Medicare ACO

Quality Metrics

• Patient Selection

• Data Imports

• Gap Analysis

• 70% Completion Status

• Performance Scoring

• Provider Scorecard

Network Financial Performance

• Visuals

• Analytics Dashboard

  • Risk Stratification | Financial Benchmarks

• Provider Scorecard

• Aggregate Expenditure and Utilization

• Quick Data Tool - Episodes of Care

• Query Builder

Patient Lookup

• 4-Year Drug and Health History

• Risk Score | Benchmark

• Out-of-Network Migration

• Indicators and Predictions

• Cost and Utilization

• HCC Coding Assist Tool

• Quality Gaps and FHIR EHR Get Calls

• Patient-Generated Engagement

Data Sources

Epic, Cerner, Allscripts, AthenaHealth, eClinicalWorks

MEDICARE

Medicare CCLF for ACO, DCE and PCF

Medicare DPC FHIR

Medicare Blue Button FHIR 

Medicare Advantage

Medicare ACO

Primary Care First (PCF)

Direct Contracting Entity (DCE)

Clinical

•Quality Reporting Document Architecture (QRDA)

•Fast Healthcare Interoperability Resources (FHIR)

•HL7 Lab

•Admit, Discharge, Transfer (ADT)

Other Payer

•Medicaid

•Commercial

•Self-Insured Employer TPA

Patient-Generated 

•RPM Device Data

•Events-Based Health Screening Interventions

•Text Notifications

•Interactive Health History