What that means
A direct care entity (DCE) is a group of doctors, hospitals and other health care providers who agree to work together to provide you with high-quality care in a way that lowers overall health care costs. For all our members who are Medicare patients, this will not impact your benefits. In fact, it will only add to the care you receive.
Why that’s good for you
Being part of a DCE means you will receive:
- Greater care within the extensive Optum network
- More opportunity for speciality care
- Coordination with services if you go out-of-network
- Cost savings with value-based care
Value Based Care:
A comprehensive approach to care
Value-based care is a holistic and long-term approach to your wellbeing. This means rather than just treating the illness, we look at your care in a more preventive way. That means more attention to chronic conditions and overall wellness, which leads to healthier outcomes for you, and fewer bills for emergency or acute intervention.
DCE Public Reporting Information
To learn more about your medical benefits or Medicare coverage, contact the number on the back of your insurance ID card or visit medicare.gov.
To learn more about CareMount DCE:
90 South Bedford Road
Mount Kisco, NY 10549
Norma Jean Potter, Administrative Assistant, Population Health, Phone: (914) 302-8543, [email protected]
DCE Hours of Operation: 8 a.m. – 5 p.m. EST
Participants and Preferred Providers
Our DCE is made up of primary care providers and specialists. These providers have agreed to work together with us to coordinate care.
Includes home health agencies and skilled nursing facilities/centers
Note: Medicare fee for service beneficiaries have the freedom to seek the services and providers of their choice and are not limited to the providers listed above.
There are no joint ventures between CareMount DCE and any of its Participating Providers or Preferred Providers and Facilities.
Clinical and Administrative Leaders
Our DCE has a Management Committee to provide oversight and strategic direction.
DCE Governance Committee
|Scott D. Hayworth, MD||Committee Chairperson; Participating Provider Representative; Voting Member CareMount Medical & CareMount Health Solutions|
|Kevin J. Conroy, MS||Committee Member; Voting Member CareMount Health Solutions|
|Peter Bittner||Committee Member; Medicare Beneficiary & Consumer Advocate; Voting Member Bilotta Kitchens|
|Peter J. Kelly, MBA||Committee Member; Voting Member CareMount Health Solutions|
|Richard P. Morel, MD, MMMA, FACP||Committee Member; Participating Provider Representative; Voting Member CareMount Medical & CareMount Health Solutions|
|Irene Borgen||Committee Member; Voting Member CareMount Medical|
|Lisa Bardack, MD, FACP||Committee Member; Participating Provider Representative; Voting Member CareMount Medical & CareMount Health Solutions|
CareMount DCE Officers:
1) Executive Director of CareMount Value Partners IPA, LLC: Peter J. Kelly, MBA, Chief Value Officer, CareMount Medical
2) Medical Director: Richard P. Morel, MD, MMM, FACP, Chief Physician Executive, CareMount Medical
3) Compliance Official: Kristina Stolzenberg, Compliance and Privacy Director, CareMount Health Solutions
CareMount DCE Operations Sub-Committee Members:
1) Chris Sclafani, PE, MBA, Committee Chair
2) Peter J. Kelly, MBA, Chief Value Officer & Executive Director of CareMount ACO, LLC, Committee Vice-Chair
3) Richard P. Morel, MD, MMM, FACP, Medical Director
4) Alicia K. Beardsley, PA-C, CareMount ACO LLC Compliance Officer, Chief Clinical Officer , CareMount Medical
5) Lewis Kohl, DO, CMIO, Chief Safety Officer CareMount Medical
6) Nicholas Korchinski, CIO CareMount Health Solutions
7) Susan Monaco, Chief Revenue Officer, CareMount Health Solutions
8) Matthew Kamen, Chief Strategy & Analytics Officer, Population Health CareMount Health Solutions
9) Jessica Klarl, MBA, VP, Quality and Physician Enablement, CareMount Health Solutions
10) Kate Casaday, MPH, Director of Market Operations, CareMount Health Solutions
11) Alexis Adusei, MPH, Manager of Market Operations, CareMount Health Solutions
12) Lisa Bardack, MD Chief Medical Officer CareMount Medical
13) Alyssa Pepper, MPH Senior Vice President of Payor Relations, CareMount Health Solutions
Quality Performance Results
Quality Performance Scoring Data. On a quarterly basis, CMS will provide data regarding the DCE’s performance for a prior quarter of the Agreement Performance Period on quality measures.
Please email the Direct Contracting Model help desk with any questions or comments at [email protected].