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Solutions for ACO REACH

We can help you take the next steps to attain better outcomes for the populations you serve while achieving financial savings that exceed the CMS discount in the model. We offer the first end-to-end solution that addresses all aspects of the ACO REACH program.

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How Cedar Gate Value-Based Care Analytics Can Help

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Develop a health equity plan using the Area Deprivation Index

Identify health equity insights by accessing data in our powerful enterprise data management tools. Informed by CMS files and the Area Deprivation Index, REACH ACOs can develop an impactful health equity plan to help improve access to care and health for the beneficiary population.

Conduct analyses to project performance and select a program participation option

Actuarial modeling technology projects performance based on available CMS or EHR data, and the parameters of your specific ACO agreement or contract. You can use these actuarial insights to determine the most advantageous ACO REACH participation option.

Surface potential HCC coding opportunities

Enrich beneficiary data with HCC scores sourced from CMS and HHS sources. Use this information to identify coding opportunities within the population. Additionally, you can pair our Value-Based Care Analytics application with our Care Management application to automatically place cohorts in task-based workflows that inform patient outreach and pre-visit planning to address HCC coding opportunities.

Identify preferred providers for the REACH ACO provider network

Assess the profile of populations that are aligned with a provider. Surface insights related to provider performance, and key attributes of the patient population, which you can leverage in prospective beneficiary attribution strategies.

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Analytics are critical to ACO REACH success. Learn more about what Cedar Gate offers to drive your value-based care goals.

Product-Screenshots-CMHow Cedar Gate Care Management & Population Health Can Help 

Align your care team to execute a health equity plan 

  • Sort patients into task-based care coordination workflows that support your health equity plan. Assign tasks to the appropriate care team member to ensure each professional is practicing at the top of their license. Additionally, you can use our Value-Based Care Analytics application to dynamically access and update priority cohorts based on various different factors.

Align your care team collect information for HCC compliance 

  • Configure Cedar Gate’s application to include HCC coding gap insights on disease burden within the care team workflow, then use that information to prioritize outreach to a patient and inform pre-visit planning.

Collect usable SDoH data through questionnaires 

  • Customize surveys from our library of questionnaires to support the specific requirements of value-based care models like ACO REACH. Use questionnaires as part of a centralized care management operation, ensuring consistent collection of information by providers, and avoiding data access issues that arise when data is stored in disparate EHRs.
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How Cedar Gate Payment Technology Can Help

Process capitation claims and payments to network providers 

Power the complete capitation adjudication process and automatically distribute capitation payments using our Capitation Adjudication module that was purpose-built for models like ACO REACH. Avoid the errors and manual work you are likely to encounter when you try to use a legacy solution that was originally built for fee-for-service payments to adjudicate capitated payments.

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Reconcile actual vs. expected capitation and model the distribution of capitation claims

Integrate key data types, like CCLF, CRF, and 837 transaction files using our Capitation Adjudication and Value-Based Care Analytics applications together. These tools model the distribution of capitation payments and reconcile expected vs. actual capitation payments to ensure the correct payment was received.

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Our End-to-End Platform Can Help

Use our Enterprise Data Management System interface library to collect inbound data from 35 domains. The system cleanses, enhances, and augments your data using thousands of rules and parameters. You get a high-value dataset that is continuously refreshed and available through standard APIs in all the applications on our value-based care platform. You can also connect to third-party applications with our data warehouse via published interfaces to share clean, usable data with other vendors or applications as needed.

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Ready for ACO REACH?

Our technology and services are flexible and can be used individually or together for a complete end-to-end solution.

 

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DISCOVER MORE

Blog Post

Essential Tools for Population Health & Capitated Payments

What are essential software tools to succeed in the new ACO REACH model? Greg Caressi from Frost & Sullivan discusses what to look for in a solution provider. 

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Press Release

Cedar Gate Delivers Composable Platform Launching New Era of ACO REACH

Cedar Gate Technologies (Cedar Gate), a leading value-based care software and technology services company, today announced the company has calibrated its platform to support the full spectrum of ACO REACH requirements.

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Press Release

Cedar Gate Highly Rated in KLAS 2021 Report

Cedar Gate Technologies (Cedar Gate), a leading value-based care performance management company, announces the company’s platform is highly rated in the recently released KLAS Research Report “Downside Risk in Population Health Management 2021.”

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Press Release

Cedar Gate Technologies Achieves HITRUST Risk-based, 2-year Certification to Further Mitigate Risk in Third-Party Privacy, Security, and Compliance

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EXPLORE SOLUTIONS

The right solution for your value-based journey is only a click away. Our modular technology is quickly and easily integrated into current systems and complements existing IT investments so that we can grow with you. Learn more today!

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