South Shore Physician Hospital Organization
The South Shore Physician Hospital Organization (South Shore PHO) provides managed care health insurance contracting and administrative services for its two organizational members: South Shore Hospital and the Physicians Organization of the South Shore.
We are committed to enhancing our community’s access to primary and specialty care services. We also help our members manage total medical expense to improve the affordability of high-quality health care. We achieves these goals by encouraging our members to work together in pursuit of the Triple Aim: better care for individuals, better health for populations, and lower cost per capita.
We are consistently recognized by Blue Cross/Blue Shield of Massachusetts, Harvard Pilgrim Health Plan, and Tufts Associated Health Plan for innovation and clinical achievement in the delivery of healthcare services.
Physicians who are interested in learning more about South Shore PHO should contact Carrie Scott, Manager, Provider Relations and Enrollment, South Shore PHO, at cscott [at] southshorehealth.org.
We offer the following for our members:
Under such contracts, members agree to deliver certain healthcare services to their managed care patients for a contracted payment amount. These arrangements are called “risk-based” contracts because some or all of the provider’s payments from an insurer are at risk if certain patient care quality and utilization targets are not met. It is expected that the majority of patient care will be delivered by and among those who are South Shore PHO members because they share a commitment to achieve the same quality and cost containment goals for their patients.
South Shore PHO helps our members successfully administer risk-based and other health insurance contracts. Services include data warehouse access and interoperable electronic information exchange among our member providers.
South Shore PHO works with members to develop and implement pathways to better coordinate patient care, increase the appropriate use of lower-cost interventions, encourage the use of community-based care, and use disease-management protocols for patients with chronic health conditions. Our nurses assist members and their office staff in collecting, reviewing and acting on quality data. We also make calls and send reminder letters to patients about the importance of scheduling recommended health screenings.
South Shore PHO offers opportunities to remain current with emerging risks related to healthcare reform, as well as traditional risks such as malpractice claims, workers’ compensation costs, and many other diverse liabilities.