CMS Reporting

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ACO Name and Location

CVS ACO, LLC
233 Spring Street, 12th Floor
New York, NY 10013

Primary Contact Name	Khue Nguyen
Primary Contact Phone Number	925-464-0701
Primary Contact Email Address	knguyen@cvshealth.com

ACO Participants	ACO Participant in Joint Venture
MINUTECLINIC DIAGNOSTIC OF OHIO LLC	N
OHIO STATE UNIVERSITY	N
OHIO STATE UNIVERSITY - CAP	N
OHIO STATE UNIVERSITY HOSPITALS	N
OHIO STATE UNIVERSITY ORTHOPEDIC	N
OSU EMERGENCY MEDICINE LLC	N
OSU EYE PHYSICIANS AND SURGEONS, LLC	N
OSU FAMILY PRACTICE SERVICES	N
OSU GENERAL INTERNAL MEDICINE LLC	N
OSU GYN & OB CONSULTANTS, LLC	N
OSU HEALTH SYSTEM ANESTHESIA	N
OSU HEALTH SYSTEM NEUROSURGERY	N
OSU INTERNAL MEDICINE LLC	N
OSU NEUROSCIENCE CENTER, LLC	N
OSU OBSERVATION MEDICINE, LLC	N
OSU OTOLARYNGOLOGY HEAD AND NECK SURGERY LLC	N
OSU PATHOLOGY SERVICES, LLC	N
OSU PHYSICAL MEDICINE AND REHABILITATION, LLC	N
OSU PLASTIC SURGERY, LLC	N
OSU PSYCHIATRY, LLC	N
OSU RADIATION ONCOLOGY LLC	N
OSU RADIOLOGY LLC	N
OSU SPORTS MEDICINE CENTER	N
OSU SURGERY, LLC	N
OSU UROLOGY, LLC	N
YUMA REGIONAL MEDICAL CENTER	N

Member First Name	Member Last Name	Member Title/Position	Member’s Voting Power (Expressed as a percentage)	Membership Type	ACO Participant Legal Business Name, if applicable
Mohamed	Diab	CEO	15%	Other	N/A
Khue	Nguyen	Treasurer	4%	Other	N/A
Jonathan	Rubens	Secretary	4%	Other	N/A
David	Fairchild	CMO	15%	ACO Participant Representative	MinuteClinic Diagnostic of Ohio LLC
Rachit	Thariani	Chief Administrative Officer	15%	ACO Participant Representative	Ohio State University
Jonathan	Parsons	Executive Vice Chair of Clinical Operations	15%	ACO Participant Representative	Ohio State University
Aaron	Clark	Medical Director	15%	ACO Participant Representative	Ohio State University
Brent	Mulgrew	Medicare Beneficiary Representative	2%	Medicare Beneficiary Representative	N/A
Naveenth	Kumar	Executive	15%	ACO Participant Representative	Yuma Regional Medical Center

Due to rounding, ‘Member’s Voting Power’ may not equal 100 percent.

Mohamed Diab, MD	ACO Executive
Aaron Clark, MD	Medical Director
Emma Oakley	Compliance Officer
Rayna Caplan	Quality Assurance/Improvement Officer

Committee Name	Committee Leader Name and Position
TBD

Amount of Shared Savings/Losses

Shared Savings Distribution

Fourth Agreement Period	Performance Year N/A Proportion invested in infrastructure: N/A% Proportion invested in redesigned care processes/resources: N/A% Proportion of distribution to ACO participants: N/A%
Third Agreement Period	Performance Year N/A Proportion invested in infrastructure: N/A% Proportion invested in redesigned care processes/resources: N/A% Proportion of distribution to ACO participants: N/A%
Second Agreement Period	Performance Year N/A Proportion invested in infrastructure: N/A% Proportion invested in redesigned care processes/resources: N/A% Proportion of distribution to ACO participants: N/A%
First Agreement Period	Performance Year N/A Proportion invested in infrastructure: N/A% Proportion invested in redesigned care processes/resources: N/A% Proportion of distribution to ACO participants: N/A%

Our ACO did not participate in the Shared Savings Program in Performance Year 2023; therefore, this section is not applicable at this time.

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

Skilled Nursing Facility (SNF) 3-Day Rule Waiver:
- Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR § 425.612.

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