Direct Contracting
Auxilium Health Network
| DCE Participant | Type of Provider |
| ADIOFEL MARK MENDOZA | DC Participant Provider |
| Afshar Neda | DC Participant Provider |
| ALFRED CISNEROS | DC Participant Provider |
| AMH Comprehensive Medical Centers | DC Participant Provider |
| ANDREW MUI | DC Participant Provider |
| Baldwin Park Medical Group Inc. | DC Participant Provider |
| BENJAMIN BEHROOZAN | DC Participant Provider |
| BEVERLY CHIONG | DC Participant Provider |
| BRIAN YANG | DC Participant Provider |
| CARE PLUS MEDICAL GROUP INC | DC Participant Provider |
| CHRISTINA LEE | DC Participant Provider |
| CHRISTOPHER LINEBACK | DC Participant Provider |
| CHRISTOPHER TOUPIN | DC Participant Provider |
| COURTNEY COOPER | DC Participant Provider |
| DEBRALYNNE ZICKAFOOSE | DC Participant Provider |
| DENNIS KIM | DC Participant Provider |
| DEWEY PILLAI | DC Participant Provider |
| EDGARDO FALCON | DC Participant Provider |
| EDWIN MANGUNE | DC Participant Provider |
| GENARO MARTINEZ | DC Participant Provider |
| George Adepeju | DC Participant Provider |
| GEORGE JAYATILAKA | DC Participant Provider |
| GERARDO CANCHOLA | DC Participant Provider |
| GREGORY SMITH | DC Participant Provider |
| HEATHER PLESKOW-WEISMAN | DC Participant Provider |
| HELEN TRAN | DC Participant Provider |
| JACOB FLORES | DC Participant Provider |
| JASON GROOMER | DC Participant Provider |
| JEFF HUANG | DC Participant Provider |
| JEFFREY EDMUNDS | DC Participant Provider |
| JM GEISS DO APC | DC Participant Provider |
| JONATHAN DINH | DC Participant Provider |
| JOSE DE LA LLANA | DC Participant Provider |
| JOSEPH DEMATTIA | DC Participant Provider |
| JUAN SAM | DC Participant Provider |
| KALIASH DHAMIJA | DC Participant Provider |
| KAREN KIM | DC Participant Provider |
| KAVEN HOSSEINZADEH | DC Participant Provider |
| KENNETH KIM | DC Participant Provider |
| KWAN TAN | DC Participant Provider |
| LEEANN GREEN | DC Participant Provider |
| MALVIN YAN | DC Participant Provider |
| MARJAN SABA | DC Participant Provider |
| MERCEDES DE LAS ALAS | DC Participant Provider |
| MICHAEL CHARVIS | DC Participant Provider |
| MOHAMMAD SADRI | DC Participant Provider |
| NIKITA SMITH | DC Participant Provider |
| NOBLEQUEST HEALTH FOUNDATION INC | DC Participant Provider |
| PAUL SUCGANG | DC Participant Provider |
| PREVENTIVE CARE NETWORK MEDICAL SERVICES, INC. | DC Participant Provider |
| PROMPT HEALTHCARE INC A MEDICAL CORPORATION | DC Participant Provider |
| RAKESH SHISHODIA | DC Participant Provider |
| RAVINDRA GAUTAM | DC Participant Provider |
| RAVINDRA GAUTAM, M.D., INC. | DC Participant Provider |
| REUVEN SISON | DC Participant Provider |
| RUBEN RUIZ | DC Participant Provider |
| SAMARITANA MEDICAL CLINIC,INC. | DC Participant Provider |
| SOFIA GONZALEZ-POST | DC Participant Provider |
| STEVEN ROSENBLATT | DC Participant Provider |
| SUHAIL JAFREY | DC Participant Provider |
| SUSAN SHARP | DC Participant Provider |
| SUZANNE CHANG | DC Participant Provider |
| TRINH KOSOBUCKI | DC Participant Provider |
| VICTOR NGUYEN | DC Participant Provider |
| VINH VU | DC Participant Provider |
| WILLIAM CHU | DC Participant Provider |
| WINSTON WONG | DC Participant Provider |
| YU-NAN HSU | DC Participant Provider |
| ADEL ZAKI | Preferred Participant |
| ARMIN VISHTEH | Preferred Participant |
| ARTIN GEVORGIAN | Preferred Participant |
| HSIU HSIEN LING | Preferred Participant |
| KOUROSH HAROUNIAN | Preferred Participant |
| LUNG CHANG | Preferred Participant |
| MOHAMED KATTIH | Preferred Participant |
| RAYMOND TATEVOSSIAN | Preferred Participant |
| RAYMUNDO BAUTISTA | Preferred Participant |
| REGINALD AJAKWE | Preferred Participant |
| ROSTAM KHOSHSAR | Preferred Participant |
| STANLEY SCHINKE | Preferred Participant |
| TRANG DUONG | Preferred Participant |
Leadership
| Name | Title/Position |
| Chris Tsang | CEO |
| Karen Kim, M.D. | Medical Director |
| Michael Cambron, PhD | EVP |
Governing Body
| Name | Title/Position | Membership Type |
| Karen Kim, M.D. | Voting Member | DCE Participant Provider |
| William Chu | Voting Member | DCE Participant Provider |
| Ronald Trabanino | Community Liason | N/A |
| Makabis Yousefpour, DPM | Voting Member | DCE Preferred Provider |
| Chris Tsang | Voting Member | N/A |
| Michael Cambron, PhD | Voting Member | N/A |
EMPLOYER: AUXILIUM HEALTH NETWORK
Performance Review
We will be updated with shared savings, losses and quality as it becomes available in 2022
Contact Us
Address: 159 E Huntington Dr Suite #9 Arcadia CA, 91006
Primary Contact:
Karen Kim MD
Medical Director
Phone Numbers
323 694 6732
info@auxiliumhealth.us
Frequently Asked Questions (FAQ)s
DCE is a legal entity which participates in Direct Contracting pursuant to a Participation Agreement with CMS. Various types of organizations may apply to become a DCE including Accountable Care Organizations (ACOs). Under Direct Contracting, there will be three types of DCEs with different characteristics and operational parameters.
Q: What is the Direct Contracting Model?
The Direct Contracting Model creates a new opportunity for the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) to test an array of financial risk-sharing arrangements expected to reduce Medicare expenditures while preserving or enhancing the quality of care furnished to beneficiaries. The Direct Contracting Model leverages lessons learned from other Medicare Accountable Care Organization (ACO) initiatives, such as the Medicare Shared Savings Program and the Next Generation ACO (NGACO) Model, as well as innovative approaches from Medicare Advantage (MA) and private sector risk-sharing arrangements. This model is part of a strategy by the CMS Innovation Center to use the redesign of primary care as a platform to drive broader health care delivery system reform. The model creates a variety of pathways for participants to take on financial risk supported by enhanced flexibilities. Because the model reduces burden, supports a focus on complex, chronically and seriously ill patients, and aims to encourage organizations to participate that have not typically participated in Medicare fee-for-service (FFS) Innovation Center models, we anticipate that this model will appeal to a broad range of physician organizations and other types of health organizations.
What are the model options under Direct Contracting?
The CMS Innovation Center will test up to three voluntary risk-sharing options: 1) Professional, a lower-risk option (50 percent Shared Savings/Shared Losses) and Primary Care Capitation (PCC) equal to seven percent of the total cost of care benchmark for enhanced primary care services; and 2) Global, a full risk option (100 percent Shared Savings/Shared Losses) and either PCC or Total Care Capitation (TCC). CMS has also sought comment on a potential third option, the Geographic Option, which is another full risk option (100 percent Shared Savings/Shared Losses) that will offer an opportunity for participants to assume total cost of care risk for Medicare Parts A and B services for Medicare FFS beneficiaries in a defined target region.
Q: What are the benefits of participating in Direct Contracting?
Direct Contracting is intended to test whether the risk-based payment strategies available under the model align financial incentives and offer model participants (Direct Contracting Entities or DCEs) flexibility in engaging health care providers and patients in care delivery that results in preserving or enhancing quality of care while at the same time reducing the total cost of care. Specifically, Direct Contracting offers:
- Multiple risk-sharing arrangements
- Flexible beneficiary alignment options, including enhancements to voluntary alignment relative to existing Medicare initiatives
- Capitation payment options that vary by risk-sharing arrangement
- Benefit enhancements and payment rule waivers to improve care coordination and service delivery
- A focus on complex chronic and seriously ill beneficiaries, and
- Options for organizations that have not participated in Medicare FFS previously
Q: How many years is Direct Contracting?
The model will be implemented over six performance years (PY1-6), with an optional initial Implementation Period (IP). The IP will occur from October 2020 through March 2021, PY1 will occur from April 2021 through December 2021, and PY2, PY3, PY4, PY5 and PY6 will occur in calendar years 2022, 2023, 2024, 2025, and 2026 respectively.
Q: What is the difference between DC Participant Providers and Preferred Providers?
DC Participant Providers are the core providers and suppliers in the Professional and Global Options. Beneficiaries are aligned to the DCE through the DC Participant Providers and these providers and suppliers are responsible for, among other things, reporting quality through the DCE and committing to beneficiary care improvement. DC Participant Providers, unlike Preferred Providers, are subject to the Capitation Payment Mechanism selected by the DCE, which involves Medicare Fee-For-Service claims reductions and the requirement that the DCE and the DC Participant Provider enter into a negotiated payment arrangement.
Preferred Providers contribute to DCE goals by extending and facilitating valuable care relationships beyond the DCE. For example, Preferred Providers may participate in benefit enhancements approved and available in PY1 and alternative payment arrangements with the DCE. Services furnished by Preferred Providers will not be considered in beneficiary alignment and Preferred Providers are not responsible for reporting quality through the DCE.
In addition to DC Participant Providers and Preferred Providers, beneficiaries aligned to a DCE may also choose to receive services from Medicare FFS providers and suppliers that are not associated with the DCE.
Q: How does CMS align beneficiaries to DCEs?
For the purpose of assigning accountability for risk sharing and the total cost of care, beneficiaries may be aligned to a DCE in two ways; however, the beneficiary alignment options available to a DCE will depend upon the DCE type. The two beneficiary alignment options are as follows:
- Claims-based alignment where beneficiaries are aligned based on the plurality of primary care services furnished by DC Participant Providers, as evidenced in claims utilization data.
- Voluntary alignment where beneficiaries communicate their desire to be aligned with a DC Participant Provider.