Civic Intelligence

Boston Accountable Care Organization Inc.

990 • Fiscal year 2018 • EIN 47-3468314

Oct 01, 2017 to Sep 30, 2018 • Filed on Aug 13, 2019

One Boston Medical Center PlaceBoston, MA 02118

(617) 638-7901

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

87th percentile

0.80x

Higher debt load relative to assets than 87% of similar nonprofits.

2018 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2018

Liabilities / Revenue

92nd percentile

3.44x

Higher debt load relative to revenue than 92% of similar nonprofits.

2018 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2018

Net Margin

3rd percentile

-108%

Higher net margin than 3% of similar nonprofits.

2018 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2018

Top Officer Pay

20th percentile

$0

Higher top officer pay than 20% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2018 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2018

Asset Growth

5th percentile

-19%

Faster asset growth than 5% of similar nonprofits.

2018 filings • 501(c)3 • $5M-$10M nonprofits • Annualized from 2017 to 2018

Revenue Growth

7th percentile

-39%

Faster revenue growth than 7% of similar nonprofits.

2018 filings • 501(c)3 • $5M-$10M nonprofits • Annualized from 2017 to 2018

Assets

Down

$8,812,733

Down $2,072,342 (-19%) from 2017

Net Assets

Up

$1,719,673

Up $2,589,734 (+298%) from 2017

Liabilities

Down

$7,093,060

Down $4,662,076 (-40%) from 2017

Revenue

Down

$2,064,751

Down $1,332,808 (-39%) from 2017

Expenses

Down

$4,304,841

Down $1,598,177 (-27%) from 2017

Net Income

Up

-$2,240,090

Up $265,369 (+11%) from 2017

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$30M$20M$10M$0-$10MAssets 2015: $810,808Liabilities 2015: $1,488,661Net Assets 2015: -$677,8532015Assets 2016: $5,874,921Liabilities 2016: $5,409,089Net Assets 2016: $465,8322016Assets 2017: $10,885,075Liabilities 2017: $11,755,136Net Assets 2017: -$870,0612017Assets 2018: $8,812,733Liabilities 2018: $7,093,060Net Assets 2018: $1,719,6732018Assets 2019: $29,117,050Liabilities 2019: $22,674,365Net Assets 2019: $6,442,6852019Assets 2020: $28,865,430Liabilities 2020: $23,657,790Net Assets 2020: $5,207,6402020Assets 2021: $22,135,062Liabilities 2021: $17,591,717Net Assets 2021: $4,543,3452021Assets 2022: $29,651,949Liabilities 2022: $24,948,587Net Assets 2022: $4,703,3622022Assets 2023: $18,260,640Liabilities 2023: $16,061,782Net Assets 2023: $2,198,8582023Assets 2024: $22,870,298Liabilities 2024: $22,190,840Net Assets 2024: $679,4582024

Highlighted filing

2018

Assets$8,812,733
Liabilities$7,093,060
Net Assets$1,719,673

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$30M$20M$10M$0-$10MRevenue 2015: $359,505Expenses 2015: $336,545Net Income 2015: $22,9602015Revenue 2016: $1,736,009Expenses 2016: $2,539,800Net Income 2016: -$803,7912016Revenue 2017: $3,397,559Expenses 2017: $5,903,018Net Income 2017: -$2,505,4592017Revenue 2018: $2,064,751Expenses 2018: $4,304,841Net Income 2018: -$2,240,0902018Revenue 2019: $15,381,190Expenses 2019: $20,316,312Net Income 2019: -$4,935,1222019Revenue 2020: $7,646,247Expenses 2020: $8,881,292Net Income 2020: -$1,235,0452020Revenue 2021: $3,965,825Expenses 2021: $4,630,120Net Income 2021: -$664,2952021Revenue 2022: $2,484,776Expenses 2022: $2,324,759Net Income 2022: $160,0172022Revenue 2023: $3,631,833Expenses 2023: $6,136,337Net Income 2023: -$2,504,5042023Revenue 2024: $1,873,416Expenses 2024: $3,392,816Net Income 2024: -$1,519,4002024

Highlighted filing

2018

Revenue$2,064,751
Expenses$4,304,841
Net Income-$2,240,090
Jump To
Filing Snapshot
Filing Period
Oct 1, 2017 to Sep 30, 2018
Signed
Aug 13, 2019
Return Version
2017v2.3
Gross Receipts
$2,064,751
Mission and Program Overview

Mission

See Schedule O

Balance Sheet Detail
LineBeginningEndChange
Assets
Accounts Receivable$6,524,838$4,513,251▼ $2,011,587
Cash and Non-Interest-Bearing Accounts$4,360,237$4,299,482▼ $60,755
Savings and Temporary Cash Investments$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Land, Buildings, and Equipment, Net$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Prepaid Expenses and Deferred Charges$0$0→ $0
Total Assets$10,885,075$8,812,733▼ $2,072,342
Other Assets Total$0$0→ $0
Liabilities
Other Liabilities$9,684,394$4,169,623▼ $5,514,771
Accounts Payable and Accrued Expenses$2,070,742$2,923,437▲ $852,695
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$11,755,136$7,093,060▼ $4,662,076
Net Assets / Fund Balance
Unrestricted Net Assets$-870,061$1,719,673▲ $2,589,734
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Total Net Assets Fund Balance$-870,061$1,719,673▲ $2,589,734
Total Liabilities and Net Assets / Fund Balance$10,885,075$8,812,733▼ $2,072,342
Compensation and Service Providers

Board Members and Trustees

NameTitle
Sandra CotterellPresident/Director
Alastair Bell MDDirector
Michelle NadowDirector
Ravin Davidoff MDDirector
Thea James MDDirector
William J Halpin JrDirector
Alice Jacobs MDDirector (As of 10/17/2017)
Cheryl BartlettDirector (As of 10/17/2017)
David Henderson MDDirector (As of 10/17/2017)
Lauren Nentwich MDDirector (As of 10/17/2017)
Nancy PaullDirector (As of 10/17/2017)
Barry BockDirector (As of 10/23/2017)
Amy PfefferDirector (As of 10/30/2017)
Spiros HatirasDirector (As of 10/30/2017)
Charles OrlandoDirector (As of 2/6/2018)
Cynthia SierraDirector (As of 2/7/2018)
Charles Williams MDDirector (e 10/17/17)
Jason Worcester MDDirector (e 10/17/17)
Jonathan Olshaker MDDirector (e 10/17/17)
Paul Hendessi MDDirector (e 10/17/17)
Stanley Hochberg MDDirector (e 12/21/17)
Azzie YoungDirector (E 12/6/17)
Francis DoyleDirector (e 12/6/17)
Christopher BrandonDirector (e 8/18)
William Creevy MDTreasurer/Director
David BeckClerk

Highest Paid Contractors

ContractorServicesLocationCompensation
Athenahealth INCHealth Data Analytic311 ARSENAL ST, Watertown, MA 02472$130,000
Victoria B AbramsManagement17 TANGLEWOOD DRIVE, Concord, MA 01742$107,978
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$2,064,751
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$-2,240,090
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$2,210,795
Other Expenses$2,094,046
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$1,753,283--$1,753,283
Other Expenses$1,388,613--$1,388,613
Fees for Services Management-$624,195-$624,195
Other Employee Benefits$457,512--$457,512
Information Technology$120,000--$120,000
Fees for Services Accounting-$11,000-$11,000
Office Expenses$7,125--$7,125
Travel$3,382--$3,382
Total Functional Expenses$3,669,646$635,195$0$4,304,841
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Reserve for Contract Losses$2,608,943
Due to Bmchs$820,407
Managed Care Risk Contracts$606,333
Due to Bmc$119,484
Due to Bmc Mso$14,456
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 2

CERTAIN OFFICERS AND DIRECTORS OF BACO ALSO SERVE AS OFFICERS AND DIRECTORS OF BMC. BUSINESS RELATIONSHIPS - CHRISTOPHER BRANDON, CHERYL BARTLETT, FRANCIS DOYLE, SPIROS HATIRAS, MICHELLE NADOW, NANCY PAULL, AMY PFEFFER, CYNTHIA SIERRA, CHARLES WILLIAMS, AZZIE YOUNG, ALASTAIR BELL, RAVIN DAVIDOFF, STANLEY HOCHBERG, AND THEA JAMES, ARE EMPLOYEES OF BMC AND BARRY BOCK, WILLIAM J. HALPIN JR, AND SANDRA COTTERELL ARE TRUSTEES OF BMC WHERE DAVID BECK AND CHARLES ORLANDO SERVES AS OFFICERS. BUSINESS RELATIONSHIPS - DAVID HENDERSON, JONATHAN OLSHAKER, PAUL HENDESSI, AND WILLIAM R. CREEVY ARE ALL EMPLOYED PHYSICIANS OF THE FACULTY PRACTICE PLANS WHERE DAVID BECK SERVES AS AN OFFICER OF THE PLANS. BUSINESS RELATIONSHIPS - ALICE JACOBS, LAUREN NENTWICH, JASON WORCESTER ARE EMPLOYEES OF Faculty Practice Foundation, Inc., William Creevy serves as a trustee and officer of Faculty Practice Foundation, Inc., where David Beck also serves as an officer. BUSINESS RELATIONSHIPS - DAVID BECK, WILLIAM CREEVY, CHARLES ORLANDO, SANDRA COTTERELL EACH SERVES AS AN OFFICER AND/OR DIRECTOR OF BMS HEALTH SYSTEM. BUSINESS RELATIONSHIP - DAVID BECK AND SANDRA COTTERELL EACH SERVES AS AN OFFICER AND/OR DIRECTOR OF BOSTON MEDICAL SYSTEM HEALTH PLAN. BUSINESS RELATIONSHIP - DAVID BECK AND RAVIN DAVIDOFF EACH SERVES AS OFFICERS/TRUSTEE OF BOSTON UNIVERSITY AFFILIATED PHYSICIANS, INC.

Form 990, Part VI, Section A, Line 7A

The following organizations have the power to appoint directors to the baco board: 1. Boston medical center corporation shall appoint (6) directors; 2. Faculty practice foundation, inc. Shall appoint (6) directors; 3. Participating community health centers will appoint a total of (6) directors; and 4. Baco's patient advisory comittee shall appoint one (1) consumer representative.

Form 990, Part VI, Line 11B

Baco's form 990 is prepared by kpmg and reviewed by bmc's internal management. Following that review, bmc's internal management and kpmg present the form 990 to the bmc audit committee for review and comment. The completed form 990 is provided to all members of the board of directors prior to the form being filed with the irs.

Form 990, Part VI, Line 12C

Conflict of interest questionaires for the fiscal year end september 30, 2018 were distributed by boston medical center's ("bmc"), an affiliated organization, corporate compliance department. The chief compliance officer of bmc or her designee queries trustees, officers and directors on at least an annual basis regarding relationships that may create potential conflicts of interest. The chief compliance officer or her designee reviews all disclosures and determines whether there are actual or potential conflicts of interest. The chief compliance officer or her designee informs the chief legal counsel of any actual or potential conflicts of interest. The chief legal counsel advises the board of trustees and officers of the corporation accordingly.

Form 990, Part VI, Line 19

Baco does not make its governing documents, conflict of interest policy, or financial statements publicly available. However, the articles of the organization are posted on the secretary of the commonwealth's website.

Filing and Contact Details

Filer

Filer Name
Boston Accountable Care Organization Inc
EIN
47-3468314
In Care Of
% KAITLYN CLIFFORD
Phone
6176387901
Address
ONE BOSTON MEDICAL CENTER PLACE, BOSTON, MA 02118

Signing Officer

Name
David Beck
Title
Clerk
Phone
6176387901
Signed
2019-08-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Sandra Cotterell
Formed
2015
Legal Domicile
Ma
Voting Board Members
17
Independent Board Members
17
Employees
0
Volunteers
17

Preparer

Firm
Kpmg Llp
Address
60 South Street, Boston, MA 02111
Preparer
Shy Joseph
Phone
6179881000
Supplemental Narrative

Additional Explanations

Form 990, Part I, Line 1 & Part III, Line 1

Boston accountable care organization, inc. (baco) shall at all times be organized and operated exclusively for charitable, educational and/or scientific purposes within the meaning of section 501(c)(3) of the internal revenue code. The mission of baco is to improve the healthcare of the populations that boston medical center corporation (bmc), the faculty practice foundation, inc. (fpf) physicians, and community health centers (chcs) serve. To provide the best care possible, an accountable care organization (aco) is designed to better manage all aspects of healthcare, in an effort to improve the health of the population served while operating more efficiently. Baco will integrate the resources of bmc, the fpf, and the chcs to provide more effective, higher quality and less expensive care for patients of baco.

Form 990, Part XI, Line 9

Transafer from Affiliate - Boston Medical Center $4,300,000

Financial Statement Notes

Schedule D, Part X, Line 2

The Health System Corporation, the Medical Center, BMCHP, UDF, ECMF, BUAP, Faculty and the Plans, BACO, BMCICS, and BMCIC of Vermont are all nonprofit corporations that have been recognized as tax-exempt pursuant to Section 501(C)(3) of the Internal revenue Code. The shareholders of NAB are nonprofit, tax-exempt corporations. The Health System recognized tax positions when it is more-likely than-not that the positions will be sustainable based on the merits of the position. Management has concluded that there are not material uncertain tax positions that need to be recorded as of September 30, 2018 and 2017. The Health System annually assesses whether it must recognize an unrelated business income tax expense (UBIT). The amounts recognized as UBIT expense were not material to the Health Systems consolidated operations or changes in net assets for the years ended September 30, 2018 and 2017.

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This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt250
IRS990/Form990PartVIISectionAGrp/PersonNm0Cheryl Bartlett
IRS990/Form990PartVIISectionAGrp/PersonNm1Alastair Bell MD
IRS990/Form990PartVIISectionAGrp/PersonNm2Barry Bock
IRS990/Form990PartVIISectionAGrp/PersonNm3Christopher Brandon
IRS990/Form990PartVIISectionAGrp/PersonNm4Ravin Davidoff MD
IRS990/Form990PartVIISectionAGrp/PersonNm5Francis Doyle
IRS990/Form990PartVIISectionAGrp/PersonNm6William J Halpin Jr
IRS990/Form990PartVIISectionAGrp/PersonNm7Spiros Hatiras
IRS990/Form990PartVIISectionAGrp/PersonNm8David Henderson MD
IRS990/Form990PartVIISectionAGrp/PersonNm9Paul Hendessi MD
IRS990/Form990PartVIISectionAGrp/PersonNm10Stanley Hochberg MD
IRS990/Form990PartVIISectionAGrp/PersonNm11Alice Jacobs MD
IRS990/Form990PartVIISectionAGrp/PersonNm12Thea James MD
IRS990/Form990PartVIISectionAGrp/PersonNm13Michelle Nadow
IRS990/Form990PartVIISectionAGrp/PersonNm14Lauren Nentwich MD
IRS990/Form990PartVIISectionAGrp/PersonNm15Jonathan Olshaker MD
IRS990/Form990PartVIISectionAGrp/PersonNm16Charles Orlando
IRS990/Form990PartVIISectionAGrp/PersonNm17Nancy Paull
IRS990/Form990PartVIISectionAGrp/PersonNm18Amy Pfeffer
IRS990/Form990PartVIISectionAGrp/PersonNm19Cynthia Sierra
IRS990/Form990PartVIISectionAGrp/PersonNm20Charles Williams MD
IRS990/Form990PartVIISectionAGrp/PersonNm21Jason Worcester MD
IRS990/Form990PartVIISectionAGrp/PersonNm22Azzie Young
IRS990/Form990PartVIISectionAGrp/PersonNm23Sandra Cotterell
IRS990/Form990PartVIISectionAGrp/PersonNm24William Creevy MD
IRS990/Form990PartVIISectionAGrp/PersonNm25David Beck
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IRS990/Form990PartVIISectionAGrp/TitleTxt1Director
IRS990/Form990PartVIISectionAGrp/TitleTxt2Director (As of 10/23/2017)
IRS990/Form990PartVIISectionAGrp/TitleTxt3Director (e 8/18)
IRS990/Form990PartVIISectionAGrp/TitleTxt4Director
IRS990/Form990PartVIISectionAGrp/TitleTxt5Director (e 12/6/17)
IRS990/Form990PartVIISectionAGrp/TitleTxt6Director
IRS990/Form990PartVIISectionAGrp/TitleTxt7Director (As of 10/30/2017)
IRS990/Form990PartVIISectionAGrp/TitleTxt8Director (As of 10/17/2017)
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IRS990/Form990PartVIISectionAGrp/TitleTxt10Director (e 12/21/17)
IRS990/Form990PartVIISectionAGrp/TitleTxt11Director (As of 10/17/2017)
IRS990/Form990PartVIISectionAGrp/TitleTxt12Director
IRS990/Form990PartVIISectionAGrp/TitleTxt13Director
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IRS990/Form990PartVIISectionAGrp/TitleTxt15Director (e 10/17/17)
IRS990/Form990PartVIISectionAGrp/TitleTxt16Director (As of 2/6/2018)
IRS990/Form990PartVIISectionAGrp/TitleTxt17Director (As of 10/17/2017)
IRS990/Form990PartVIISectionAGrp/TitleTxt18Director (As of 10/30/2017)
IRS990/Form990PartVIISectionAGrp/TitleTxt19Director (As of 2/7/2018)
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IRS990/Form990PartVIISectionAGrp/TitleTxt21Director (e 10/17/17)
IRS990/Form990PartVIISectionAGrp/TitleTxt22Director (E 12/6/17)
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