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We started this series with a simple observation: The Value-Based Care world—for which your ACO was built—has greatly altered. ACOs now have a much bigger charge to manage specialty care for their patients and to adopt CMS tools to negotiate rates with high performance networks. The TEAM payment model is live and ACOs have a role. ASM arrives in 2027 with more ACO investment. LEAD will reshape the ACO model for the next decade. Ahead lies a deeper role in care management, quality outcomes, and coordinated care across all types of providers, not just ACO participating providers. The same high-risk primary care patient sitting in your ACO panel is very likely the same person walking into a TEAM surgery or an ASM episode.
This new reality demands better technology. But here’s the honest truth: Many ACOs have no platform now and are still working their services from claims data with no aggregated data to back it up. Further, most Value-Based Care platforms are not yet organized to handle all the functions your ACO will need.
Don’t lose time researching the ultimate system. Begin a process now that will enable your ACO to meet this central need: a unified hub for Value-Based Care that can draw from every relevant data source to give your team a single coherent view of each patient, then support the interventions for that patient in each episodic or condition-based payment model. You need to be building toward that hub and evaluating your current tools against those needs, if your ACO is to be at the center of your Value-Based Care ecosystem.