As CMS’ September 8th deadline to finalize ACO REACH provider networks approaches, high-performing ACO are focused on strategic provider alignment and capitation readiness to drive sustainable performance.
Best Practices for Network Selection
- Target The Right Providers: Prioritize providers who consistently outperform cost benchmarks—derived from both regional metrics and historical claims data—and demonstrate strong quality performance to earn back CMS’ 2% quality withhold.
- Ensure Risk Readiness: Retain providers experienced in downside risk and proactive care management, particularly those service underserved and high-need populations.
- Align to Long-Term Value: Build a network prepared for full capitation in 2026, with partners capable of delivering value under prospective, population-based payments.
Cedar Gate: Purpose-Built for Capitation Success
Cedar Gate’s end-to-end platform empowers ACOs to thrive under capitation with:
- Streamlined Payment Operations: Manage capitation under a single provider ID across multiple lines of business.
- Analytics-Driven Funds Flow: Evaluate, reconcile, and optimize capitation payments with visibility into provider-level performance and financial accountability.
