVP/Chief Health Officer, South Shore Health System
  • Matthew Weiss, MD, ACO Participant, Chief Strategy Officer, South Shore Health System

Bylaws Committee

  • John Stevenson, MD, Chair, ACO Participant, SVP/Chief Health Officer, South Shore Health System
  • Patricia Hopkins, MD

ACO Advisory Committee

  • Stephen Johnson, MD, Chair, ACO Participant, Coastal Medical Associates
  • William Calhoun, MD, ACO Participant, South Shore Radiology Associates
  • David Halle, MD, ACO Participant, South Shore Medical Center
  • Edward Nalband, MD, ACO Participant, South Shore Medical Center
  • Matthew Weiss, MD, ACO Participant, Chief Strategy Officer, South Shore Health System
  • Julie Kembel, Medicare Beneficiary
  • Quality & Performance Committee
  • Stephen Johnson, MD, Chair, ACO Participant, Coastal Medical Associates
  • Jeffrey Bennett, MD, ACO Participant, South Shore Urology
  • Jason Erlich, MD, ACO Participant, South Shore Anesthesia
  • Nahid Kennedy, DO, ACO Participant, Atlantic Primary Care
  • Edward Rao, MD, Crown Obstetrics & Gynecology

Aggregate Amount of Shared Savings/Losses

  • 2017 – Performance Year 1: no data to report (Track 1)

How Shared Savings Are Distributed

  • Proportion invested in infrastructure: TBD
  • Proportion invested in redesigned care processes and other resources: TBD
  • Proportion distributed to ACO participants: TBD

Quality Performance Results

2017 Quality Performance Results – N/A

Payment Rule Waivers

ACO does not use the SNF 3-day Rule Waiver as a Track 1 ACO.

For additional information about Accountable Care Organizations, please visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Last Updated: January 20, 2017

 © 2017 South Shore Physician Hospital Organization
1221 Main Street Suite 202, South Weymouth, MA 02190
Phone: 781-624-4200   Fax: 781-624-4221