PACS ACO Quality Assurance Program
PACS maintains a comprehensive physician-directed and beneficiary-centered Quality Assurance and Improvement Program that includes performance standards for: (1) quality of care, (2) patient experiences and (3) cost-effectiveness.
PACS emphasizes adherence to evidence-based clinical guidelines and care delivery processes that focus on the needs of individual beneficiaries while maintaining a perspective on the broader population the ACO serves. The PACS Medical Director reports all findings to the board which directs the Quality Assurance and Improvement Program.
PACS utilizes and follows all NCQA standards and guidelines, and all MSSP quality-related recommendations/regulations. PACS and all preferred vendors maintain appropriate protection of health information, including the removal of member names, when providing benchmark, historical, and comparative data for ongoing quality improvement.
PACS Quality Assurance Policy - CLICK HERE
*MANDATORY* Provider Response for Quality Reporting (to be eligible for Shared Savings) - CLICK HERE
PACS Meeting the Quality Measure Requirements Explanation - CLICK HERE
CMS CAHPS Survey for ACOs Quality Assurance Guidelines - CLICK HERE
PACS ACO Compliance Program
Purpose: To describe the processes designed to oversee and ensure compliance with all applicable federal and state rules, regulations and laws, as well as CMS rules and regulations for the PACS MSSP ACO, its practices and participating providers.
Policy: As part of the ACO’s participation in the MSSP, it is required to develop and maintain an effective comprehensive compliance program to detect, correct and prevent incidences of non-compliance with the requirements of the MSSP, and address potential incidences of fraud, waste and abuse relating to the MSSP and federal health care programs. This ACO Compliance Program, “ACO CP” is specific to ACO operations. The ACO CP shall remain in compliance with, and be updated periodically to reflect changes in applicable laws and regulations.
PACS Compliance and Ethics Training - CLICK HERE
PACS ACO Compliance including Annual Certification Forms - CLICK HERE