PBACO was established to improve healthcare delivery based on Accountable Care Organizations’ principles and purpose; the “three part aim” of improving patient experience, improving population health, and decreasing per capita healthcare costs. PBACO will establish, define, implement, evaluate, and periodically update each ACO component by promoting:
— Beneficiary Engagement
— Evidenced-based Medicine
— Care Plan Coordination
— Internal Quality and Cost Metrics Reporting and Improvement
— PBACO is actively changing the healthcare climate in your community!
PBACO INCLUDES BOTH PRIMARY CARE AND SPECIALIST PHYSICIANS, as both are critical for coordinating collaborative healthcare for optimized outcomes. There are 275 PCPs and 175 Specialist physician members in PBACO and PBACO has over 79,000 Medicare lives.
PBACO’S INITIAL APPROACH TO DELIVERING ACCOUNTABLE CARE is by empowering the primary care physicians to act as BENEFICIARY ADVOCATES through building a relationship of trust, understanding and dependability. The goal is to get the beneficiary, who has open access to any primary care physician specialist, or hospital, to remain aligned closely with their PBACO physician. The physician will identify the unique healthcare needs of each beneficiary to create a personalized healthcare plan. The coordinated execution and evolution of this personalized plan will be the basis with which the physician will prove and demonstrate his/her dedication to the beneficiary’s health and well-being and deliver quality outcomes, appropriate utilization, and exceptionally improved beneficiary engagement. Aside from engaging the beneficiary to be involved in their care to the maximum extent possible, the personalized care plan will implement best practices based on evidence-based medicine; coordinate care among and between providers and facilities; use data to support continuous quality improvement; use community resources to the extent necessary to support and assure the beneficiary received the specific care they need at that time.
The Centers for Medicare & Medicaid Services (CMS) has established a Medicare Shared Savings Program (Shared Savings Program) to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs. Eligible providers, hospitals, and suppliers may participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO).
The Shared Savings Program is designed to improve beneficiary outcomes and increase value of care by:
—Promoting accountability for the care of Medicare FFS beneficiaries
—Requiring coordinated care for all services provided under Medicare FFS
—Encouraging investment in infrastructure and redesigned care processes
The Shared Savings Program will reward ACOs that lower their growth in health care costs while meeting performance standards on quality of care and putting patients first. Participation in an ACO is purely voluntary.
For additional information about the Shared Savings Program, visit: