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ACO REACH Success Requires Accurate & Reliable Analytics

BLOG | August 30, 2022

For many ACOs, the biggest questions surrounding the launch of the ACO REACH program are whether your organization can meet the performance parameters set forth by CMS for this new VBC model. With upside and downside risk, as well as the risk-adjusted capitation payments, REACH ACOs want to feel confident about their ability to maintain quality scores while managing total costs.



One of the best predictors of future performance is current and past performance. Cedar Gate’s Value-Based Care Analytics (VBCA) application pulls information from prior years in a risk-based program, as well as from CMS, to predict risk and success in the program. This helps ACOs determine whether they were above or below projected benchmarks and dig into the data on ways to improve in the coming year.

That includes analysis of:

  • High-cost care utilization rates
  • Quality metrics and the gaps in care that could improve quality
  • HCC risk score and RAF
  • Medication utilization patterns and medication compliance
  • Claims, quality, and PCP engagement
  • Provider performance and opportunities to leverage the expanded role of nurse practitioners in underserved areas
  • Ability to hit financial targets for specific value-based program parameters

The comprehensive analytics tools from Cedar Gate are also designed to pull data from Area Deprivation Index (ADI). The application uses that data to identify risks for specific populations or geographic areas that are essential to creating a health equity plan. In addition to broad geographic targeting, the VBCA tools narrow down more precise risks for individual patients, and predictive modeling to help healthcare providers improve outreach to vulnerable populations.

With the right analytics software, your organization can understand what happened in the past and predict what might happen in the future. In the ACO REACH program with both upside and downside risk, these prescriptive and predictive capabilities are essential to hit care and cost targets. Contact us today to learn more about how our VBCA tools are purpose-built for ACO REACH success.

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