In the world of Accountable Care Organizations (ACOs), success hinges on a delicate balance: delivering high-quality care while controlling costs. To navigate this complex landscape, ACOs must rely on accurate risk adjustment and advanced analytics. At OptMyCare, we’ve crafted solutions that don’t just meet these needs—they anticipate them. Let’s talk about how our approach can help your ACO establish accurate benchmarks, qualify for shared savings, and, most importantly, provide the right care at the right time.

Establishing a Strong Foundation to Succeed in VBC (with RAF and Quality)

Imagine trying to hit a target you can’t quite see. That’s what it can feel like when setting benchmarks without the right data. Our Risk Adjustment Analytics takes the guesswork out of this process by ensuring every detail is captured:

     > Risk Adjustment Factor (RAF) Management: RAF is the backbone of establishing an accurate benchmark for your ACO. Our platform ensures that risk is calculated correctly, helping you optimize coding and improve the predictability of your financial performance. Accurate RAF management sets the stage for reliable cost projections and sustainable savings.

     > Nailing Quality Measures: Meeting quality measures is a must for any ACO aiming for shared savings. Our platform doesn’t just track these measures—it helps you achieve them. By providing clear, actionable insights, we make it easier for your team to meet and exceed the required standards, ensuring that your ACO qualifies for maximum shared savings.

Advanced Analytics: Your Key to Efficient, Patient-Centered Care

Beyond benchmarks, the real challenge is delivering care that’s both effective and efficient. This is where our Advanced Data Solutions come in, offering a clinical edge that turns data into action.

1.  Spotting At-Risk Patients Before It’s Too Late

In healthcare, timing is everything. Our predictive model is designed with clinical precision, identifying patients who are at risk of disease progression before it happens. This isn’t just about flagging potential issues—it’s about understanding the why behind the risk. We dive deep into each patient’s clinical history, pulling out the factors that might otherwise go unnoticed.

2.  Understanding the “Why” Behind the Risk

Knowing a patient is at risk is only half the battle. Understanding why they’re at risk—and what can be done about it—is where real progress happens. We provide detailed insights into the specific risk factors at play for each patient. This level of detail equips your clinicians with the information they need to tailor care in a way that’s both proactive and precise.

3.  Delivering Actionable, Evidence-Based Care Recommendations

Clinical care is most effective when it’s grounded in evidence. That’s why our recommendations aren’t just suggestions—they’re clinically validated, evidence-based actions that your team can implement immediately. These are not one-size-fits-all solutions but personalized plans designed to mitigate the identified risks for each patient.

4.  Financial Projections that Inform Clinical Decisions

The financial health of an ACO is deeply intertwined with patient outcomes. Our platform provides financial projections at both the patient and population levels, helping you make informed decisions that benefit your patients and your bottom line:

     > Patient-Level Focus: We provide granular financial projections that highlight where the greatest financial risks lie, allowing your team to focus on the patients who need it most. By engaging these patients early, you can prevent costly complications down the road.

     > Population-Level Insights: Beyond individual patients, our analytics cover a wide range of disease states, providing a big-picture view of your population’s health. These insights help you spot trends and adjust strategies to meet the needs of your entire ACO.

A Conversation About Your ACO’s Future

At the end of the day, the goal is simple: better care for patients and better financial outcomes for your ACO. But achieving this is anything but simple. It requires the right tools, the right insights, and a partner who understands the clinical nuances of healthcare delivery. At OptMyCare, we’re here to be that partner, providing the data and analytics you need to succeed in an increasingly complex healthcare environment.

Let’s have a conversation about how we can help your ACO meet its goals—both clinical and financial. Reach out to us to learn more.