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Humana Care Solutions

Accountable Care Organization (ACO)

ACO overview

Humana Direct Contracting Entity, Inc., d.b.a. Humana Care Solutions is a Accountable Care Organization (“ACO”) that has partnered with primary care centers across the United States. Through this partnership, Humana Care Solutions and Participant Primary Care & Preferred Providers work together to provide improved care management and improved care coordination. As partners, we share in healthcare delivery expertise and experience, providing high-value, high-quality care.

ACO Name and location

Humana Direct Contracting Entity, Inc., d.b.a. Humana Care Solutions
500 W. Main St. Louisville, KY 40202

For inquiries:
P.O. Box 14168
Lexington, KY 40512-4168

ACO Primary Contact

Identification of all ACO Participating and Preferred Providers

ACO Key Clinical and Administrative Leaders

  • Executive Director: Gina Mooi, Humana, Inc.
  • Executive Clinician: Dr. Todd Prewitt, Humana, Inc.
  • Participating Provider Executive Clinician: Dr. Joan Hunter, Vancouver Clinic
  • Data and Analytics Leader: Natalie Dillon, Humana, Inc.
  • Physician Engagement Leader: Sara Nassif, Humana, Inc.
  • Physician Engagement Leader: William (Will) Quamson, Humana, Inc.
  • Strategy Leader: Kerri Gilligan, Humana, Inc.
  • Finance Leader: Ben Rasp, Humana, Inc.
  • Operations Leader: Sarah Rosenbaum, Humana Inc.
  • Compliance Leader: Teresa (Terri) Schorr, Humana, Inc.
  • Legal Counsel: Jane Susott, Humana, Inc.

ACO Governing Body

  • Strategic Executive: Oraida Roman, Humana, Inc.
  • Clinical Executive: Dr. Brian Powers, Humana, Inc.
  • Participant Provider: Dr. Ketan Hira, Summit Medical Group
  • Participant Provider: Dr. Aaron Jones, Summit Medical Group
  • Participant Provider: Dr. David Kricsfeld, Encompass Medical Group
  • Participant Provider: Dr. Bhavana Vora, Summit Medical Group
  • Participant Provider: Dr. Craig Riley, The Vancouver Clinic
  • Participant Provider: Dr. David Kricsfeld, Encompass Medical Group
  • Participant Provider: Dr. Jeremy Chrisman, The Vancouver Clinic
  • Participant Provider: Dr. Jonathan Laymance, Summit Medical Group
  • Participant Provider: Onyx Reed, Prime West
  • Participant Provider: Sue Freeman, Pine Park Health
  • Participant Provider: Kari Cedillo, Pine Park Health
  • Medicare Beneficiary: Richard (Dick) Shamrell, Retired USAF
  • Consumer Advocate: William (Bill) Edelstein, Retired

Identification of joint ventures between or among the ACO and any of its DC Participant Providers and Preferred Providers

  • None

ACO Shared Savings and Shared Losses

PY2021

  • Total Shared Savings Losses: $5.4M
  • Proportion of Shared Savings invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare cost for Beneficiaries: 76%
  • Proportion of Shared Savings distributed to Participant or Preferred Providers: 24%

PY2022

  • Total Shared Savings Losses: $25.6M
  • Proportion of Shared Savings invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare cost for Beneficiaries: 29%
  • Proportion of Shared Savings distributed to Participant or Preferred Providers: 71%

ACO Quality Measure Performance

PY2021

  • 100%

PY2022

  • 100%

For more information, call 888-899-8660.

Frequently asked questions, PDF