Care Solutions ACO | CenterWell Senior Primary Care

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Our longstanding collaboration with Medicare in value-based care

ACO MSSP model

The Medicare Shared Savings Program (MSSP) improves quality and reduces cost through a value-based system that rewards better health outcomes by focusing on preventive care, care coordination and overall better management of patients' health. CenterWell Care Solutions partners with providers to improve quality, grow attribution and succeed in the MSSP without downside risk to partner practices. We believe that by partnering with Medicare and healthcare providers, we can make a meaningful difference in the lives of our patients, making sure they receive the right care at the right time.

ACO LEAD model

Similar to MSSP, the ACO Long-Term Enhanced ACO Design (LEAD) program supports value-based care initiatives that aim to improve outcomes, drive attribution growth and maintain no downside risk for partner practices. As the successor to ACO REACH, LEAD is a global risk model through which CenterWell Care Solutions will continue its partnership with Medicare. Building on lessons learned from prior models, LEAD offers greater savings potential over a 10-year performance period. It also supports more predictable cash flow through capitation payments and helps streamline specialist partnerships through CMS-Administered Risk Arrangements (CARA).

A track record of performance

CenterWell Care Solutions has made significant strides in improving quality and reducing costs, with the following 2023 key achievements.

15.7%

Savings Rate

$9.4 million

Total Cost of Care Savings

98.4%

Quality Score

These achievements directly impact patient care and the ACO by:

• Lowering hospital admissions

• Avoiding unplanned admissions for chronic disease patients

• Timely follow-up care post-discharge

Through these efforts, CenterWell Care Solutions continues to excel in both cost reduction and quality improvement, benefiting both Medicare and the patients we serve.

CenterWell Care Solutions is committed to improving healthcare outcomes and enhancing the patient experience. In 2021, CenterWell Care Solutions began contracting with CMS to participate in initiatives aimed at improving care quality and lowering healthcare costs.

CenterWell Care Solutions partners with CMS to provide more coordinated, patient-centered care. These models focus on improving care quality, addressing health disparities and reducing healthcare costs. By participating in either model, CenterWell Care Solutions continues to prioritize delivering high-value care that benefits both patients and healthcare providers. Our goal has always been to foster a collaborative approach between patients and providers to better coordinate care and treatment options. We understand that effective communication and collaboration are key to improving health outcomes, and we are dedicated to helping patients navigate their healthcare needs.

CenterWell Care Solutions Inc. is a separate entity under Humana’s Primary Care Organization that is contracted directly with CMS and bears responsibility of financial risk under CMS risk arrangements. CenterWell Care Solutions reinvests shared savings into Humana’s Primary Care Organization to help drive patient engagement and improve care for Medicare beneficiaries. Moreover, CenterWell Care Solutions Inc. is wholly owned and does not maintain any joint venture partnerships.

It’s important to note that Medicare patients’ benefits remain unchanged. Beneficiaries can still see any doctor, hospital, or healthcare provider that accepts Medicare. However, by being aligned with an ACO, Medicare patients become eligible for additional benefits, including more proactive and enhanced care coordination services. This means that patients will receive better support in managing their health, ensuring they get the right care when they need it most.

Participating in an ACO also allows for better data sharing and insights into a patient’s medical history, which can help inform their care plan. This collaboration between healthcare providers aims to enhance personalized and timely patient care by leveraging a comprehensive understanding of their health, leading to better outcomes and a more streamlined healthcare experience.

Performance Year 2023 (Centers for Medicare and Medicaid Services. “PY2023 ACO REACH Financial Results.” CMS.gov, 8 Nov. 2024, aco-reach-py2022-fin-qual-results.xlsx):

Total Quality Score: 98.4%
Risk-Standardized All-Condition Readmissions (ACR) Score: 15.31 (a lower score indicates better performance)
Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) (UAMCC) score: 27.60 (a lower score indicates better performance)
Total Shared Savings: $9.4MM
Proportion of Shared Savings invested in infrastructure, redesigned care processes and other resources: 25% of the savings were reinvested to strengthen population health capabilities, including data and analytics tools.
Proportion of Shared Savings distributed to providers: the ACO primarily operates on a physician staff model, where 100% of the savings is allocated to the parent company.

Performance Year 2022 (Centers for Medicare and Medicaid Services. “PY2022 GPDC Financial Results.” CMS.gov, 23 Oct. 2023, gpdc-py2022-financial-results.xlsx):

Total Quality Score: 100%
Risk-Standardized All-Condition Readmissions (ACR) Score: 15.33 (a lower score indicates better performance)
Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) (UAMCC) score: 34.33 (a lower score indicates better performance)
Total Shared Savings: $7.3MM
·Proportion of Shared Savings invested in infrastructure, redesigned care processes and other resources: 25% of the savings were reinvested to strengthen population health capabilities, including data and analytics tools.
Proportion of Shared Savings distributed to providers: the ACO primarily operates on a physician staff model, where 100% of the savings is allocated to the parent company.

Performance Year 2021 (Centers for Medicare and Medicaid Services. “PY2021 GPDC Financial Results.” CMS.gov, 23 Nov. 2022, Appendix_GPDC PY2021 Financial Results.xlsx):

Total Quality Score: 100%
Risk-Standardized All-Condition Readmissions (ACR) Score: 15.74 (a lower score indicates better performance)
Risk-Standardized, All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (per 100 person-years) (UAMCC) score: 32.69 (a lower score indicates better performance)
Total Shared Savings: $3.8MM
Proportion of Shared Savings invested in infrastructure, redesigned care processes and other resources: 25% of the savings were reinvested to strengthen population health capabilities, including data and analytics tools.
Proportion of Shared Savings distributed to providers: the ACO primarily operates on a physician staff model, where 100% of the savings is allocated to the parent company.

At CenterWell Care Solutions, we are committed to transforming healthcare by improving patient outcomes, enhancing care coordination, and optimizing value-based care for providers. As a participating provider, you gain access to resources, support, and incentives designed to help you succeed in a value-based environment.

Why Join Our ACO?

Enhanced care coordination: Improve patient outcomes with streamlined, data-driven care models.

Performance-based incentives: Participate in shared savings opportunities and innovative reimbursement models.

Operational and clinical support: Leverage population health analytics, provider engagement tools and dedicated support teams.
Flexibility and alignment: Work collaboratively within a network that prioritizes patient-centered care while maintaining provider independence.

We also provide further opportunities for providers through our MSO, CenterWell IPA Solutions. CenterWell IPA Solutions offers providers the resources to build better, more efficient practices without sacrificing their independence. Our value-based care model focuses on patient care while building scalable, successful practices. As a payor agnostic organization, we work across many health plans and lines of business, creating better health for seniors and practices.

To learn more about CenterWell IPA Solutions, visit our website linked here.

CenterWell Care Solutions - Clinical and Administrative Leaders:

Renee Buckingham – President, Humana Primary Care Organization
Dr. Vivek Garg – Chief Medical Officer, Humana Primary Care Organization
Richard Lindsay-Jones – Vice President, Chief Financial Officer, Humana Primary Care Organization
Dr. Erika Pabo – Chief MSO Operations Officer, Humana Primary Care Organization
Terri Schorr – Associate VP, Medicare Compliance, Humana

Renee Buckingham – President, Humana Primary Care Organization
Dr. Lee Epstein – Market Chief Medical Officer, ACO Participant Provider, Conviva Care Centers
Dr. Anitha Mullangi – Market Chief Medical Officer, ACO Participant Provider, Conviva Care Centers
Dr. Sonali Kumar – ACO Participant Provider, CenterWell Senior Primary Care
Dr. Jessica Rosario – ACO Participant Provider, CenterWell Senior Primary Care
Dr. Soett Ramirez-Estrada – ACO Participant Provider, CenterWell Senior Primary Care
Dr. Jacquelin Castillo – ACO Participant Provider, Conviva Care Centers
Dr. Prasanth Rao – ACO Participant Provider, Conviva Care Centers
Caitlin Donovan – Senior Director, National Patient Advocate Foundation
Gust Nicholson – Medicare Beneficiary

To view our participant provider, use the link below:

Participant providers

Hospice and palliative preferred providers:

CenterWell Home Health® is a national home health agency providing extensive patient coverage across the country. With over 350 locations in 37 states, it makes sure easy access to quality home health services for patients nationwide (“Home Health Care Agencies,” Center for Medicare & Medicaid Services, Nov. 23 2025, last accessed April 6, 2026.):
- CenterWell Home Health is a national leader in quality outcomes, with over 53% of its branches earning a rating of 4.5 stars or higher for Quality of Patient Care. Additionally, 99% of branches have received a rating of 3 stars or higher, demonstrating a strong commitment to exceptional patient care.
- Customized clinical pathways and proactive care transitions model
- Advanced Clinical Programs utilize evidence-based interventions to empower and motivate patients through education, helping them manage their conditions and make lasting lifestyle changes. These programs include:
  - Safe Strides®: Identify and address the factors contributing to fall risk. Fall syndrome management, risk factor reduction and vestibular rehabilitation.
  - CenterWell Keeping Hearts at Home®: Helping to improve health condition management for cardiac and pulmonary conditions. Includes telehealth monitoring.
  - Daily Difference with Diabetes™: Providing diabetes self-management education and support (DSMES) helping people with diabetes (PWD) reach their glycemic goals.
  - PRIME Wound Care®: Helping to prevent or overcome wounds, improve skin integrity and overall health habits through prevention, intervention, management and education (PRIME).
- The Aftercare Program (15/30/45 days) provides post-discharge interventions to help patients avoid unnecessary hospitalizations.

Gentiva Health Services is a leading national hospice and palliative care provider dedicated to delivering compassionate, high-quality care to patients and families across the country. With over 590 locations in 38 states, Gentiva ensures broad access to expert hospice and palliative care, helping patients navigate their journey with comfort, dignity, and support.
- Committed to care, driven by compassion. Gentiva takes pride in delivering top-tier clinical excellence. 96% of patients who receive hospice services would recommend Gentiva (“Hospice Care – National CAHPS Hospice Survey Data,” Center for Medicare & Medicaid Services, May 21, 2025, last accessed April 6, 2026.).
- Round-the-clock care, every day of the year. Gentiva offers 24/7/265 nurse availability, ensuring that referrals are accepted, and patient care is provided every day, all year long. Additionally, they are dedicated to admitting eligible patients within 3 hours of receiving are referral, ensuring prompt and efficient care when it is needed most.
- Personalized care for patients and caregivers. Gentiva provides tailored support for each unique journey, offering compassionate care every step of the way. These programs include:
  - Care Transition Program: Ensures patients receive the right level of care at the right time, right at home
  - 13-month Bereavement Program: Supports loved ones through their loss
  - Specialized Clinical Algorithms: Drives disease-specific interventions
  - National We Honor Veterans Program: Serves the unique needs of those who have served our country

VITAS Healthcare is a leading national hospice and palliative care provider specializing in compassionate end-of-life care, service patients and familiars across 15 states. Their interdisciplinary teams support patients with advanced illness by offering in-home hospice services, palliative care and 24/7 clinical availability.
- Care coordination: Dedicated VITAS representatives deliver real-time patient updates and provider-specific reports to improve communication and outcomes.
- 24/7/265 access to care, giving healthcare professionals, patients and families peace of mind with around-the-clock availability for admissions or clinical support.
- Personalized care for patients and caregivers: VITAS provides tailored support for each unique journey, offering compassionate care every step of the way. These programs include:
  - Routine home care: Routine visits in the home by a multidisciplinary care team
  - Continuous care: Symptom management at the patient’s bedside for up to 24 hours per day
  - Inpatient care: Round-the-clock care in a hospice inpatient facility or a nursing facility
  - Respite care: 24-hour care in a hospital or hospice facility for up to 5 days

Labs and Diagnostic Preferred Providers:

Quest Diagnostics: As a preferred lab provider for CenterWell ACO, Quest delivers services with point-of-care support and practice management solutions to give clinicians the real-time diagnostic information needed to meet patient needs. Quest is a national lab and diagnostic vendor that offers extensive patient coverage with over 2,000 patient service centers available nationwide to facilitate easy access to testing for our ACO patients.
- State of the art laboratories around the country for innovative technologies and improved turnaround times, with rapid response labs in certain geographies to accommodate same-day testing needs
- MyQuest® patient portal for online lab appointment scheduling and direct access to results
- Low or no out-of-pocket testing costs for many patients due to in-network status for 90% of insured lives nationwide
- Advanced diagnostic capabilities to reduce high-cost, out-of-network testing

LabCorp: offers a comprehensive suite of services, including more than 6,500 diagnostic tests, along with robust tools to support patient care management.
- For over 50 years, LabCorp has worked closely with managed care partners and health plan sponsors to empower better patient care by enhancing member experience and access, reducing costs and improving life quality and expectancy. Our tools and solutions help you evaluate and target at-risk patients for early intervention to improve patient health and increase satisfaction.
- Located within a few miles of 95% of the U.S. population and committed to improving lives and enabling access for all.
- Supports quality metric and outcome improvements through targeted gaps in care programs and analytics
- Advanced diagnostic capabilities to reduce high-cost and drive efficiencies

To view our preferred provider, use the link below:

Preferred providers

Erik Nelson – Associate Director, Value-Based Care Programs

Email: enelson5@centerwell.com

CenterWell Care Solutions, Inc.

101 E. Main Street

Louisville, KY 40202

866-716-5930

Questions?

If you have questions about this program, please call us at 866-716-5930. Or, you may call Medicare at 1-800-MEDICARE (1-800-633-4227; TTY users may call 1-877-486-2048). You can learn more about ACO REACH here: ACO REACH | CMS Innovation Center.

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Centerwell services:

CenterWell Care Solutions

Our longstanding collaboration with Medicare in value-based care

ACO MSSP model

ACO LEAD model

A track record of performance

About CenterWell Care Solutions

How Medicare beneficiaries benefit from being in an ACO

Performance year results

Join the CenterWell Care Solutions ACO

CenterWell ACO Clinical and Administrative Leaders

CenterWell ACO Board of Governors

Participant providers

Preferred providers

CenterWell ACO primary contact

Our longstanding collaboration with Medicare in value-based care

ACO MSSP model

ACO LEAD model

A track record of performance

About CenterWell Care Solutions

How Medicare beneficiaries benefit from being in an ACO

Performance year results

Join the CenterWell Care Solutions ACO

CenterWell ACO Clinical and Administrative Leaders

CenterWell ACO Board of Governors

Participant providers

Preferred providers

CenterWell ACO primary contact