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Lore Health ACO: Help with everyday health

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Ethics and compliance
Lore Health ACO

Meet the Lore ACO team

Our team brings together decades of experience in healthcare delivery, clinical practice, and patient care to create a better healthcare system.

Mark Briesacher Mark Briesacher

Dr. Mark Briesacher

Executive Director

Rick Miller Rick Miller

Dr. Rick Miller

Medical Director

Teresa Hall Teresa Hall

Teresa Hall

Chief Compliance Officer

Organizational information

ACO Name and Location

Lore Health ACO, LLC
101 W. Broadway, 9th Floor
San Diego, CA 92101

ACO Primary Contact

Teresa Hall
compliance@lore.co

Organizational Information ACO Participants (ACO Participant in Joint Venture Y/N)

  • Health Associates of Tampa Bay PA (N)
  • First Choice Community Healthcare, Inc (N)
  • Inflammation Medical Group (N)
  • Irene Malek MD Professional Corp. (N)
  • Neighborhood Healthcare (N)
  • Soham Patel MD PA (N)
  • Springfield Medical Care Systems, Inc (N)
  • USC Care Medical Group, Inc (N)

ACO Governing Body

ACO Advocates, Beneficiary, and Executive (20% of Voting Total):

  • Joanna Honeycutt | Medicare Beneficiary | 10% | Beneficiary Representative
  • Paula Branson, NBC-HWC | Consumer Advocate | 5% | Community Stakeholder
  • Mark Briesacher, MD | ACO Executive | 5% | Lore Health ACO

ACO Participant Directors (80% of Voting Total)

  • Adam Ameele, Psy.D. | ACO Participant | 13.33% | Springfield Medical Care Systems
  • Jeffrey Hay, MD | ACO Participant | 13.33% | USC Care Medical Group
  • Katina Murray, MD | ACO Participant | 13.33% | USC Care Medical Group
  • Jim Schultz, MD | ACO Participant | 13.33% | Neighborhood Healthcare
  • Jennifer Pentecost, MD | ACO Participant | 13.33% | First Choice Community Healthcare
  • James LaBelle, MD | ACO Participant | 13.33% | Inflammation Medical

Key Clinical and Executive Leadership

  • ACO Executive: Mark Briesacher, MD
  • Senior Medical Director: Rick Miller, MD
  • Chief Compliance Officer, Quality Assurance/Improvement Officer: Teresa Hall

Types of ACO Participants that Formed the ACO

  • ACO professionals
  • ACO professionals in group practice arrangements
  • FQHCs

Shared Savings and Loss Information

Amount of Shared Savings/Losses

First Agreement Period

  • Performance Year 2023, $-579,456

Shared Savings Distribution

First Agreement Period

  • Performance Year 2023
    • Proportion invested in infrastructure: N/A
    • Proportion invested in redesigned care processes/resources: N/A
    • Proportion of distribution to ACO participants: N/A

Quality Performance Results

2023 Quality Performance Results. Quality performance results are based on the eCQMs/MIPS CQM Measure Set collection type.

Measure # Measure Name Collection Type Reported Performance Rate Current Year Mean Performance Rate (SSP ACOs)
Measure #001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) MIPS CQM 38.66 35.18
Measure #134 Preventive Care and Screening: Screening for Depression and Follow-up Plan MIPS CQM 35.51 43.70
Measure #236 Controlling High Blood Pressure MIPS CQM 66.60 69.63
Measure #479 Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups Administrative Claims 0.1662 0.1553
Measure #321 CAHPS for MIPS CAHPS for MIPS Survey 3.17 6.25
CAHPS-1 Getting Timely Care, Appointments, and Information CAHPS for MIPS Survey 76.12 83.68
CAHPS-2 How Well Providers Communicate CAHPS for MIPS Survey 93.64 93.69
CAHPS-3 Patient's Rating of Provider CAHPS for MIPS Survey 91.62 92.14
CAHPS-4 Access to Specialists CAHPS for MIPS Survey 74.13 75.97
CAHPS-5 Health Promotion and Education CAHPS for MIPS Survey 55.90 63.93
CAHPS-6 Shared Decision Making CAHPS for MIPS Survey 58.64 61.60
CAHPS-7 Health Status and Functional Status CAHPS for MIPS Survey 73.81 74.12
CAHPS-8 Care Coordination CAHPS for MIPS Survey 83.17 85.77
CAHPS-9 Courteous and Helpful Office Staff CAHPS for MIPS Survey 89.77 92.31
CAHPS-11 Stewardship of Patient Resources CAHPS for MIPS Survey 19.85 26.69

For previous years' Financial and Quality Performance Results, please visit: Data.CMS.gov

Payment Rule Waivers

Skilled Nursing Facility (SNF) 3-Day Rule Waiver:

  • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.
Compliance and Ethics

Our commitment to an ethical and compliant culture

Our commitment

Lore Health and Lore Health ACO ("We", "Our", or "Us") are committed to operating with integrity for all of our members, providers, and partners.

Compliance reporting system

To accomplish that, we have established an Ethics and Compliance submission process for reports related to all Fraud, Waste, and Abuse or non-compliance with federal, state, or local laws.

24/7 compliance support

Our Ethics & Compliance submission process operates 24 hours a day, seven days a week and is operated directly by our compliance team. The Ethics and Compliance process is designed to protect your confidentiality and your anonymity, if requested. You may submit the below form, email us at compliance@lore.co, or call us at 888-413-5673 to begin a report.

Retaliation prohibition

We prohibit retaliation against anyone who, in good faith, reports a possible violation or who participates in an investigation, even if sufficient evidence is not found to substantiate the concern. After investigation, we are required to report probable violations of law to an appropriate law enforcement agency.

Compliance question or concern submission form

All fields required