UNC Senior Alliance is a Next Generation Accountable Care Organization (ACO). A Next Generation ACO is a group of doctors, hospitals and other health care providers working together with Medicare to provide patients high-quality, coordinated service and care.
If your primary care physician is a member of UNC Senior Alliance, your current benefits do not change and you can still choose any doctor or hospital that accepts Medicare, at any time.
If you have general questions or would like more information about accountable care organizations, please visit: https://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/ or call 1-800-MEDICARE (1-800-633-4227 (TTY users should call 1-877-486-2048)).
Name & Mailing Address
UNC Senior Alliance
2000 Perimeter Park Dr., Suite 140
Morrisville, NC 27560
Key Clinical and Administrative Leaders
- Mark Gwynne, DO, President/Executive Medical Director, UNC Senior Alliance, UNC Health
- Robb Malone, PharmD, Chief Operating Officer, UNC Senior Alliance, UNC Health
- Robin Shuping, Chief Compliance Officer, UNC Health
Board of Managers:
- Kevin Biese, MD, MAT, UNC Faculty Physicians
- Ernie Bovio, MBA, UNC/REX Healthcare
- Mark Clarkson, MD, Raleigh Capitol ENT
- Charles Cook, MD, Raleigh Associated Medical Specialists
- Darren DeWalt, MD, MPH, UNC Faculty Physicians
- Erin Ennis, MD, UNC Physicians Network
- Matt Ewend, MD, UNC Health
- Lynne Fiscus, MD, MPH, UNC Physicians Network
- Janet Hadar, MSN, MBA, UNC Health
- Gloria Herrera, MD, Gloria Herrera, MD
- Lee Isley, PhD, FACHE, Nash UNC Health
- Charlie Lehmann, Medicare Beneficiary/Consumer Advocate
- Eugene Maynard, MD, Benson Area Medical Center
- Susan Moore, MD, MPH, UNC/REX Healthcare
- Howard Newell, MD, UNC Physicians Network
- Rig Patel, MD, UNC/REX Healthcare
- John Powell, MD, UNC Caldwell, Southfork Medical Park
- Michael Steiner, MD, UNC Faculty Physicians
- Robert Wehbie, MD, UNC/REX Healthcare
Performance Metrics & Quality
Payer Strategy & Finance
Network Development, Professional Standards & Compliance
We partner with the following Skilled Nursing Facilities (SNFs):
- Brian Center - Southpoint
- Brian Center Health and Retirement
- Carol Woods Retirement Community
- Carolina Point
- Capital Nursing & Rehabilitation
- Liberty Commons Nursing & Rehabilitation Center of Johnston
- Litchford Falls Healthcare
- Peak Resources - Alamance
- Peak Resources - Brookshire Nursing Center
- Pruitt Health-Raleigh
- Springbrook Nursing and Rehabilitation
- Zebulon Rehabilitation
- Rex Hospital, Inc.
- Rex Hospital, Inc. - Apex
There are no joint ventures.
Shared Savings and Losses: Agreement Period Beginning 2017
Financial Performance Results
(note that all figures below reflect shared savings/loss after sequestration):
- Performance Year 2019: $14,302,389 (80% distributed to Next Generation Participants and Preferred Providers; 20% invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for Beneficiaries)
- Performance Year 2018: $65,885
- Performance Year 2017: -$2,495,812
Quality Measures Results
Next Generation ACO Participation Waiver Disclosures
The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that otherwise limit innovation by ACOs participating in the Next Generation ACO Model (see HHS, Notice of Amended Waivers of Certain Fraud and Abuse Laws in Connection with the Next Generation ACO Model, published December 29, 2016). Pursuant to that notice, UNC Senior Alliance seeks protection under the Next Generation ACO Participation Waiver for the following arrangements set forth below:
UNCSA will provide financial support to the UNC School of Medicine Department of Family Medicine in order to support and sustain the REACH Program from January 1, 2017 through June 30, 2017. The Program provides enhanced home-based primary care and other necessary services to medically complex patients living in Assisted Living Facilities or at home, including a significant number of Medicare beneficiaries who are attributed to UNCSA. This arrangement supports UNCSA’s objectives related to improving care coordination and ensuring care is provided to Next Gen Beneficiaries in the most efficient, cost-effective and medically appropriate setting.
Effective February 27, 2017, UNCSA provides all ACO Participants and Preferred Providers with access to HealthLink PM, an after-hours call coverage and nurse-based triage service for assisting Next Generation Beneficiaries with their care needs. The phone service is an important tool in our efforts to improve the quality and lower the total cost of care provided to our Next Generation Beneficiaries.
Effective October 1, 2018, UNCSA will provide funding to Johnston County Emergency Medical Services to support its community paramedicine program for Medicare beneficiaries attributed to UNCSA’s Next Generation ACO. Johnston EMS’s community paramedicine program provides in-home visits to patients with a history of frequent acute care use and hospital readmissions, with a goal of reducing readmission rates and improving the patients’ overall health.