ACO Name and Location

Broward Guardian, LLC
2450 Hollywood Boulevard
Suite 601
Hollywood, Florida 33020

ACO Primary Contact

John Harkins, Executive Director
jharkins@bguardian.org
+1.954.544.4065

Organizational information

ACO Participants
ACO Participants ACO Participant in Joint Venture
Saad Mirza, MD PAN
Mudasiru A. Carew, DO PAN
West Ky Abrams, DO PAN
Emilio Pando, MD PAN
Internal Medicine Specialty Associates, PAN
Hector Fabregas, MD PAN
Yaneth Trujillo, MD PAN
Family Practice of Davie, Inc.N
Mosbah Chehab, M.D., PLLCN
Comprehensive Health & Wellness Center P.A.N
REEDER MEDICAL GROUP LLCN
Wayne N. Evancho DO PAN
Calzada Primary Care, PAN
Chris Ramsaran Family And Sports MedicineN
HEALTHSTONE MEDICAL GROUP LLCN
Evergreen Medical Center, PAN
SPILLER HEART INSTITUTE LLCN
DOV S LINZER MD LLCN
CARDIAC & VEINWORX LLCN
COMPREHENSIVE CARDIOLOGY CONSULTANTS LLCN
Wayne H. Case, MD PAN
Reyes Reyes PAN
Leslie Shawn DO PAN
Dr Harry Pepe and Associates IncN
Safecare Medical Center, IncN
South Broward Hospital DistrictN
Howard M. Graubard, MD PAN
Medical Offices of Scott B. Halperin, MD PAN
Steven R. Linzer, DO PAN
Zoraida Rivera-Hidalgo MD PAN
Jeffrey Rothstein, DO PAN
Leonard J. Hoenig, MD PAN
Total Healthcare Of South Florida IncN
Van Buren Medical Center, IncN
Florida Institute for Cardiovascular Care, PAN
MARIO MAGCALAS MD PAN
Bahta and Associates, IncN
Prangnuan Durand D.O., P.A.N
Beth and Howard Braver, MD PAN
Hernando Giraldo MD, PAN
Juan Carlos Rondon, MD PAN
Durairaj Venkatasamy Md PaN
Joshua Z. Steiner, DO PAN
HEALTHY PARTNERS PRIMARY CARE LLCN
HEALTHSTONE PRIMARY CARE PARTNERS LLCN
Family Medical Center of Hollywood, PAN

ACO governing body:
Member Member's Voting Power Membership Type ACO Participant TIN Legal Business Name/DBA, if Applicable
Last Name First Name Title/Position
Stone, MD Charles Chair 1 of 7 Votes ACO Participant and Voting Member Internal Medicine Specialty Associates
Fabregas, MD Hector Vice Chair 1 of 7 Votes ACO Participant and Voting Member Hector Fabregas MD PA
Reyes, MD Rene Medical Director 1 of 7 Votes Aco Participant and Voting Member Reyes & Reyes MD
Greenstein, MD Marc Board Member 1 of 7 Votes ACO Participant and Voting Member Evergreen Medical Center, PA
Macaluso, MD Tom Board Member 1 of 7 Votes Voting Member Chief Quality Officer Memorial Healthcare System
Shulruff Larry Board Member 1 of 7 Votes Voting Member ACO Beneficiary Representative
Evancho, MD Wayne Board Member 1 of 7 Votes ACO Participant and Voting Member Wayne Evancho DO PA

Key ACO clinical and administrative leadership:
John Harkins ACO Executive
Dr. Rene Reyes Medical Director
Angela Velasco Compliance Officer
Dr. Larry Shulruff Quality Assurance/Improvement Officer

Associated committees and committee leadership:
Committee Name Committee Leader Name and Position
Beneficiary Engagement & Satisfaction Team (BEST) Dr. Larry Shulruff, Chair
Executive Committee Dr. Charles Stone, Chair
Finance and Contracting Committee Mr. John Harkins, Chair
Information Technology Committee Dr. Hector Fabregas, Chair
Quality Committee Dr. Tom Macaluso, Chair
Utilization & Care Coordination Committee Dr. Rene Reyes, Chair

Types of ACO participants, or combinations of participants that formed the ACO:
  • Networks of individual practices of ACO professionals
  • Partnerships or joint venture arrangements between hospitals and ACO professionals

Shared Savings and Losses:

Amount of Shared Savings/Losses
  • Second Agreement Period
    • Performance Year 2017, $3,729,517
  • First Agreement Period
    • Performance Year 2016, $3,115,928
    • Performance Year 2015, $5,220,484
    • Performance Year 2014, $0
Shared Savings Distribution
  • Second Agreement Period
    • Performance Year 2017
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 65%
  • First Agreement Period
    • Performance Year 2016
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 65%
    • Performance Year 2015
      • Proportion invested in infrastructure: 35%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 65%
    • Performance Year 2014
      • Proportion invested in infrastructure: 0%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 0%

Payment Rule Waivers

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

Quality Performance Results

2017 Quality Performance Results:
ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 80.55 80.60
ACO-2 CAHPS: How Well Your Providers Communicate 95.43 93.13
ACO-3 CAHPS: Patients' Rating of Provider 93.75 92.31
ACO-4 CAHPS: Access to Specialists 85.39 83.32
ACO-5 CAHPS: Health Promotion and Education 67.16 62.30
ACO-6 CAHPS: Shared Decision Making 76.84 75.85
ACO-7 CAHPS: Health Status/Functional Status 69.23 73.05
ACO-34 CAHPS: Stewardship of Patient Resources 26.61 25.68
ACO-8 Risk-Standardized, All Condition Readmission 15.68 15.01
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 18.35 18.46
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 80.74 79.16
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 67.11 61.74
ACO-43 Ambulatory Sensitive Condition Acute Composite (AHRQ* Prevention Quality Indicator (PQI #91)) 1.89 1.93
ACO-11 Use of Certified EHR Technology 100.00 98.48
ACO-12 Medication Reconciliation 89.63 75.32
ACO-13 Falls: Screening for Future Fall Risk 87.97 74.38
ACO-44 Imaging Studies for Low Back Pain 68.97 67.32
ACO-14 Preventive Care and Screening: Influenza Immunization 61.22 72.52
ACO-15 Pneumonia Vaccination Status for Older Adults 61.03 72.92
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 74.52 70.69
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 81.55 90.48
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 98.07 61.98
ACO-19 Colorectal Cancer Screening 69.95 64.58
ACO-20 Breast Cancer Screening 82.65 70.05
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 80.80 79.89
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 16.82 16.47
ACO-41 Diabetes: Eye Exam   52.62 50.37
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 70.36 71.47
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 80.46 86.86

Please note, the ACO-40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples and the ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes quality measure is not included in public reporting due to a non-material technical error.

Note: In the Quality Performance Results file(s) above, search for “Broward Guardian, LLC” to view the quality performance results. This ACO can also be found by using the ACO ID A49262 in the public use files on data.cms.gov.



2016 Quality Performance Results:
ACO# Measure Name Rate ACO Mean
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 81.61 79.9
ACO-2 CAHPS: How Well Your Providers Communicate 94.16 92.63
ACO-3 CAHPS: Patients' Rating of Provider 92.92 91.93
ACO-4 CAHPS: Access to Specialists 85.67 83.52
ACO-5 CAHPS: Health Promotion and Education 62.49 60
ACO-6 CAHPS: Shared Decision Making 76.97 75.28
ACO-7 CAHPS: Health Status/Functional Status 70.15 71.82
ACO-34 CAHPS: Stewardship of Patient Resources 24.1 27.52
ACO-8 Risk-Standardized, All Condition Readmission 15.1 14.7
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) 17.79 18.17
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 63.32 53.2
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 84.71 75.23
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 64.42 59.81
ACO-9 Ambulatory Sensitive Conditions Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 16.13 9.27
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8 ) 13.18 14.53
ACO-11 Percent of PCPs who Successfully Meet Meaningful Use Requirements 53.33 82.72
ACO-39 Documentation of Current Medications in the Medical Record 45.54 87.54
ACO-13 Falls: Screening for Future Fall Risk 61.48 64.04
ACO-14 Preventive Care and Screening: Influenza Immunization 28.55 68.32
ACO-15 Pneumonia Vaccination Status for Older Adults 31.22 69.21
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow Up 70.42 74.45
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 93.5 90.98
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 57.51 53.63
ACO-19 Colorectal Cancer Screening 45.51 61.52
ACO-20 Breast Cancer Screening 66.72 67.61
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-up Documented 74.4 76.84
ACO-42 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 74.74 77.72
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 17.87 18.24
ACO-41 Diabetes: Eye Exam   29.15 44.94
ACO-28 Hypertension (HTN): Controlling High Blood Pressure 74.25 70.52
ACO-30 Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 75 85.05
ACO-31 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 86.79 88.67
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%) 73.3 79.67

2015 Quality Performance Results Table
Measure Number Measure Name 2015 Reporting Period
ACO Performance Rate Mean Performance Rate (SSP- ACOs)
ACO-1 CAHPS: Getting Timely Care, Appointments, and Information 81.14 80.61
ACO-2 CAHPS: How Well Your Providers Communicate 94.27 92.65
ACO-3 CAHPS: Patients' Rating of Provider 92.96 91.94
ACO-4 CAHPS: Access to Specialists 83.96 83.61
ACO-5 CAHPS: Health Promotion and Education 61.72 59.06
ACO-6 CAHPS: Shared Decision Making 71.98 75.17
ACO-7 CAHPS: Health Status/Functional Status 70.73 72.30
ACO-34 CAHPS: Stewardship of Patient Resources 25.67 26.87
ACO-8 Risk Standardized, All Condition Readmission 15.53 14.86
ACO-35 Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM)* Readmission 19.38 18.07
ACO-36 All-Cause Unplanned Admissions for Patients with Diabetes 56.52 54.60
ACO-37 All-Cause Unplanned Admissions for Patients with Heart Failure 82.98 76.96
ACO-38 All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions 66.65 62.92
ACO-9 Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) 1.88 1.11
ACO-10 Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) 1.23 1.04
ACO-11 Percent of Primary Care Physicians who Successfully Meet Meaningful Use Requirements 69.12 80.14
ACO-39 Documentation of Current Medications in the Medical Record* 95.47 84.07
ACO-13 Falls: Screening for Future Fall Risk 62.25 56.46
ACO-14 Preventive Care and Screening: Influenza Immunization 34.62 62.03
ACO-15 Pneumonia Vaccination Status for Older Adults 17.97 63.73
ACO-16 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up 86.6 71.15
ACO-17 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 93.46 90.16
ACO-18 Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan 56.12 45.25
ACO-19 Colorectal Cancer Screening 39.31 60.06
ACO-20 Breast Cancer Screening 58.66 65.67
ACO-21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented 80.29 70.04
ACO-40 Depression Remission at Twelve Months N/A N/A
ACO-27 Diabetes Mellitus: Hemoglobin A1c Poor Control 26.57 20.38
ACO-41 Diabetes: Eye Exam 17.48 41.05
ACO-28 Hypertension: Controlling High Blood Pressure 69.5 69.62
ACO-30 Ischemic Vascular Disease: Use of Aspirin or Another Antithrombotic 78.88 83.82
ACO-31 Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 52.94 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%) 52.96 77.73

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

2012-2014 Quality Performance Results Table
Measure Number Measure Name 2012 Reporting Period 2013 Reporting Period 2014 Reporting Period
ACO Performance Rate Mean Performance of all ACO’s ACO Performance Rate Mean Performance of all ACO’s ACO Performance Rate Mean Performance of all ACO’s
ACO-1 Getting Timely Care, Appointments, and Information Not in operations Not in operations Not in operations Not in operations 84.82 80.13
ACO-2 How Well Your Doctors Communicate Not in operations Not in operations Not in operations Not in operations 94.46 92.39
ACO-3 Patients’ Rating of Doctor Not in operations Not in operations Not in operations Not in operations 93.43 91.58
ACO-4 Access to Specialists Not in operations Not in operations Not in operations Not in operations 83.95 83.97
ACO-5 Health Promotion and Education Not in operations Not in operations Not in operations Not in operations 61.19 58.29
ACO-6 Shared Decision Making Not in operations Not in operations Not in operations Not in operations 75.32 74.6
ACO-7 Health Status/Functional Status Not in operations Not in operations Not in operations Not in operations 69.03 71.1
ACO-8 Risk Standardized, All Condition Readmissions Not in operations Not in operations Not in operations Not in operations 15.82 15.15
ACO-9 ASC Admissions: COPD or Asthma in Older Adults Not in operations Not in operations Not in operations Not in operations 2.28 1.08
ACO-10 ASC Admission: Heart Failure Not in operations Not in operations Not in operations Not in operations 1.37 1.19
ACO-11 Percent of PCPs who qualified for EHR Incentive Payment Not in operations Not in operations Not in operations Not in operations 52.36 76.71
ACO-12 Medication Reconciliation Not in operations Not in operations Not in operations Not in operations 100 82.61
ACO-13 Falls: Screening for Fall Risk Not in operations Not in operations Not in operations Not in operations 8.32 45.6
ACO-14 Influenza Immunization Not in operations Not in operations Not in operations Not in operations 21.31 57.51
ACO-15 Pneumococcal Vaccination Not in operations Not in operations Not in operations Not in operations 4.3 55.03
ACO-16 Adult Weight Screening and Follow-up Not in operations Not in operations Not in operations Not in operations 38.6 66.75
ACO-17 Tobacco Use Assessment and Cessation Intervention Not in operations Not in operations Not in operations Not in operations 88.17 86.79
ACO-18 Depression Screening Not in operations Not in operations Not in operations Not in operations 9.95 39.27
ACO-19 Colorectal Cancer Screening Not in operations Not in operations Not in operations Not in operations 7.04 56.14
ACO-20 Mammography Screening Not in operations Not in operations Not in operations Not in operations 10.43 61.41
ACO-21 Proportion of Adults who had blood pressure screened in past 2 years Not in operations Not in operations Not in operations Not in operations 31.53 60.24
ACO-22 Hemoglobin A1c Control (HbA1c) (<8 percent) Not in operations Not in operations Not in operations Not in operations 13.07 N/A
ACO-23 Low Density Lipoprotein (LDL) (< 100 mg/dL) Not in operations Not in operations Not in operations Not in operations N/A N/A
ACO-24 Blood Pressure (BP) < 140/90 Not in operations Not in operations Not in operations Not in operations 8.28 N/A
ACO-25 Tobacco Non-Use Not in operations Not in operations Not in operations Not in operations 6.97 N/A
ACO-26 Aspirin Use Not in operations Not in operations Not in operations Not in operations 5 N/A
ACO-27 Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent) Not in operations Not in operations Not in operations Not in operations 81.05 20.35
ACO-28 Percent of beneficiaries with hypertension whose BP < 140/90 Not in operations Not in operations Not in operations Not in operations 8.33 68.02
ACO-29 Percent of beneficiaries with IVD with complete lipid profile and LDL control < 100mg/dl Not in operations Not in operations Not in operations Not in operations N/A N/A
ACO-30 Percent of beneficiaries who use Aspirin or other antithrombotic Not in operations Not in operations Not in operations Not in operations 3.91 80.79
ACO-31 Beta-Blocker Therapy for LVSD Not in operations Not in operations Not in operations Not in operations 0 82.71
ACO-32 Drug Therapy for Lowering LDL-Cholesterol Not in operations Not in operations 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 Not in operations Not in operations 62.5 N/A

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


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