Benefits

A valid episode framework describes the way in which clinicians and patients interact and can generate the actionable information for clinicians, payers, purchasers, patients, and other stakeholders to make sense of service patterns, cost, and efficiency. The standard framework can be used to measure resource use, price, set benchmarks, align quality metrics, and optimize value within and across systems and regions. Agencies, organizations, and individuals can benefit from and contribute to the common resources. The benefits of PACES include:

Defining the clinical episode of care in a patient-centric manner.

Better accounting for relevant services used to manage a patient episode.

Creating a standard episode-based framework for performance improvement.

Enabling consistency between payment models, costs of producing care, and performance measurement.

Promoting alignment across payer episode-based payment models as well as provider assessment of all resources needed to manage a patient.

Promoting the ability to identify “true” variations in costs and quality and establish comparisons within and across providers.

Having a single chassis upon which to build risk-based contracts for any number of conditions and procedures.

Improving the effectiveness and efficiency of Accountable Care Organizations.