Healthcare industry veteran Joe Caruncho is diving back into the field he knows best, announcing the launch of Genuine Health Group, an analytics-based healthcare company focused on helping doctors successfully transition to value-based payment models. Caruncho gained recognition as co-founder and CEO of Preferred Care Partners, a Medicare Advantage plan he helped grow to 55,000 members and more than $750 million in annual revenues. United Healthcare acquired Preferred Care Partners in 2012.
His new venture, Genuine Health, hits the ground running, announcing today it agreed to purchase PremierMD Accountable Care Organization (“ACO”) from PremierMD’s parent company. The ACO operates under a contract with the Centers for Medicare and Medicaid Services (“CMS”) as part of CMS’ Medicare Shared Savings Program.
Miami Accountable Care Organizations, or ACOs, like PremierMD are a healthcare delivery model that rewards providers for demonstrating high-quality healthcare results – or outcomes – instead of paying them for the volume of services they deliver. It aims to incentivize “fee for performance” vs. “fee for service.”
Under Caruncho’s lead, Genuine Health Group will greatly expand beyond PremierMD’s current 70 physicians, most of whom practice in Broward County. His plans call for recruiting as many as 1,000 primary care doctors from Miami-Dade, Broward, and nationally. In addition, the ACO will transition to an “Advanced Payment Model,” whereby the company assumes financial risk for the cost of caring for Medicare patients who are part of the Miami ACO. As an Advanced Payment Model, member physicians will qualify for a five percent bonus from Medicare and be exempt from cumbersome new reporting requirements called “MIPS.”
“Genuine Health Group is launching at a vital time for both physicians and patients,” says Caruncho. “Physicians are facing the most fundamental change in the healthcare industry in over 30 years. The healthcare industry is moving aggressively from the traditional fee-for-service system toward a fee-for-value system, rewarding physicians for keeping their patients healthy. The acquisition of PremierMD ACO puts us in a leadership position to provide better care, at a lower cost, and help doctors earn real incentives for keeping patients healthy.”
PremierMD ACO has operated since 2014 under the leadership of its President and founder, Dr. Victor Toledano. In its short history, the physician ACO has demonstrated significant cost savings, compared to benchmarks, for delivering care to the Medicare beneficiaries it serves.
“Now, with access to Genuine Health Group’s experience, advanced analytics and technology, our participating providers will have better information about their patients’ medical status and how to best meet their individual healthcare needs,” said Dr. Toledano, who will continue to lead PremierMD ACO.
With the launch of his new enterprise, Caruncho and his leadership team bring a wealth of industry knowledge garnered over three decades. In addition to Caruncho, the Genuine Health Group team includes co-founder Dr. Orlando Lopez-Fernandez, Jr., who was the co-founder of Preferred Care Partners and served as its Chief Medical Officer. Dr. Lopez-Fernandez will lead the company’s clinical initiatives.
“The healthcare industry is finally adopting a reimbursement model that rewards doctors for providing quality over quantity when it comes to delivering healthcare,” said Dr. Lopez-Fernandez, Jr. “ACOs like PremierMD provide an ideal platform to help our physicians transition to a true, value-based delivery system.”
For more information on Genuine Health Group and value-based care, or to schedule an interview with Joe Caruncho, please contact Meieli Sawyer at 305-668-0070 or firstname.lastname@example.org.